Tian Zhen, Li Lei, Zhang Chun-Ye, Gu Ting, Li Jiang
Department of Oral Pathology, Ninth People's Hospital, School of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Oral Pathol Med. 2016 Oct;45(9):698-703. doi: 10.1111/jop.12414. Epub 2015 Dec 29.
In practices, some cases of salivary basal cell tumors that consist mainly of cribriform growth pattern are difficult to differentiate from adenoid cystic carcinoma (AdCC). Identification of reliable molecular biomarkers for the differential diagnosis between them is required.
Twenty-two cases of cribriform salivary basal cell tumors (at least 10% cribriform pattern present in each tumor) comprising 18 cases of basal cell adenoma (BCA) and four cases of basal cell adenocarcinoma (BcAC) were collected between 1985 and 2008. Twenty cases of cribriform AdCC were retrieved from our archives. MYB protein expression and gene abnormalities were detected in all cases by immunohistochemistry (IHC) and fluorescent in situ hybridization (FISH) analyses, respectively.
Neither MYB protein nor split genes were detected in any of the cases of cribriform basal cell tumors, while 55% (11/20) of cases of cribriform AdCC had MYB protein expression. High MYB expression was detected in 81.8% (9/11) cases, while low expression was found in the remaining cases. FISH analysis indicated that nine AdCC tumors with high MYB protein expression were split gene-positive, while MYB gene splitting was not detected in the 11 cases with low or absent MYB protein expression.
The molecular changes in AdCC differ from those associated with cribriform basal cell tumors, which further confirms that cribriform basal cell tumors and AdCC are two distinct tumor entities. Simultaneous detection of MYB protein expression and the associated molecular changes could be beneficial in differentiating salivary cribriform basal cell tumors from AdCC.
在实际工作中，一些主要呈筛状生长模式的涎腺基底细胞肿瘤病例难以与腺样囊性癌（AdCC）相鉴别。需要鉴定可靠的分子生物标志物以进行二者的鉴别诊断。
收集了1985年至2008年间的22例筛状涎腺基底细胞肿瘤（每个肿瘤中至少有10%的筛状模式），其中包括18例基底细胞腺瘤（BCA）和4例基底细胞腺癌（BcAC）。从我们的存档中检索出20例筛状AdCC。分别通过免疫组织化学（IHC）和荧光原位杂交（FISH）分析检测所有病例中的MYB蛋白表达和基因异常情况。
在任何筛状基底细胞肿瘤病例中均未检测到MYB蛋白和基因断裂，而55%（11/20）的筛状AdCC病例有MYB蛋白表达。81.8%（9/11）的病例检测到MYB高表达，其余病例为低表达。FISH分析表明，9例MYB蛋白高表达的AdCC肿瘤为基因断裂阳性，而在11例MYB蛋白低表达或无表达的病例中未检测到MYB基因断裂。
AdCC的分子变化与筛状基底细胞肿瘤不同，这进一步证实筛状基底细胞肿瘤和AdCC是两种不同的肿瘤实体。同时检测MYB蛋白表达及相关分子变化有助于鉴别涎腺筛状基底细胞肿瘤与AdCC。
