title: Prognostic significance of p27Kip1, Ki-67, and CRTC1-MAML2 fusion transcript in mucoepidermoid carcinoma: a molecular and clinicopathologic study of 101 cases.
abstract: OBJECTIVE
  Mucoepidermoid carcinoma (MEC) is the most frequently detected primary malignancy of the salivary gland and is characterized by a marked variation in prognosis. In the present study, we investigated the prognostic significance of p27Kip1, Ki-67, and CRTC1 (also called MECT1, TORC1, and WAMTP1)-MAML2 fusion in MEC.
  
  
  METHODS
  MEC cases (n = 101) were examined for p27Kip1 and Ki-67 expression using immunohistochemistry and for CRTC1-MAML2 fusion transcript using reverse transcriptase-polymerase chain reaction.
  
  
  RESULTS
  p27Kip1, Ki-67, and the CRTC1-MAML2 fusion transcript were expressed in 71, 31, and 34 of the 101 cases, respectively. p27Kip1 and CRTC1-MAML2 fusion were associated with favorable clinicopathologic tumor features and Ki-67 with aggressive clinicopathologic features. Multivariate survival analyses were performed that included the following 10 clinicopathologic factors: age, gender, tumor site, tumor size, nodal metastasis, clinical stage, histologic grade, p27 expression, Ki-67 expression, and CRTC1-MAML2 fusion. For disease-free survival, only p27Kip1 expression was significant as an independent prognostic factor. For overall survival, p27Kip1 expression, CRTC1-MAML2 fusion, and tumor size were significant. In each analysis, p27Kip1 and CRTC1-MAML2 fusion were independent of the clinical stage. Ki-67 expression was not selected in either multivariate analysis.
  
  
  CONCLUSIONS
  p27Kip1 and CRTC1-MAML2 fusion were associated with favorable clinicopathologic tumor features, and both were useful in predicting the overall survival of patients with MEC. For disease-free survival, p27Kip1 might be the most useful prognostic factor. In contrast, Ki-67 might not be a very powerful prognostic indicator for either survival point.
authors.affiliation: Department of Pathology, Nagoya City University Graduate School of Medical Sciences, Kawasumi, Nagoya, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Miyabe
authors.forename: Mitsukuni
authors.initials: M
authors.lastname: Okabe
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Nagatsuka
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: Akira
authors.initials: A
authors.lastname: Inagaki
authors.forename: Kei
authors.initials: K
authors.lastname: Ijichi
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Nagai
authors.forename: Tadaaki
authors.initials: T
authors.lastname: Eimoto
authors.forename: Motoo
authors.initials: M
authors.lastname: Yokoi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Shimozato
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Inagaki
mesh_terms: D000367:Age Factors; D014408:Biomarkers, Tumor / Q000096:biosynthesis* / Q000235:genetics; D018277:Carcinoma, Mucoepidermoid / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D050760:Cyclin-Dependent Kinase Inhibitor p27 / Q000096:biosynthesis* / Q000235:genetics; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D019394:Ki-67 Antigen / Q000096:biosynthesis* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D015514:Oncogene Proteins, Fusion / Q000096:biosynthesis* / Q000235:genetics; D011379:Prognosis; D012334:RNA, Neoplasm / Q000032:analysis; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012468:Salivary Gland Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D012737:Sex Factors; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; C495418:MECT1-MAML2 fusion protein, human; D015514:Oncogene Proteins, Fusion; D012334:RNA, Neoplasm; D050760:Cyclin-Dependent Kinase Inhibitor p27