Butler Randall T, Spector Matthew E, Thomas Dafydd, McDaniel Andrew S, McHugh Jonathan B
Department of Pathology, University of Michigan, 1500 E. Medical Center Drive, Room 2G332 UH, Ann Arbor, MI, 48109, USA.
Head Neck Pathol. 2014 Jun;8(2):133-40. doi: 10.1007/s12105-013-0493-5. Epub 2013 Sep 25.
Salivary duct carcinoma is a highly aggressive salivary gland malignancy that may be misdiagnosed as high-grade mucoepidermoid carcinoma. We utilized tissue microarrays with 78 examples of mucoepidermoid carcinoma and 47 salivary duct carcinomas to evaluate the utility of an immunohistochemical panel consisting of androgen receptor, Her2/neu, p63, and cytokeratin 5/6 in distinguishing these entities. Among all cases in the cohorts, androgen receptor was highly specific for salivary duct carcinoma, while cytokeratin 5/6 and p63 were specific for mucoepidermoid carcinoma. While the rate of unequivocal Her2/neu overexpression among the salivary duct carcinomas was low (8.9 %), discrimination of salivary duct carcinoma was enhanced when this marker was used in combination with androgen receptor due to profound sensitivity. The immunohistochemical panel was particularly efficacious at distinguishing the problematic subset of high-grade mucoepidermoid carcinomas from salivary duct carcinoma. Utilization of this set of immunohistochemical markers allows reliable differentiation of salivary duct and mucoepidermoid carcinoma, a distinction with important prognostic and therapeutic implications.
涎腺导管癌是一种侵袭性很强的涎腺恶性肿瘤，可能会被误诊为高级别黏液表皮样癌。我们利用组织芯片，其中包含78例黏液表皮样癌和47例涎腺导管癌的样本，来评估由雄激素受体、Her2/neu、p63和细胞角蛋白5/6组成的免疫组化panel在鉴别这些实体中的效用。在该队列的所有病例中，雄激素受体对涎腺导管癌具有高度特异性，而细胞角蛋白5/6和p63对黏液表皮样癌具有特异性。虽然涎腺导管癌中明确的Her2/neu过表达率较低（8.9%），但由于该标志物具有高度敏感性，当与雄激素受体联合使用时，对涎腺导管癌的鉴别能力会增强。该免疫组化panel在区分高级别黏液表皮样癌与涎腺导管癌这一有问题的亚组时特别有效。使用这组免疫组化标志物能够可靠地区分涎腺导管癌和黏液表皮样癌，这一区分具有重要的预后和治疗意义。
