2 Department of Otolaryngology, "Attikon" University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece;
2 Department of Pathology, "Attikon" University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Anticancer Res. 2023 Apr;43(4):1709-1717. doi: 10.21873/anticanres.16323.
BACKGROUND/AIM: Adenoid cystic carcinoma (ACC) is an aggressive neoplasm even though it has low-grade histological appearance and slow growth. The aim of this study was to identify the immunohistochemical and molecular characteristics of ACC, as well as their correlation with the clinical course of patients.
This is a retrospective multicenter analysis. We included 50 patients diagnosed with ACC in the head and neck between 2000 and 2021. The expression of MYB proto-oncogene transcription factor (MYB), neurotrophic tyrosine kinase receptor (NTRK), human epidermal receptor-2 (HER-2), and Ki-67 was examined through immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH). We also performed a clinical follow-up of the patients.
The median age of the patients was 58.5 years; moreover, 54% of the patients were male. Compared with female patients, male patients were at a higher risk of both recurrence and death. No HER-2-positive cases were revealed. MYB expression was positive in 28 (56%) cases. However, MYB expression did not significantly affect survival. NTRK expression was positive in eight (16%) cases. NTRK-positive patients had worse overall survival (OS) than NTRK-negative patients (p=0.0246). Additionally, the percentage of NTRK-stained cells was negatively correlated with disease-free survival (p=0.0016) and OS (p=0.0027).
There was no correlation between MYB positivity and survival. Contrarily, NTRK-positive patients had worse survival, indicating that NTRK is a negative prognostic factor. Tropomyosin receptor kinase inhibitors can be used to treat these patients. Furthermore, MYB-targeted inhibitors are promising therapeutic agents.
背景/目的：腺样囊性癌（ACC）尽管具有低级别组织学特征和缓慢的生长速度，但仍是一种侵袭性肿瘤。本研究旨在确定 ACC 的免疫组织化学和分子特征，以及它们与患者临床病程的相关性。
这是一项回顾性多中心分析。我们纳入了 2000 年至 2021 年间在头颈部诊断为 ACC 的 50 例患者。通过免疫组织化学（IHC）和荧光原位杂交（FISH）检测 MYB 原癌基因转录因子（MYB）、神经营养酪氨酸激酶受体（NTRK）、人表皮受体-2（HER-2）和 Ki-67 的表达。我们还对患者进行了临床随访。
患者的中位年龄为 58.5 岁；此外，54%的患者为男性。与女性患者相比，男性患者复发和死亡的风险更高。未发现 HER-2 阳性病例。28 例（56%）患者的 MYB 表达呈阳性。然而，MYB 表达与生存无显著相关性。8 例（16%）患者的 NTRK 表达呈阳性。NTRK 阳性患者的总生存期（OS）比 NTRK 阴性患者差（p=0.0246）。此外，NTRK 染色细胞的百分比与无病生存期（DFS）和 OS 呈负相关（p=0.0016 和 p=0.0027）。
MYB 阳性与生存无相关性。相反，NTRK 阳性患者的生存较差，表明 NTRK 是一个负预后因素。可使用 Tropomyosin 受体激酶抑制剂治疗这些患者。此外，MYB 靶向抑制剂是有前途的治疗药物。
