title: Clinicopathological characteristics and cell cycle proteins as potential prognostic factors in myoepithelial carcinoma of salivary glands.
abstract: Myoepithelial carcinoma (MCA) is a rare malignancy of salivary glands that was included in the WHO Classification of Head and Neck Tumors in 1991. MCA has shown a broad spectrum of clinical outcomes, but attempts to identify prognostic markers for this malignancy have not resulted in significant progress. Conventional histopathological characteristics such as tumour grade, nuclear atypia, mitotic index and cell proliferation have failed to predict the outcome of MCA. In this study, we reviewed the histopathology of 19 cases of MCA focusing on nuclear atypia, mitotic count, tumour necrosis, nerve and vascular invasion and occurrence of a pre-existing pleomorphic adenoma in connection to the MCA. Histopathological characteristics and clinical information were correlated with the immunohistochemical expression of cell cycle proteins including c-Myc, p21, Cdk4 and Cyclin D3. The proportion of tumour cells immunoreactive for these markers and their intensity of staining were correlated with clinical information using logistic regression, Kaplan-Meier and Cox regression. Using logistic regression analysis, cytoplasmic c-Myc expression was associated with the occurrence of metastases (P = 0.019), but limitations of semi-quantitation of immunostaining and the limited number of cases preclude definitive conclusions. Our data show that the occurrence of tumour necrosis predicts poor disease-free survival in MCA (P = 0.035).
authors.affiliation: Department of Pathology, Haartman Institute, University of Helsinki, P.O. Box 21, Haartmaninkatu 3, FIN-00014, Helsinki, Finland. passadorio@gmail.com.|Department of Pathology, São Leopoldo Mandic Research Centre, Campinas, Brazil. passadorio@gmail.com.
authors.forename: F
authors.initials: F
authors.lastname: Passador-Santos
authors.affiliation: Department of Pathology, Haartman Institute, University of Helsinki, P.O. Box 21, Haartmaninkatu 3, FIN-00014, Helsinki, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Grönroos
authors.affiliation: Department of Otolaryngology and Surgical Oncology, University of Toronto, Toronto, ON, M5S, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Irish
authors.affiliation: Department of Otolaryngology and Surgical Oncology, University of Toronto, Toronto, ON, M5S, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Gilbert
authors.affiliation: Department of Otolaryngology and Surgical Oncology, University of Toronto, Toronto, ON, M5S, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Gullane
authors.affiliation: Department of Pathology, University of Toronto, Toronto, ON, M5S, Canada.
authors.forename: B
authors.initials: B
authors.lastname: Perez-Ordonez
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, P.O. Box 220, FI-00029 HUS, Helsinki, Finland.|Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, SE-171 77, Stockholm, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Mäkitie
authors.affiliation: Department of Pathology, Haartman Institute, University of Helsinki, P.O. Box 21, Haartmaninkatu 3, FIN-00014, Helsinki, Finland.|Department of Pathology, University of Turku, Kiinamyllynkatu 10, 20520, Turku, Finland.
authors.forename: I
authors.initials: I
authors.lastname: Leivo
mesh_terms: D008949:Adenoma, Pleomorphic / Q000473:pathology; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D018797:Cell Cycle Proteins / Q000378:metabolism*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008297:Male; D008875:Middle Aged; D009208:Myoepithelioma / Q000737:chemistry / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D012468:Salivary Gland Neoplasms / Q000737:chemistry / Q000378:metabolism / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor; D018797:Cell Cycle Proteins
keywords: Cell cycle proteins; Head and neck cancer; Immunohistochemistry; Myoepithelial carcinoma; Salivary gland