Carcinoma ex pleomorphic adenoma of the salivary glands: distinct clinicopathologic features and immunoprofiles between subgroups according to cellular differentiation.
In carcinoma ex pleomorphic adenoma (CXPA), pleomorphic adenoma (PA) and diverse carcinoma components showing luminal (ductal) or non-luminal (myoepithelial) differentiation coexist. To elucidate the clinicopathological implications of cellular differentiation in CXPA and the potential role of p53, vascular endothelial growth factor (VEGF), c-erbB-2, c-kit, and glucose transporter 1 (Glut-1) in carcinogenesis, we analyzed 11 CXPAs with luminal differentiation (CXPAs-LD) and 6 CXPAs with non-luminal differentiation (CXPAs-NLD) and compared protein expressions in residual PAs and carcinomas by immunohistochemistry. Among the CXPAs-LD, 5 were invasive and 8 were histologically high-grade tumors. The 5-year survival rate was 72.7%. P53, c-erbB-2, VEGF, and Glut-1 were more immunoreactive in carcinoma components than in PAs (P = 0.008, 0.004, 0.002, and 0.024, respectively); c-erbB-2 overexpression was associated with high histological grade (P = 0.024). Carcinoma components frequently lacked c-kit expression (P = 0.009). CXPAs-NLD were all low-grade and invasive with a larger mean tumor size (5.2 cm) than CXPAs-LD (3.3 cm) (P = 0.040). The patients remained disease-free without significant immunohistochemical expression. The immunoprofiles and clinical course of CXPA differed according to cellular differentiation. Therefore, it is important to report the histological subtype and to assess potential biomarkers in diagnostic and therapeutic trials.
['Kim|Jeong Won|JW|', 'Kwon|Gui Young|GY|', 'Roh|Jong-Lyel|JL|', 'Choi|Seung-Ho|SH|', 'Nam|Soon Yuhl|SY|', 'Kim|Sang Yoon|SY|', 'Cho|Kyung-Ja|KJ|']
D008949:Adenoma, Pleomorphic D000328:Adult D000368:Aged D014408:Biomarkers, Tumor D002277:Carcinoma D002454:Cell Differentiation D005260:Female D051246:Glucose Transport Proteins, Facilitative D006801:Humans D008297:Male D008875:Middle Aged D019009:Proto-Oncogene Proteins c-kit D018719:Receptor, ErbB-2 D012468:Salivary Gland Neoplasms D016159:Tumor Suppressor Protein p53 D042461:Vascular Endothelial Growth Factor A
Carcinoma ex Pleomorphic Adenoma p53 Vascular Endothelial Growth Factor c-erbB-2 c-kit Glucose Transporter 1 Histological Types Prognosis