RESUMEN
RATIONALE: Pulmonary mucoepidermoid carcinoma (PMEC) is a rare lung malignancy, especially in combination with ALK mutations, whose clinical presentation lacks specificity and for which there are no standardized treatment guidelines. PATIENT CONCERNS: We report a case of a patient with PMEC-predominant primary lung cancer combined with an ALK mutation. DIAGNOSES: One patient was diagnosed with PMEC combined with ALK mutation. INTERVENTIONS: After diagnosis by puncture pathology, the patient was treated with oral targeted drugs. OUTCOMES: The patient's cough and fever were controlled, her diet improved significantly, and she gained 20 pounds in 6 months. During this period, the primary and metastatic foci in the lungs were significantly reduced on repeat chest CT. CONCLUSION: PMEC combined with ALK mutation is an extremely rare primary lung cancer, and the diagnosis is mainly based on pathology, histology and immunohistochemistry. The application of molecularly targeted drugs to patients with mutations can significantly improve the prognosis of patients with PMEC, which is expected to be a new breakthrough in the treatment of PMEC.
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Quinasa de Linfoma Anaplásico , Neoplasias Pulmonares , Humanos , Quinasa de Linfoma Anaplásico/genética , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/diagnóstico , Femenino , Mutación , Persona de Mediana Edad , Carcinoma Mucoepidermoide/genética , Carcinoma Mucoepidermoide/patología , Carcinoma Mucoepidermoide/diagnóstico , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Due to the relative rarity of malignant sublingual gland tumors, diagnosing and treating them clinically pose challenges. Hence, there's a need to explore the pathological types, characteristics, treatment methods, and prognosis of primary malignant tumors of the sublingual gland to improve our understanding and management of these rare yet highly malignant conditions. METHODS: This study reviewed cases of primary malignant sublingual gland tumors, analyzing their characteristics. The treatment methods included surgical excision, with additional radiotherapy, or brachytherapy for advanced stages or positive surgical margins. The study also summarized different treatment approaches, including lymph node dissection and soft tissue reconstruction using free flaps such as the anterolateral thigh flap and forearm flap. RESULTS: We have gathered 23 cases of sublingual gland malignancies treated at the Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, from January 2013 to May 2024. The most common pathological types were adenoid cystic carcinoma and mucoepidermoid carcinoma, with rare cases of mucosa-associated lymphoid tissue (MALT) lymphoma and nonspecific salivary gland clear cell carcinoma. Early diagnosis and surgical intervention were crucial for a favorable prognosis. Marginal mandibulectomy was necessary for cases involving the mandible. Patients with positive preoperative lymph node detection required cervical lymph node dissection. Extensive tissue defects in the floor of the mouth were effectively reconstructed with free flaps to prevent oral-mandibular fistula. CONCLUSION: Surgical excision remains the preferred treatment for malignant sublingual gland tumors. Early diagnosis and comprehensive surgical management are essential for improving prognosis. The study's limitations include a small sample size and short follow-up duration, necessitating further research with larger clinical samples to confirm these findings.
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Neoplasias de la Glándula Sublingual , Humanos , Femenino , Persona de Mediana Edad , Masculino , Neoplasias de la Glándula Sublingual/patología , Neoplasias de la Glándula Sublingual/terapia , Adulto , Anciano , Pronóstico , Adulto Joven , Escisión del Ganglio Linfático , Carcinoma Adenoide Quístico/terapia , Carcinoma Adenoide Quístico/patología , Carcinoma Adenoide Quístico/cirugía , Carcinoma Adenoide Quístico/diagnóstico , Estudios Retrospectivos , Carcinoma Mucoepidermoide/patología , Carcinoma Mucoepidermoide/cirugía , Carcinoma Mucoepidermoide/terapia , Procedimientos de Cirugía Plástica/métodosAsunto(s)
Carcinoma Mucoepidermoide , Mucina 5AC , Neoplasias Gástricas , Humanos , Masculino , Neoplasias Gástricas/patología , Neoplasias Gástricas/metabolismo , Carcinoma Mucoepidermoide/patología , Carcinoma Mucoepidermoide/metabolismo , Carcinoma Mucoepidermoide/diagnóstico , Persona de Mediana Edad , Mucina 5AC/metabolismo , Diagnóstico Diferencial , Proteína p53 Supresora de Tumor/metabolismo , Antígeno Ki-67/metabolismoRESUMEN
Mucoepidermoid carcinoma arising from minor salivary glands at the base of the tongue is rare. Surgical excision of the tumours remains the primary treatment of choice. The prognosis of this tumour depends on optimum clearance of the disease surgically, clinical staging and histopathological grading. Postoperatively, radiotherapy depends on the grading and histopathological features of the tumour. Long-term follow-up is a must to detect early recurrences of oropharyngeal tumours. In our case, the tumour was removed by the transoral route because it was a limited tumour and for better postoperative functional outcomes. Concurrent chemoradiotherapy was advised to address the perineural invasion and residual tumour of the base of the tongue region.
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Carcinoma Mucoepidermoide , Neoplasias de la Lengua , Humanos , Neoplasias de la Lengua/patología , Neoplasias de la Lengua/diagnóstico , Neoplasias de la Lengua/terapia , Carcinoma Mucoepidermoide/patología , Carcinoma Mucoepidermoide/diagnóstico , Carcinoma Mucoepidermoide/cirugía , Masculino , Adolescente , Glándulas Salivales Menores/patología , Neoplasias de las Glándulas Salivales/patología , Neoplasias de las Glándulas Salivales/diagnóstico , Neoplasias de las Glándulas Salivales/terapia , FemeninoRESUMEN
BACKGROUND: Canonical transient receptor potential channels play a crucial role in cancer cell proliferation. While TRPC6 subtype detection in submandibular glands and the relevance of some TRPC channels in this gland have been shown in animal models, its histological detection in human lacrimal and submandibular glands, as well as related tumors, lacks systematic study. Studying TRPC6 in humans could lead to new therapeutic options. This research aimed to immunohistochemically detect TRPC6 in human samples of physiological lacrimal and submandibular glands and of adenoid cystic carcinoma and mucoepidermoid carcinoma. METHODS: Seven fixed body donors and samples of six cancer patients were examined. The ten tissue samples collected from the submandibular and lacrimal glands were then processed into histological slides and stained with hematoxylin-eosin. Tumor samples were provided as sections. TRPC6 presence was determined by immunohistochemistry, which was performed by indirect detection with a primary TRPC6 antibody, a secondary HRP-conjugated antibody and the chromogen diaminobenzidine. RESULTS: Results confirm TRPC6 expression in all ten physiological gland samples: all samples showed a immunohistochemical signal with varying intensity. No significant gender-specific differences could be observed. TRPC6 was detected in four of six submandibular adenoid cystic carcinoma and the mucoepidermoid carcinoma samples, especially in tumor cells' cytoplasma and nuclei. Excretory ducts consistently showed TRPC6. Mucous tubules, their nuclei and the nuclei of adipocytes generally showed no signal while serous acini and their nuclei showed a weak TRPC6 signal. CONCLUSION: The discovery of TRPC6 in glandular tissue indicates a role in salivary gland function and calcium homeostasis is a basis for further research into its significance for tumor development in adenoid cystic carcinoma and mucoepidermoid carcinoma of salivary glands. TRPC6 could be used as a target for treatment of these tumors. However, the correlation between TRPC6 and submandibular and lacrimal gland diseases requires further exploration.
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Carcinoma Adenoide Quístico , Inmunohistoquímica , Aparato Lagrimal , Neoplasias de las Glándulas Salivales , Glándula Submandibular , Canal Catiónico TRPC6 , Humanos , Femenino , Masculino , Neoplasias de las Glándulas Salivales/patología , Neoplasias de las Glándulas Salivales/metabolismo , Persona de Mediana Edad , Aparato Lagrimal/patología , Aparato Lagrimal/metabolismo , Carcinoma Adenoide Quístico/patología , Carcinoma Adenoide Quístico/metabolismo , Canal Catiónico TRPC6/metabolismo , Glándula Submandibular/patología , Glándula Submandibular/metabolismo , Anciano , Adulto , Carcinoma Mucoepidermoide/patología , Carcinoma Mucoepidermoide/metabolismo , Biomarcadores de Tumor/metabolismo , Biomarcadores de Tumor/análisisRESUMEN
The Sclerosing subtype of mucoepidermoid carcinoma is rare, with only 39 cases reported in literature. We present a new case of sclerosing mucoepidermoid carcinoma (SMEC) with MAML2 rearrangements. A 49-year-old woman with Sjögren's syndrome experienced recurrent submandibular sialadenitis and sialolithiasis, leading to the removal of her right gland. Postoperative imaging revealed a calcified mass in her left gland which was subsequently resected. The pathologic examination revealed a well-defined tumor with extensive fibrous stroma, predominantly epidermoid cells, and occasional mucinous components. There was a dense lymphocytic and plasma cell infiltrate at the tumor's periphery. Immunohistochemistry was positive for p40 and CK7, few IgG4+ plasma cells. No eosinophils were identified. Fluorescence in situ hybridization (FISH) revealed rearrangement of the MAML2 (11q21) region. Adjuvant radiation was not recommended because of the patient's history of autoimmune diseases and the fact that the tumor was small, localized, and had negative resection margins. The patient was advised to undergo a repeat CT scan of the neck, scheduled for 3 months later. This case highlights the importance of considering SMEC in the differential diagnosis of patients with sialolithiasis or Sjögren's syndrome.
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Carcinoma Mucoepidermoide , Hallazgos Incidentales , Sialadenitis , Síndrome de Sjögren , Neoplasias de la Glándula Submandibular , Transactivadores , Humanos , Femenino , Carcinoma Mucoepidermoide/patología , Carcinoma Mucoepidermoide/cirugía , Persona de Mediana Edad , Sialadenitis/patología , Neoplasias de la Glándula Submandibular/patología , Hibridación Fluorescente in Situ , Reordenamiento Génico , Diagnóstico Diferencial , Tomografía Computarizada por Rayos X , Inmunohistoquímica , Factores de Transcripción/genéticaAsunto(s)
Adenocarcinoma , Carcinoma Mucoepidermoide , Neoplasias Pulmonares , Humanos , Carcinoma Mucoepidermoide/patología , Carcinoma Mucoepidermoide/cirugía , Carcinoma Mucoepidermoide/diagnóstico , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/cirugía , Neoplasias Pulmonares/diagnóstico , Adenocarcinoma/patología , Adenocarcinoma/cirugía , Adenocarcinoma/diagnóstico , Adenocarcinoma/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos X , Neumonectomía/métodos , Neoplasias Primarias Múltiples/patología , Neoplasias Primarias Múltiples/cirugíaRESUMEN
OBJECTIVES: To investigate prognostic factors in patients with head and neck Mucoepidermoid Carcinoma (MEC), especially the impact of treatment modalities on survival. METHODS: Patients with primary head and neck MEC between 2000 and 2015 were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Prognostic factors related to Overall Survival (OS) and Cancer-Specific Survival (CSS), as well as the impact of treatments, were evaluated by multivariable Cox regression analysis. RESULTS: We identified 2692 patients diagnosed with head and neck MEC, of whom 1397 (51.89%) had a parotid gland primary, 569 (22.14%) died, and 341 (12.67%) died of MEC. Older age (≥53 years), males, unmarried, lower income, tumor site in other head and neck areas, higher tumor grade, larger tumor size, and higher stage were related to poorer OS and CSS. Patients who did not undergo surgery (HR=3.20, 95% CI 2.45â4.18) had worse OS, while no significant difference was detected between partial and total organ excision on patients' OS (p=0.729). For combination therapy, patients who received radiotherapy only (HR=3.21, 95% CI 2.27-4.53) or no surgery and no radiotherapy (HR=2.59, 95% CI 1.83-3.67) were correlated with worse OS (vs. surgery only), but no significant difference was detected between surgery only and surgery combined with radiotherapy on patients' OS (p=0.218). For CSS, the corresponding results were consistent with OS. CONCLUSION: Surgical resection only may be a better survival option for head and neck MEC.
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Carcinoma Mucoepidermoide , Neoplasias de Cabeza y Cuello , Programa de VERF , Humanos , Carcinoma Mucoepidermoide/terapia , Carcinoma Mucoepidermoide/mortalidad , Carcinoma Mucoepidermoide/patología , Masculino , Femenino , Persona de Mediana Edad , Adulto , Pronóstico , Neoplasias de Cabeza y Cuello/terapia , Neoplasias de Cabeza y Cuello/mortalidad , Anciano , Adulto Joven , Estadificación de Neoplasias , Adolescente , Clasificación del TumorRESUMEN
Objective: To analyze the risk factors affecting regional lymph node metastasis in salivary gland mucoepidermoid carcinoma (MEC) and to establish a nomogram model for individually predicting lymph node metastasis in salivary gland MEC. Methods: The clinical data of 2 152 patients with salivary gland MEC from 1975 to 2020 were collected from the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute. The collected data were divided into training cohort (1 506 cases) and validation cohort (646 cases) according to the ratio of 7â¶3. Single-factor regression and multi-factor logistic regression were used to screen factors related to local lymph node metastasis in salivary gland MEC, with constructing of a nomogram. Calibration curve, receiver operating characteristic (ROC) curve, area under the ROC curve (AUC) and decision curve analysis were used to evaluate model performance in the validation cohort and the total cohort. Statistical tests were performed using SPSS (26.0) and R (4.3.0) software. Results: Multivariate logistic regression results showed that M stage [OR(95%CI):12.360(3.295-46.365), P=0.014], pathological grade â ¡ãâ ¢ãâ £[OR(95%CI): 1.956(1.329-2.879), 9.654(6.309-14.772), 9.298(6.072-14.238), P<0.001], T staging T2, T3, T4[OR(95%CI): 1.706(0.932-3.124), 3.021(1.790-5.096), 3.311(1.925-5.695), P<0.001], and gender [OR(95%CI):0.759(0.593-0.972), P=0.029] were independent factors affecting local lymph node metastasis in salivary gland MEC. Through verification in the validation cohort and the total cohort, the AUC values were greater than 0.8, and the calibration curve was close to the perfect reference line, proving that the constructed nomogram model had good specificity and sensitivity for predicting local lymph node metastasis in salivary gland MEC. Conclusion: M stage, pathological grade, T stage, and gender are risk factors for predicting regional lymph node metastasis and the established-nomogram has good predictive performance for local lymph node metastasis in salivary gland MEC.
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Carcinoma Mucoepidermoide , Metástasis Linfática , Nomogramas , Neoplasias de las Glándulas Salivales , Humanos , Neoplasias de las Glándulas Salivales/patología , Carcinoma Mucoepidermoide/patología , Factores de Riesgo , Femenino , Masculino , Ganglios Linfáticos/patología , Modelos Logísticos , Curva ROC , Programa de VERF , Estadificación de Neoplasias , Persona de Mediana EdadRESUMEN
PURPOSE: To investigate the relationship between preoperative systemic immune-inflammation index (SII) and relapse-free survival (RFS) after surgical resection of mucoepidermoid carcinoma(MEC). METHODS: The data of 135 patients with MEC who underwent surgical resection in the First Affiliated Hospital of Zhengzhou University from January 2016 to July 2019 were collected, and the receiver operating characteristic(ROC) curve was performed on the SII of patients. The optimal cut-off value was obtained by ROC analysis. Therefore, the patients' SII index was divided into high and low group, and survival analysis was performed by Kaplan-Meier method. Cox proportional regression model and least absolute shrinkage and selection operator (LASSO) were used to analyze the factors influencing prognosis, and a nomogram model was built to predict patients' relapse-free survival(RFS). Area under curve (AUC) and correction curve were used to evaluate the model and verify the consistency. RESULTS: Survival analysis showed that the RFS rate in low SII group was significantly higher than that in high SII group. Cox proportional hazard regression model showed high SII(HR=2.179, 95%CI: 1.072-4.426, P=0.031) and low tumor differentiation(HR=6.894, 95%CI: 2.770-17.158, P=0.000) and cervical lymph node metastasis (HR=2.091, 95%CI: 1.034-4.230, P=0.040) were significant predictors of poor RFS. CONCLUSIONS: The lower the preoperative SII, the better the prognosis of patients. The nomogram prognosis of MEC based on SII is effective.
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Carcinoma Mucoepidermoide , Inflamación , Nomogramas , Modelos de Riesgos Proporcionales , Humanos , Carcinoma Mucoepidermoide/inmunología , Carcinoma Mucoepidermoide/patología , Carcinoma Mucoepidermoide/cirugía , Carcinoma Mucoepidermoide/mortalidad , Pronóstico , Inflamación/inmunología , Curva ROC , Estimación de Kaplan-Meier , Supervivencia sin Enfermedad , Femenino , MasculinoRESUMEN
Our goal was to assess the impact of childhood/adolescent cancer history on overall survival (OS) and disease-specific survival (DSS) in patients with parotid mucoepidermoid carcinoma (MEC). Patients who underwent surgical treatment for primary parotid MEC and those with a second malignancy of parotid MEC were retrospectively identified from the Surveillance, Epidemiology, and End Results (SEER) database. The primary outcome variables were OS and DSS. The hazard ratios (HRs) of these survival rates associated with cancer history were analysed using Cox regression models. In total, 2681 patients were included, 263 of whom had a second malignancy. The 10-year OS rates in the primary (72%) and second malignancy groups (59%) were significantly different. Cox regression confirmed that a history of cancer tended to decrease OS (p = 0.062, HR: 1.28, 95% confidence interval: 0.99 to 1.64). Subgroup analyses showed that a history of solid tumour as opposed to haematological cancer predicted worse OS, with central nervous system tumours exhibiting a more significant influence than others (p = 0.030 vs p = 0.088). Cancer history was not related to DSS. A history of childhood/adolescent cancer negatively influenced the prognosis of patients with parotid MEC, and this effect was primarily driven by a history of solid malignancy.
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Carcinoma Mucoepidermoide , Neoplasias de la Parótida , Humanos , Carcinoma Mucoepidermoide/cirugía , Carcinoma Mucoepidermoide/patología , Neoplasias de la Parótida/cirugía , Masculino , Femenino , Pronóstico , Adolescente , Estudios Retrospectivos , Niño , Adulto , Persona de Mediana Edad , Tasa de Supervivencia , Programa de VERF , Neoplasias Primarias Secundarias , Anciano , Preescolar , Adulto JovenRESUMEN
Parotid gland pathology represents a web of differential diagnoses. There are many complex cases that require extensive diagnostic tests for a complete and correct final pathology diagnosis. Currently the official classification of parotid gland tumors extends over more than 40 subtypes. We performed a query of the PubMed database regarding the use of molecular biology tests in performing a better characterization of the tumors in specific cases. By using fluorescence in situ hybridization (FISH), reverse transcription polymerase chain reaction (RT-PCR) or next-generation sequencing, the team managing complex cases can offer a personalized therapeutic solution. We review the molecular differential diagnosis according to published articles in the last 5 years for many types of parotid gland tumors ranging from benign to borderline malign tumors to malign aggressive tumors. Mucoepidermoid carcinoma is a distinct subtype of parotid malignancy that was the subject of a consistent number of articles. However, the molecular biology diagnosis techniques helped more in excluding the diagnosis of mucoepidermoid carcinoma, and probably retrospectively limiting the number of cases with this final diagnosis. In Romania, the molecular biology diagnosis is available only in limited research facilities and should receive more consistent funding that will make it available on a larger scale. The novelty of this scoping review is that we propose an algorithm for molecular differential diagnosis of the tumors that could be encountered in the parotid gland.
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Neoplasias de la Parótida , Humanos , Neoplasias de la Parótida/diagnóstico , Neoplasias de la Parótida/genética , Neoplasias de la Parótida/patología , Carcinoma Mucoepidermoide/diagnóstico , Carcinoma Mucoepidermoide/genética , Carcinoma Mucoepidermoide/patología , Diagnóstico Diferencial , Técnicas de Diagnóstico Molecular/métodos , Biomarcadores de Tumor/genética , Hibridación Fluorescente in Situ/métodos , Secuenciación de Nucleótidos de Alto Rendimiento/métodosRESUMEN
Hepatobiliary mucoepidermoid carcinoma is a rare malignant tumor comprising mucous, intermediate, and epidermoid cells. Herein, we presented a case of primary liver mucoepidermoid carcinoma preoperatively misdiagnosed as conventional intrahepatic cholangiocarcinoma. A 67-year-old male was admitted to our hospital. Preoperative laboratory tests showed increased aspartate transaminase, alanine transaminase, and carbohydrate antigen 19-9. Abdominal Computer Tomography revealed a 4.8 × 4.9 cm liver mass in segment VI. A preliminary diagnosis of intrahepatic cholangiocarcinoma was made, with undergoing partial hepatectomy. However, on histopathology, the tumor comprised a mixture of epidermoid, mucous, and intermediate cells with diffuse infiltrating at the tumor margin. On special stains, mucous and intermedia cells were positive for mucicarmine and Alcian blue, whereas epidermoid cells were positive for Keratin 5/6 and p63. Intermediate cells are also positive for p63. All tumor cells were positive for Keratin 7. The Ki-67 index was 35%. The final diagnosis was primary hepatic mucoepidermoid carcinoma. Although rare, hepatic mucoepidermoid carcinoma should be considered in the intrahepatic cholangiocarcinoma differential diagnosis. We reviewed previous studies and found that hepatobiliary mucoepidermoid carcinoma is more likely to originate from the biliary tract adjacent to the tumor.
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Carcinoma Mucoepidermoide , Neoplasias Hepáticas , Humanos , Masculino , Carcinoma Mucoepidermoide/patología , Carcinoma Mucoepidermoide/diagnóstico , Carcinoma Mucoepidermoide/cirugía , Carcinoma Mucoepidermoide/diagnóstico por imagen , Anciano , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/cirugía , Colangiocarcinoma/patología , Colangiocarcinoma/diagnóstico , Colangiocarcinoma/diagnóstico por imagen , Colangiocarcinoma/cirugía , Neoplasias de los Conductos Biliares/patología , Neoplasias de los Conductos Biliares/diagnóstico , Neoplasias de los Conductos Biliares/diagnóstico por imagen , Neoplasias de los Conductos Biliares/cirugía , Diagnóstico Diferencial , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: While several studies reported epidermal growth factor receptor (EGFR) expression in salivary gland cancer (SGC), results varied due to a lack of unified definition of EGFR positivity. In this study, we assessed the EGFR expression level using both EGFR positive score and cumulative EGFR score in the patients with SGC. METHODS: Between January 2010 and April 2021, 102 patients with SGC who underwent surgical resection were reviewed retrospectively by immunohistochemistry. The membrane staining intensity was scored as follows: no staining (0), weak staining (1+), intermediate staining (2+), and strong staining (3+). The cumulative EGFR score was determined on a continuous scale of 0-300 using the formula:1 × (1+: percentage of weakly stained cells) + 2 × (2+: percentage of moderately stained cells) + 3 × (3+: percentage of strongly stained cells). RESULTS: EGFR expression in SGC varied widely even among the same as well as different histopathological types. The average EGFR positive scores were 46.0 %, 55.7 %, 51.6 %, 1.0 %, 26.8 %, 50 %, and 76.8 % for mucoepidermoid carcinoma (MEC), salivary duct carcinoma (SDC), adenoid cystic carcinoma (AdCC), acinic cell carcinoma (AcCC), adenocarcinoma NOS (ACNOS), carcinoma ex pleomorphic adenoma (CAexPA), and squamous cell carcinoma (SqCC), respectively. The average cumulative EGFR scores were 82, 91, 80, 1, 52, 93, and 185 for MEC, SDC, AdCC, AcCC, ACNOS, CAexPA, and SqCC, respectively. CONCLUSIONS: EGFR positive scores and cumulative EGFR scores in SGCs varied among the various histological types, and even in the same histological type. These scores may predict the clinical outcome of SGC treated with EGFR-targeting therapies, such as head and neck photoimmunotherapy, and need to be evaluated in future studies.
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Adenoma Pleomórfico , Carcinoma Adenoide Quístico , Carcinoma Mucoepidermoide , Receptores ErbB , Neoplasias de las Glándulas Salivales , Humanos , Receptores ErbB/metabolismo , Neoplasias de las Glándulas Salivales/patología , Neoplasias de las Glándulas Salivales/metabolismo , Masculino , Femenino , Persona de Mediana Edad , Carcinoma Mucoepidermoide/patología , Carcinoma Mucoepidermoide/metabolismo , Estudios Retrospectivos , Anciano , Carcinoma Adenoide Quístico/metabolismo , Carcinoma Adenoide Quístico/patología , Adenoma Pleomórfico/patología , Adenoma Pleomórfico/metabolismo , Adulto , Inmunohistoquímica , Anciano de 80 o más Años , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/cirugía , Adulto Joven , Carcinoma de Células Acinares/patología , Carcinoma de Células Acinares/metabolismoRESUMEN
BACKGROUND: The impact of timing of PORT initiation for major salivary gland cancers on survival is unknown. We aim to examine the impact of PORT timeliness on overall survival (OS) of patients with major salivary gland cancers. METHODS: This was a cross-sectional analysis using data from the National Cancer Database (2004-2017) and included patients with major salivary gland cancer treated with surgery and PORT. RESULTS: In total, 5701 patients were included (3133 [55%] male, 4644 [82%] white, mean age 59 ± 16 years). For the overall cohort, PORT >6 weeks was not associated with decreased OS (1.00 aHR, 95% CI 0.89-1.11). When specifically examining patients with mucoepidermoid carcinoma, PORT >6 weeks was associated with a decreased OS (1.27 aHR, 95% CI 1.01-1.58). CONCLUSIONS: Overall, this analysis did not demonstrate a survival benefit for initiating PORT within 6 weeks for patients with salivary gland malignancies. Subset analysis did support initiating PORT within 6 weeks after resection for patients with mucoepidermoid carcinomas. This was not demonstrated in other major salivary gland cancer histologies.
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Carcinoma Mucoepidermoide , Neoplasias de las Glándulas Salivales , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de las Glándulas Salivales/radioterapia , Neoplasias de las Glándulas Salivales/cirugía , Neoplasias de las Glándulas Salivales/mortalidad , Neoplasias de las Glándulas Salivales/patología , Femenino , Estudios Transversales , Anciano , Carcinoma Mucoepidermoide/cirugía , Carcinoma Mucoepidermoide/radioterapia , Carcinoma Mucoepidermoide/mortalidad , Carcinoma Mucoepidermoide/patología , Adulto , Radioterapia Adyuvante , Factores de Tiempo , Bases de Datos Factuales , Tasa de Supervivencia , Tiempo de Tratamiento , Estados Unidos , Estudios RetrospectivosRESUMEN
Background and Objectives: Mucin has been implicated via various mechanisms in the development and growth of tumour cells. However, mucin expression studies in salivary gland tumours are limited, especially with samples from minor salivary glands. This study aims to investigate and compare mucin expression in benign and malignant salivary gland tumours of minor and major salivary gland origins. Materials and Methods: Special stains were used to stain neutral mucin (Periodic acid Schiff), sialomucin (Alcian Blue) and sulfomucin (Aldehyde Fuschin) within tissues from six normal salivary glands and 73 salivary gland tumours including 31 pleomorphic adenomas, 27 mucoepidermoid carcinomas, and 15 adenoid cystic carcinomas. A semi-quantitative approach was used to evaluate mucin expression within ductal lumens. Sialomucin was the most expressed mucin in all salivary gland tumours, regardless of origin. Results: A significant difference was observed in the mucin expression between benign and malignant salivary gland tumours, as pleomorphic adenoma showed three times significantly higher expression of sialomucin compared to mucoepidermoid carcinoma and adenoid cystic carcinoma (p = 0.028). Pleomorphic adenomas of major glands showed 42 times significantly higher expression of sialomucin compared to those of minor glands (p = 0.000). Conclusions: Sialomucin content in pleomorphic adenomas of major glands was vastly increased compared to that in minor glands. Differential sialomucin expression in benign and malignant salivary gland tumours suggests a role in diagnosing of borderline salivary gland tumours.
Asunto(s)
Adenoma Pleomórfico , Carcinoma Mucoepidermoide , Mucinas , Neoplasias de las Glándulas Salivales , Humanos , Neoplasias de las Glándulas Salivales/metabolismo , Mucinas/análisis , Mucinas/metabolismo , Masculino , Femenino , Adenoma Pleomórfico/metabolismo , Persona de Mediana Edad , Carcinoma Mucoepidermoide/metabolismo , Carcinoma Mucoepidermoide/patología , Adulto , Anciano , Carcinoma Adenoide Quístico/metabolismo , Sialomucinas/análisis , Sialomucinas/metabolismoRESUMEN
There is a limited amount of data on the role of programmed cell death ligand (PD-L) -1 and PD-L2 in salivary gland carcinomas. We aimed to evaluate the prognostic value of PD-L1 and PD-L2 expressions, which are closely related to immune mechanisms, with respect to salivary gland tumor types and stages. Data from patients with salivary gland masses surgically removed between 2006 and 2021, diagnosed with a malignant salivary gland neoplasm, were retrospectively analyzed. Immunoreactivity for PD-L1 and PD-L2 was performed on resection materials. The mean age of 90 patients was 52.1±18.8 and 46.7% were male. Overall, 55.6% of patients were diagnosed with adenoid cystic carcinoma (ACC), 23.3% with mucoepidermoid carcinoma (MEC), 16.7% with acinic cell carcinoma (AciCC), 3.3% with ductal carcinoma (DC), and 1 patient with pleomorphic adenoma ex carcinoma (PA-ex-CA). In all, 52% of ACC, 12% of AciCC, 24% of MEC, and 12% of DC cases were at stage IV. The tumor diameter, frequencies of lymphovascular invasion, metastasis, positive surgical margin, recurrence, and mortality rates of patients at stages III and IV were significantly larger than those at stages I and II ( P <0.05). The percentages of tumor cell score (TCS) and immune cell score (ICS) for PD-L1 were significantly higher among patients with MEC compared with those with other types of tumors ( P =0.0011). However, the percentages of combined score (CS) for PD-L1 and tumor cell score for PD-L2 were comparable among tumor types ( P >0.05). No significant difference was found in these scores for PD-L1 between tumor stages ( P >0.05), but for PD-L2, all patients at stage I had TCS <1% for PD-L2, while all patients at stages II and III, and 92% of patients at stage IV had TCS ≥1% ( P <0.0001). High expression of PD-L1 was mostly observed in MEC cases ( P =0.0016), while all patients with AciCC had a low PD-L1 expression level ( P =0.0206). The mean tumor diameter, rate of lymphovascular invasion, perineural invasion, metastasis, positive surgical margin, recurrence, type of treatment, mortality, and TILs ratio did not differ significantly according to PD-L1 expression level ( P >0.05). The percentage of tumor-infiltrating lymphocytes was comparable among negative and positive PD-L1 scores according to both 1% and 5% threshold values ( P >0.05). High PD-L1 expression is rare in AciCC, while PD-L1 expression is high in MEC. Our findings underline the importance of future screening for PD-L1 and PD-L2 before patients undergoing immunotherapies in all salivary gland tumors.
Asunto(s)
Antígeno B7-H1 , Estadificación de Neoplasias , Proteína 2 Ligando de Muerte Celular Programada 1 , Neoplasias de las Glándulas Salivales , Humanos , Neoplasias de las Glándulas Salivales/patología , Neoplasias de las Glándulas Salivales/metabolismo , Neoplasias de las Glándulas Salivales/mortalidad , Antígeno B7-H1/metabolismo , Antígeno B7-H1/biosíntesis , Masculino , Femenino , Persona de Mediana Edad , Adulto , Anciano , Proteína 2 Ligando de Muerte Celular Programada 1/metabolismo , Estudios Retrospectivos , Carcinoma Adenoide Quístico/patología , Carcinoma Adenoide Quístico/metabolismo , Carcinoma Mucoepidermoide/patología , Carcinoma Mucoepidermoide/metabolismo , Regulación Neoplásica de la Expresión Génica , Inmunohistoquímica , Biomarcadores de Tumor/metabolismo , Proteínas de Neoplasias/biosíntesis , Proteínas de Neoplasias/metabolismoRESUMEN
Primary lung cancer in childhood is extremely rare, with an incidence rate of less than 2/100,0000, and pulmonary mucoepidermoid carcinoma (PMEC), is even rarer. Their symptoms are usually not specific, and there are no guidelines for their management, which makes their clinical management a challenge for pediatricians. The purpose of this report is to discuss the clinical presentation, positive signs, examinations, pathological characteristics, surgical modalities, chemotherapy regimens, and prognosis in children. The clinical data of four patients diagnosed with PMEC at the Children's Hospital of Chongqing Medical University from June 2021 to November 2022 were retrospectively analyzed, and their clinical features, treatment, and prognosis were summarized. Among them, two were male and two were female; their ages ranged from 3 years and 10 months to 10 years and 11 months, and all were staged according to tumor node metastasis classification (TNM). Immunohistochemical tests were performed in all children, among which four cases were positive for cytokeratin (CK), two cases were positive for CK7, four cases were positive for p63, about 5-10% of tumor cells were positive for Ki67. Among the four children, three had surgery alone and one had surgery + chemotherapy. All four children are presently living, with no evidence of tumor recurrence or metastasis. PMEC in children is very rare, and its age of onset and symptoms are not specific, and there is no obvious correlation with gender. Its diagnosis mainly relies on pathomorphological diagnosis, and immunohistochemical detection has no specific performance. The prognosis of children with PMEC is related to the clinical stage and whether surgery is performed. Whether further chemotherapy or radiotherapy is needed for patients who cannot undergo surgical resection and for those who have a combination of distant metastases requires further clinical studies.
Clinical presentation and treatment of 4 children with pulmonary mucoepidermoid carcinomaLung cancer in childhood is extremely rare, occurring at a rate of less than 2/1000000, and a type of lung cancer called pulmonary mucoepidermoid carcinoma (PMEC), is even rarer. The symptoms are usually not specific, and there are no guidelines for its management, which is a challenge for doctors. The purpose of this report is to discuss the signs and symptoms medical examinations, disease characteristics, surgical procedures, chemotherapy regimens and prognosis in children with pulmonary mucoepidermoid carcinoma. The clinical data of four patients diagnosed with pulmonary mucoepidermoid carcinoma at the Children's Hospital of Chongqing Medical University from June 2021 to November 2022 were analyzed, and their clinical features, treatment and prognosis were summarized. All four children are currently alive, and there is no recurrence or spread of the tumor after treatment. We have discussed various aspects of the disease, such as the rate of occurrence, causes, signs and symptoms, the way in which it might be diagnosed and treated, and the survival rate after operation, hoping to provide some insights for future work.
Asunto(s)
Carcinoma Mucoepidermoide , Neoplasias Pulmonares , Niño , Preescolar , Femenino , Humanos , Masculino , Biomarcadores de Tumor/análisis , Biomarcadores de Tumor/metabolismo , Carcinoma Mucoepidermoide/patología , Carcinoma Mucoepidermoide/terapia , Carcinoma Mucoepidermoide/diagnóstico , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/terapia , Neoplasias Pulmonares/diagnóstico , Estadificación de Neoplasias , Neumonectomía , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
BACKGROUND: Mucoepidermoid Carcinoma of the Esophagus (MECE) is a relatively rare tumor type, with most of the current data derived from case reports or small sample studies. This retrospective study reports on the 10-year survival data and detailed clinicopathological characteristics of 48 patients with esophageal MEC. METHODS: Data were collected from 48 patients who underwent curative surgery for esophageal MEC at the Fourth Hospital of Hebei Medical University between January 1, 2004, and December 31, 2020. These were compared with contemporaneous cases of Esophageal Squamous Cell Carcinoma (ESCC) and Esophageal Adenocarcinoma (EAC). Using the Kaplan-Meier method and multivariate Cox regression analysis, we investigated the clinicopathological factors affecting the survival of patients with MEC. RESULTS: The incidence of MECE was predominantly higher in males, with a male-to-female ratio of approximately 7:1. The mid-thoracic segment emerged as the most common site of occurrence. A mere 6.3% of cases were correctly diagnosed preoperatively. The lymph node metastasis rate stood at 35.4%. The overall 1-year, 3-year, 5-year, and 10-year survival rates for all patients were 85.4%, 52.1%, 37.0%, and 31.0%, respectively. Post 1:1 propensity score matching, no significant statistical difference was observed in the Overall Survival (OS) between MEC patients and those with Esophageal Squamous Cell Carcinoma (ESCC) and Esophageal Adenocarcinoma (EAC) (P = 0.119, P = 0.669). Univariate analysis indicated that T staging and N staging were the primary factors influencing the prognosis of esophageal MEC. CONCLUSIONS: MECE occurs more frequently in males than females, with the mid-thoracic segment being the most common site of occurrence. The rate of accurate preoperative endoscopic diagnosis is low. The characteristic of having a short lesion length yet exhibiting significant extramural invasion may be a crucial clinicopathological feature of MECE. The OS of patients with MEC does not appear to significantly differ from those with esophageal squamous carcinoma and adenocarcinoma.
Asunto(s)
Adenocarcinoma , Carcinoma Mucoepidermoide , Neoplasias Esofágicas , Carcinoma de Células Escamosas de Esófago , Humanos , Masculino , Neoplasias Esofágicas/patología , Neoplasias Esofágicas/mortalidad , Neoplasias Esofágicas/cirugía , Carcinoma Mucoepidermoide/patología , Carcinoma Mucoepidermoide/mortalidad , Carcinoma Mucoepidermoide/cirugía , Femenino , Persona de Mediana Edad , Estudios Retrospectivos , Anciano , Adenocarcinoma/patología , Adenocarcinoma/mortalidad , Adenocarcinoma/cirugía , Adulto , Carcinoma de Células Escamosas de Esófago/patología , Carcinoma de Células Escamosas de Esófago/mortalidad , Carcinoma de Células Escamosas de Esófago/cirugía , Tasa de Supervivencia , Metástasis Linfática/patología , Estimación de Kaplan-Meier , Pronóstico , Factores Sexuales , Estadificación de NeoplasiasRESUMEN
BACKGROUND: Salivary gland tumors (SGTs) are rare and highly heterogeneous lesions, making diagnosis a challenging activity. In addition, the small number of studies and samples evaluated difficults the determination of prognosis and diagnosis. Despite the solid advances achieved by research, there is still an intense need to investigate biomarkers for diagnosis, prognosis and that explain the evolution and progression of SGTs. METHODS: We performed a comprehensive literature review of the molecular alterations focusing on the most frequent malignant SGTs: mucoepidermoid carcinoma and adenoid cystic carcinoma. RESULTS: Due to the importance of biomarkers in the tumorigenenic process, this review aimed to address the mechanisms involved and to describe molecular and biomarker pathways to better understand some aspects of the pathophysiology of salivary gland tumorigenesis. CONCLUSIONS: Molecular analysis is essential not only to improve the diagnosis and prognosis of the tumors but also to identify novel driver pathways in the precision medicine scenario.