RESUMEN
The aim of this study was to compare the immunoexpression of epithelial mucins (MUCs) in salivary duct cysts, papillary cystadenomas, and mucoepidermoid carcinomas and to evaluate if any of these markers could be useful for differentiating between mucoepidermoid carcinoma and papillary cystadenoma. We also sought to validate the p63 expression pattern found to differentiate between mucoepidermoid carcinoma and papillary cystadenoma. Immunoexpression of MUC1, MUC2, MUC4, MUC7, and p63 was studied and quantified in 22 mucoepidermoid carcinomas, 12 papillary cystadenomas, and 3 salivary duct cysts. The immunohistochemical evaluation was collectively performed by 3 oral pathologists. Scores and trends in proportions were assessed using the nonparametric Wilcoxon-Mann-Whitney rank sum test. Mucoepidermoid carcinomas, papillary cystadenomas, and salivary duct cysts demonstrated variable MUC expression patterns. All tumors were positive for p63 immunoexpression with p63 labeling in salivary duct cysts and papillary cystadenomas (15/15) limited to the basal layers of the cystic spaces, whereas in mucoepidermoid carcinomas (22/22) the p63 labeling extended throughout the suprabasal layers (p < 0.001). This study adds more confirmatory data to validate that the reactivity pattern of p63 protein can be used in distinguishing between papillary cystadenoma and low-grade mucoepidermoid carcinoma. Although positive reactivity in a tumor with MUC1 and MUC4 was inconclusive, negative reactivity suggests the diagnosis of a benign PC or SDC.
Asunto(s)
Biomarcadores de Tumor/análisis , Carcinoma Mucoepidermoide/diagnóstico , Cistoadenoma Papilar/diagnóstico , Proteínas de la Membrana/biosíntesis , Mucinas/biosíntesis , Neoplasias de las Glándulas Salivales/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Diagnóstico Diferencial , Femenino , Humanos , Inmunohistoquímica , Masculino , Proteínas de la Membrana/análisis , Persona de Mediana Edad , Mucinas/análisisRESUMEN
OBJECTIVES: To retrospectively study the prevalence of perineural invasion (PNI) in cases of mucoepidermoid carcinoma (MEC). The study evaluated if previously assessed PNI would be increased by re-review of the original hematoxylin and eosin-stained (H&E) slides and also review of slides reacted immunohistochemically with S100 to enhance nerve visualization and whether this is associated with clinical outcome. STUDY DESIGN: Thirty-one cases were reviewed for PNI with H&E-stained slides as well as S-100-reacted slides. These results were compared with the original pathology report's PNI status when available (13 of 31). Subject demographic characteristics and clinical outcome were collected from electronic medical records. RESULTS: PNI was identified in 23% (3 of 13) of tumors in the original reports, 13% (4 of 31) of the authors' re-review of the slides, and 29% (9 of 31) by immunohistochemical assessment for S100. PNI and larger-diameter nerve involvement were significantly associated with death at 5-year follow-up. CONCLUSIONS: Immunohistochemical assessment for S100 improves the accuracy of PNI determination. PNI is a significant factor in the survival outcome of cases of MEC.