Effective Radiotherapy in Tracheobronchial Adenoid Cystic Carcinoma With Positive Surgical Margin

Primary pulmonary adenoid cystic carcinoma: A study of clinicopathological features and molecular alterations in twenty-one cases

BACKGROUND

Primary pulmonary adenoid cystic carcinoma (PACC) is a rare malignant tumor. Despite the growing sophistication of ACC research, scant studies have delved into the unique molecular alterations of ACC originating from the lung and the clinical features associations.

METHOD

Paraffin-embedded specimens of primary PACC tissues pathologically confirmed at the Affiliated Hospital of Qingdao University within the past decade were collected. We comprehensively evaluated the diversity of molecular alterations in PACC using immunohistochemistry (IHC) staining, fluorescence in-situ hybridization (FISH), and next-generation sequencing (NGS). Furthermore, the potential correlations between MYB rearrangement status and clinicopathological features were thoroughly analyzed.

RESULT

Twenty-one specimens of primary PACC were collected, including eighteen of the typical type and three of the solid-basaloid type. Fifteen (71.4 %) specimens exhibited positive MYB staining and MYB rearrangements. Notably, neither clinicopathological parameters nor MYB rearrangement predicted patients' overall survival (OS). However, MYB non-rearrangement was associated with a significantly higher rate of lymph node metastasis (75 % vs. 8.3 %, P = 0.027).

CONCLUSION

Investigating the heterogeneity and multimolecular characteristics of PACC based on different pathological types emerges as a potentially innovative strategy to pinpoint suitable candidates for targeted therapies.

Analysis of the Clinicopathological Characteristics, Genetic Phenotypes, and Prognostics of Primary Pulmonary and Bronchial Adenoid Cystic Carcinoma

BACKGROUND

Primary pulmonary and bronchial adenoid cystic carcinoma (PACC) is a rare, low-grade malignant tumor of the lung. However, the relationship between its clinical features, surgical prognosis, and genetic phenotype has not been fully described.

METHODS

PACC patient information was collected from the SEER, TCGA, and Zhongshan Hospital, Fudan University (FDZSH) databases. Overall survival (OS) was evaluated using the Kaplan-Meier method. Univariate and multivariate analyses through Cox proportional hazards regression identified risk factors that predicted OS. The limma and matfools packages from R were used to compare the differential genes and mutations between PACC and LUAD, respectively.

RESULTS

Two hundred and ninety-two patients, 14 patients, and 12 patients with PACC were identified from the SEER, TCGA, and FDZSH databases, respectively. The 3-, 5-, and 10-year OS of the PACC patients were 91.7%, 88.6%, and 85.0%, respectively, compared to 95.8%, 93.9%, and 93.3% for patients who underwent surgery. Race, pathological grade, M stage, regional node examination, and regional node positive were independent prognostic factors for the OS of patients who underwent surgery. The gene map of PACC and lung adenocarcinoma (LUAD) shows significant differences. Common mutations found in lung cancer were almost undetectable in PACC patients, whereas mutations in the NOTCH pathway were more common. TMB levels and PD-1/PD-L1 expressions were also lower in PACC patients.

CONCLUSION

Our study analyzed the main factors that influence the prognosis of PACC patients undergoing surgery and discovered the unique genetic phenotype of PACC.

Adenoid cystic carcinoma: insights from molecular characterization and therapeutic advances

Adenoid cystic carcinoma (ACC) is a malignant tumor primarily originating from the salivary glands, capable of affecting multiple organs. Although ACC typically exhibits slow growth, it is notorious for its propensity for neural invasion, local recurrence, and distant metastasis, making it a particularly challenging cancer to treat. The complexity of ACC's histological and molecular features poses significant challenges to current treatment modalities, which often show limited effectiveness. Recent advancements in single-cell RNA-sequencing (scRNA-seq) have begun to unravel unprecedented insights into the heterogeneity and subpopulation diversity within ACC, revealing distinct cellular phenotypes and origins. This review delves into the intricate pathological and molecular characteristics of ACC, focusing on recent therapeutic advancements. We particularly emphasize the insights gained from scRNA-seq studies that shed light on the cellular landscape of ACC, underscoring its heterogeneity and pathobiology. Moreover, by integrating analyses from public databases, this review proposes novel perspectives for advancing treatment strategies in ACC. This review contributes to the academic understanding of ACC by proposing novel therapeutic approaches informed by cutting-edge molecular insights, paving the way for more effective, personalized therapeutic approaches for this challenging malignancy.

[Tracheal Tumours]

Malignant primary tracheal tumours are rare. The most common histological subtypes are squamous cell carcinoma and adenoid cystic carcinoma. These two entities have different prognoses and growth patterns. Tracheobronchoscopy and thoracic sectional imaging are standard diagnostic tools for tumour staging and local evaluation. Complete surgical resection of the affected tracheal segment is the treatment of choice for limited disease without distant metastases. Incomplete gross tumour resection with additional irradiation is an acceptable therapeutic option for adenoid cystic carcinoma. Interventional endoscopy with tumour debulking or tracheal stenting and/or definitive mediastinal radiotherapy are treatment alternatives in either a locally advanced or palliative setting.