title: Impact of CRTC1/3-MAML2 fusions on histological classification and prognosis of mucoepidermoid carcinoma.
abstract: OBJECTIVE
  The aim of study was to evaluate the impact of CRTC1-MAML2 and CRTC3-MAML2 fusions on the histological classification of mucoepidermoid carcinoma (MEC) of the salivary glands and on the prognosis of patients.
  
  
  RESULTS
  MEC cases (n = 111) were screened for CRTC1-MAML2 and CRTC3-MAML2 fusions by reverse transcription polymerase chain reaction. We developed a system of 'molecular Armed Forces Institute of Pathology (AFIP) classification' that combined the AFIP histological classification proposed by Goode et al. and the presence of CRTC1-MAML2 or CRTC3-MAML2 fusions. MEC cases positive for CRTC1-MAML2 or CRTC3-MAML2 fusion formed a favourable tumour subset that was distinct from fusion-negative cases. When positive for the fusions, 'high-risk' patients, including those with a higher histological grade or an advanced clinical stage, showed an excellent prognosis. For overall survival, 'molecular AFIP classification' was selected as a powerful independent prognostic factor (P=0.0038), as was the clinical stage (P =0.0032). For disease-free survival, 'molecular AFIP classification' was also selected as an independent prognostic factor (P = 0.0006).
  
  
  CONCLUSIONS
  Molecular AFIP classification may be useful in predicting the prognosis of patients with MEC.
authors.affiliation: Department of Pathology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Okumura
authors.forename: Satoru
authors.initials: S
authors.lastname: Miyabe
authors.forename: Takahisa
authors.initials: T
authors.lastname: Nakayama
authors.forename: Yukio
authors.initials: Y
authors.lastname: Fujiyoshi
authors.forename: Hideo
authors.initials: H
authors.lastname: Hattori
authors.forename: Kazuo
authors.initials: K
authors.lastname: Shimozato
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Inagaki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018277:Carcinoma, Mucoepidermoid / Q000235:genetics* / Q000473:pathology*; D002648:Child; D004268:DNA-Binding Proteins / Q000235:genetics*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009687:Nuclear Proteins / Q000235:genetics*; D050596:Oncogene Fusion; D015514:Oncogene Proteins, Fusion / Q000235:genetics; D011379:Prognosis; D012468:Salivary Gland Neoplasms / Q000235:genetics* / Q000473:pathology*; D015534:Trans-Activators; D014157:Transcription Factors / Q000235:genetics*; D055815:Young Adult
chemical_list: C500984:CRTC1 protein, human; C495791:CRTC3 protein, human; D004268:DNA-Binding Proteins; C471297:MAML2 protein, human; D009687:Nuclear Proteins; D015514:Oncogene Proteins, Fusion; D015534:Trans-Activators; D014157:Transcription Factors