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Zhu L, Sun L, Zhang Y, Liu X, Li X, Zhou Z, Cui Y, Zhou CX, Li TJ. PON3::LCN1 and HTN3::MSANTD3 Gene Fusions With NR4A3/NR4A2 Expression in Salivary Acinic Cell Carcinoma. Am J Surg Pathol 2024; 48:681-690. [PMID: 38682454 DOI: 10.1097/pas.0000000000002219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Acinic cell carcinoma of the salivary gland (AciCC) is a low-grade carcinoma characterized by the overexpression of the transcription factor nuclear receptor subfamily 4 group A member 3 (NR4A3). AciCC has been the subject of a few molecular research projects. This study delves into AciCC's molecular landscape to identify additional alterations and explore their clinical implications. RNA sequencing and immunohistochemical staining for markers NR4A3/NR4A2, DOG-1, S100, and mammaglobin were utilized on 41 AciCCs and 11 secretory carcinoma (SC) samples. NR4A3 was evident in 35 AciCCs, while the residual 6 were NR4A3-negative and NR4A2-positive; SC samples were consistently NR4A3-negative. A novel fusion, PON3 exon 1- LCN1 exon 5, was detected in 9/41 (21.9%) AciCCs, exhibiting a classical histologic pattern with serous cell components growing in solid sheets alongside the intercalated duct-like component. Clinical follow-up of 39 patients over a median of 59 months revealed diverse prognostic outcomes: 34 patients exhibited no disease evidence, whereas the remaining 5 experienced poorer prognosis, involving local recurrence, lymph node, and distant metastasis, and disease-associated death, 4 of which harbored the PON3::LCN1 fusion. In addition, the HTN3::MSANTD3 fusion was recurrently identified in 7/41 AciCC cases. SC patients lacked both fusions. Immunohistochemistry uncovered differential expression of DOG-1, S100, and mammaglobin across samples, providing nuanced insights into their roles in AciCC. This study accentuates PON3::LCN1 and HTN3::MSANTD3 fusions as recurrent molecular events in AciCC, offering potential diagnostic and prognostic utility and propelling further research into targeted therapeutic strategies.
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MESH Headings
- Humans
- Male
- Carcinoma, Acinar Cell/genetics
- Carcinoma, Acinar Cell/pathology
- Female
- Salivary Gland Neoplasms/genetics
- Salivary Gland Neoplasms/pathology
- Salivary Gland Neoplasms/mortality
- Salivary Gland Neoplasms/metabolism
- Salivary Gland Neoplasms/chemistry
- Middle Aged
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/analysis
- Adult
- Aged
- Nuclear Receptor Subfamily 4, Group A, Member 2/genetics
- Nuclear Receptor Subfamily 4, Group A, Member 2/analysis
- Receptors, Steroid/genetics
- Receptors, Steroid/metabolism
- Receptors, Thyroid Hormone/genetics
- Receptors, Thyroid Hormone/analysis
- Receptors, Thyroid Hormone/metabolism
- Young Adult
- Gene Fusion
- Aged, 80 and over
- DNA-Binding Proteins/genetics
- Oncogene Proteins, Fusion/genetics
- Immunohistochemistry
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Affiliation(s)
- Lijing Zhu
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, China
- National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, China
| | - Lisha Sun
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ye Zhang
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, China
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoxiao Liu
- Central laboratory, Peking University School and Hospital of Stomatology, Beijing, China
| | - XueFen Li
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, China
| | - Zheng Zhou
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, China
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yajuan Cui
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, China
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chuan-Xiang Zhou
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, China
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tie-Jun Li
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, China
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Kirschnick LB, Silveira FM, Schuch LF, Vasconcelos ACU, Gomes AP, Santos JND, Santana DA, Fonseca FP, Mesquita RA, Mendonça EFD, Sousa-Neto SS, Pontes HAR, Robinson L, Heerden WV, Carlos-Bregni R, Tager EMJR, Silva LCD, Zanella VG, Rivero LF, Bittencourt R, Martins MAT, Lopes MA, Wagner VP, Vargas PA, Martins MD. Acinic cell carcinoma of the oral and maxillofacial region: an international multicenter study. Braz Oral Res 2023; 37:e050. [PMID: 37255070 DOI: 10.1590/1807-3107bor-2023.vol37.0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 12/12/2022] [Indexed: 06/01/2023] Open
Abstract
The aim of this study was to describe the prevalence, clinicopathological, and prognostic features of acinic cell carcinoma (AciCC) of the oral and maxillofacial region. AciCC cases were retrospectively retrieved from 11 pathology centers of three different countries. Medical records were examined to extract demographic, clinical, pathologic, and follow-up information. A total of 75 cases were included. Females (65.33%) with a mean age of 45.51 years were mostly affected. The lesions usually presented as an asymptomatic (64.28%) nodule (95.66%) in the parotid gland (70.68%). The association of two histopathological patterns was the most common finding (48.93%) and the tumors presented mainly conventional histopathological grades (86.11%). Surgical treatment was performed in the majority of the cases (59.19%). Local recurrence was observed in 20% of the informed cases, regional metastasis in 30.43%, and distant metastasis in 12.50%. The statistical analysis showed that the cases with a solid histopathological pattern (p=0.01), high-grade transformation (p=0.008), recurrence (p=0.007), and regional metastasis (p=0.03) were associated with poor survival. In conclusion, high histopathological transformation, presence of nodal metastasis, and recurrence were prognostic factors for AciCC of the oral and maxillofacial region.
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Affiliation(s)
- Laura Borges Kirschnick
- Universidade Estadual de Campinas - UNICAMP, Piracicaba Dental School, Department of Oral Diagnosis, Piracicaba, SP, Brazil
| | - Felipe Martins Silveira
- Universidad de la República - UDELAR, School of Dentistry, Division of Molecular Pathology, Montevideo, Uruguay
| | - Lauren Frenzel Schuch
- Universidade Estadual de Campinas - UNICAMP, Piracicaba Dental School, Department of Oral Diagnosis, Piracicaba, SP, Brazil
| | | | - Ana Paula Gomes
- Universidade Federal de Pelotas - UFPel, School of Dentistry, Diagnostic Center for Oral Diseases, Pelotas, RS, Brazil
| | - Jean Nunes Dos Santos
- Universidade Federal da Bahia - UFBA, School of Dentistry, Department of Pathology, Graduate Program in Dentistry and Health, Salvador, BA, Brazil
| | - Dandara Andrade Santana
- Universidade Federal da Bahia - UFBA, School of Dentistry, Department of Pathology, Graduate Program in Dentistry and Health, Salvador, BA, Brazil
| | - Felipe Paiva Fonseca
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Oral Surgery and Pathology, Belo Horizonte, MG, Brazil
| | - Ricardo Alves Mesquita
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Oral Surgery and Pathology, Belo Horizonte, MG, Brazil
| | | | | | - Hélder Antônio Rebelo Pontes
- Universidade Federal do Pará - UFPA, João de Barros Barreto University Hospital, Department of Oral Pathology, Belém, PA, Brazil
| | - Liam Robinson
- University of Pretoria - UP, School of Dentistry, Department of Oral Pathology and Oral Biology, Pretoria, South Africa
| | - Willie van Heerden
- University of Pretoria - UP, School of Dentistry, Department of Oral Pathology and Oral Biology, Pretoria, South Africa
| | - Román Carlos-Bregni
- Clinical Center of Head and Neck/Hospital Herrera Llerandi, Division of Pathology, Guatemala City, Guatemala
| | | | - Luan César da Silva
- Universidade Estadual de Campinas - UNICAMP, Piracicaba Dental School, Department of Oral Diagnosis, Piracicaba, SP, Brazil
| | - Virgílio Gonzales Zanella
- Santa Casa de Misericórdia de Porto Alegre, Santa Rita Hospital, Department of Head and Neck Surgery, Porto Alegre, RS, Brazil
| | - Luis Fernando Rivero
- Universidade Federal do Rio Grande do Sul - UFRGS, Faculty of Medicine, Department of Pathology, Porto Alegre, RS, Brazil
| | - Raquel Bittencourt
- Universidade Federal do Rio Grande do Sul - UFRGS, Faculty of Medicine, Department of Pathology, Porto Alegre, RS, Brazil
| | - Marco Antonio Trevizani Martins
- Universidade Federal do Rio Grande do Sul - UFRGS, Hospital de Clínicas de Porto Alegre, Department of Oral Medicine, Porto Alegre, RS, Brazil
| | - Márcio Ajudarte Lopes
- Universidade Estadual de Campinas - UNICAMP, Piracicaba Dental School, Department of Oral Diagnosis, Piracicaba, SP, Brazil
| | - Vivian Petersen Wagner
- University of Sheffield, Academic Unit of Oral and Maxillofacial Medicine and Pathology, Department of Clinical Dentistry, Sheffield, UK
| | - Pablo Agustin Vargas
- Universidade Estadual de Campinas - UNICAMP, Piracicaba Dental School, Department of Oral Diagnosis, Piracicaba, SP, Brazil
| | - Manoela Domingues Martins
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Oral Pathology, Porto Alegre, RS, Brazil
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Wockner RS, Seethala RR, Emeto TI, McCaul JA, Subramaniam SS. Epithelial-myoepithelial carcinoma of the maxillofacial and sinonasal region: a systematic review of presenting characteristics, treatment modalities, and associated outcomes. Int J Oral Maxillofac Surg 2022; 52:1-12. [PMID: 35667947 DOI: 10.1016/j.ijom.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 10/18/2022]
Abstract
Epithelial-myoepithelial carcinoma (EMC) is a rare salivary gland malignancy. Controversy exists in the literature regarding the effectiveness of treatment modalities employed in the management of EMC. This systematic review was undertaken to understand the presenting characteristics of EMC and identify the most common treatment modalities and their associated outcomes, in order to help guide an evidenced-based approach to the algorithm of care. The MEDLINE (PubMed) and Embase databases were searched (up to February 23, 2022), and the review was performed in accordance with the PRISMA statement. Fifty-seven studies (51 case reports and six case series) describing 91 cases of EMC were included in this review. In the included studies, a slow-growing painless mass was the most common presenting clinical feature. EMC was most frequently treated with surgery alone (65%). Local disease recurrence occurred in 24% of the cases and metastatic disease in 11%. A positive surgical margin was found to be associated with a higher risk of recurrence (P < 0.001), while adjuvant radiotherapy was associated with a decreased risk of local disease recurrence (P = 0.034). Metastatic disease and multimodal therapy were found to be associated with decreased disease-free and overall survival (all P < 0.05). The current literature supports surgery with clear margins as the mainstay of treatment for EMC of the salivary and seromucous glands of the head and neck. In certain situations, radiotherapy may improve disease-free survival.
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Affiliation(s)
- R S Wockner
- University of Otago, School of Medicine, Wellington, New Zealand.
| | - R R Seethala
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - T I Emeto
- Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia; World Health Organization Collaborating Centre for Vector-Borne and Neglected Tropical Diseases, James Cook University, Townsville, Queensland, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia
| | - J A McCaul
- Department of Oral and Maxillofacial Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - S S Subramaniam
- Department of Oral and Maxillofacial Surgery, Royal Melbourne Hospital, Victoria, Australia; Department of Oral and Maxillofacial Surgery, Townsville University Hospital, Queensland, Australia
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De Luca P, de Campora L, Tassone D, Atturo F, Colangeli R, Petruzzi G, Fermi M, Molinari G, Abeshi A, Cintoli G, Lo Manto A, Togo G, Ricciardiello F, Condorelli P, Raso F, Di Stadio A, Salzano G, Esposito E, D’Ecclesia A, Radici M, Iemma M, Vigili MG, Salzano FA, Magaldi L, Cassano M, Dallan I, Pellini R, Presutti L, Ionna F, de Campora E, Camaioni A. Acinic cell carcinoma of the parotid gland: Timeo Danaos et dona ferentes? A multicenter retrospective analysis focusing on survival outcome. Eur Arch Otorhinolaryngol 2022; 279:5821-5829. [PMID: 35678874 PMCID: PMC9649501 DOI: 10.1007/s00405-022-07481-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 05/30/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To analyze the demographic data, surgical and adjuvant treatment data and the survival outcomes in adult patients affected by acinic cell carcinoma of the parotid gland (AciCC). METHODS A retrospective multicenter analysis of patients treated for AciCC of the parotid gland from 2000 to 2021 was performed. Exclusion criteria were pediatric (0-18 years) patients, the absence of follow-up and patients with secondary metastatic disease to the parotid gland. Multivariable logistic regression was used to determine factors associated with survival. RESULTS The study included 81 adult patients with AciCC of the parotid gland. The median age was 46.3 years (SD 15.81, range 19-84 years), with a gender female prevalence (F = 48, M = 33). The mean follow-up was 77.7 months (min 4-max 361, SD 72.46). The 5 years overall survival (OS) was 97.5%. The 5 years disease-free survival (DFS) was 60%. No statistical differences have been found in prognosis for age (< 65 or ≥ 65 years), sex, surgery type (superficial vs profound parotid surgery), radicality (R0 vs R1 + Rclose), neck dissection, early pathologic T and N stages and adjuvant therapy (p > 0.05). CONCLUSION This study did not find prognostic factor for poorest outcome. In contrast with the existing literature, our results showed how also high-grade tumours cannot be considered predictive of recurrence or aggressive behaviour.
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Affiliation(s)
- Pietro De Luca
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy ,Department Otolaryngology Head and Neck Surgery, San Giovanni-Addolorata Hospital, Rome, Italy
| | - Luca de Campora
- Department Otolaryngology Head and Neck Surgery, San Giovanni-Addolorata Hospital, Rome, Italy
| | - Domenico Tassone
- Department Otolaryngology Head and Neck Surgery, San Giovanni-Addolorata Hospital, Rome, Italy
| | - Francesca Atturo
- Department Otolaryngology Head and Neck Surgery, San Giovanni-Addolorata Hospital, Rome, Italy
| | - Roberta Colangeli
- Department Otolaryngology Head and Neck Surgery, San Giovanni-Addolorata Hospital, Rome, Italy
| | - Gerardo Petruzzi
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Matteo Fermi
- Department of Otorhinolaryngology-Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy ,Department of Specialist, Diagnostic and Experimental Medicine, Alma Mater Studiorum University, Bologna, Italy
| | - Giulia Molinari
- Department of Otorhinolaryngology-Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Andi Abeshi
- Department of Otorhinolaryngology-Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Giulia Cintoli
- Department of Otolaryngology-Head and Neck Surgery, University of Foggia, Foggia, Italy
| | - Alfredo Lo Manto
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Modena, Modena, Italy
| | - Giulia Togo
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy
| | | | | | | | | | - Giovanni Salzano
- Otolaryngology and Maxillo-Facial Surgery Unit, Istituto Nazionale Tumori-IRCCS Fondazione G. Pascale, Naples, Italy
| | - Erik Esposito
- Otolaryngology Department, ASL Napoli 3 Sud, Torre del Greco, Naples, Italy
| | - Aurelio D’Ecclesia
- IRCCS “Casa Sollievo Della Sofferenza” San Giovanni Rotondo, Foggia, Italy
| | - Marco Radici
- Unit of Otolaryngology, S. Giovanni Calibita-Fatebenefratelli General Hospital, Rome, Italy
| | - Maurizio Iemma
- Otolaryngology Department, San Giovanni di Dio e Ruggi D’Aragona University Hospital, Salerno, Italy
| | - Maurizio Giovanni Vigili
- Department of General Surgery-Head and Neck Consultant, Istituto Dermopatico Dell’Immacolata IDI-IRCCS, Rome, Italy
| | | | - Luciano Magaldi
- Department of Otolaryngology-Head and Neck Surgery, University of Foggia, Foggia, Italy
| | - Michele Cassano
- Department of Otolaryngology-Head and Neck Surgery, University of Foggia, Foggia, Italy
| | - Iacopo Dallan
- Department of Otorhinolaryngology, Azienda Ospedaliera Universitaria, Pisa, Italy
| | - Raul Pellini
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Livio Presutti
- Department of Otorhinolaryngology-Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Franco Ionna
- Otolaryngology and Maxillo-Facial Surgery Unit, Istituto Nazionale Tumori-IRCCS Fondazione G. Pascale, Naples, Italy
| | - Enrico de Campora
- Associazione Ospedaliera Italia Centromeridionale Otorinolaringoiatrica (AOICO), Rome, Italy
| | - Angelo Camaioni
- Department Otolaryngology Head and Neck Surgery, San Giovanni-Addolorata Hospital, Rome, Italy
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van Weert S, Valstar M, Lissenberg-Witte B, Bloemena E, Smit L, van der Wal J, Vergeer M, Smeele L, Leemans CR. Prognostic factors in acinic cell carcinoma of the head and neck: The Amsterdam experience. Oral Oncol 2021; 125:105698. [PMID: 34973520 DOI: 10.1016/j.oraloncology.2021.105698] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/18/2021] [Accepted: 12/22/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION The aim was to analyse prognosticators in acinic cell carcinoma (AciCC) in two head and neck referral centers in Amsterdam, the Netherlands. MATERIALS AND METHODS Eighty- nine cases of AciCC treated between 1979 and 2016 were retrospectively reviewed. Five, - 10 -and 20- year estimates of survival were executed as well as univariate analysis of prognosticators. RESULTS The majority of AciCC were T1-T2; 89%. Two percent had nodal disease (2%). The most affected organ was the parotid gland (84%) with a female preponderance (67%). Mean age was 52 years with most cases diagnosed in the fourth to sixth decade. The majority of patients received adjuvant radiotherapy. Elective neck dissection (END) in the N0 neck showed no metastases. High grade transformation (HGT) was found in 21% of cases. Median follow up was 101.9 months. Median time to recurrence was 26 months. Nine patients developed distant metastases (DM) of whom 6 had HGT-AciCC. Median survival with DM was 7 months. Five,- ten -and twenty- year estimates were 84%, 81% and 81% for recurrence free survival respectively. Negative clinical features were advanced stage disease and tumour size > 2.6 cm. Negative histological features were a high mitotic rate, HGT, close and involved surgical margins and necrosis. CONCLUSION AciCC- HGT excluded- of the head and neck has an excellent prognosis and shows acceptable long term results. END can be considered as part of the standard treatment due to the relative high incidence of HGT- AciCC and low accuracy of cytology.
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