Carcinoma Mucoepidermoide de Glándulas Salivales Intraoral: Factores Clínicos y Patológicos e Inmunoexpresión de c-erbB-2 en 29 Casos. Vanessa Fátima. Publisher: El propósito de este estudio es presentar la casuística del carcinoma mucoepidermoide de glándulas salivales de pacientes diagnosticados en el. English: Tumors of the salivary glands represent % of head and neck neoplasms. Mucoepidermoid carcinoma (MEC) is the most common epithelial.
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Intraoral Mucoepidermoid Carcinoma of Salivary Glands: The association among clinicopathological features and c-erbB-2 oncoprotein expression was evaluated in twenty-nine cases of intra-oral mucoepidermoid carcinoma MEC.
MEC was prevalent in the female gender Microscopically, 27 cases Its intracellular component has a tyrosine kinase activity, whereas the extracellular domain may act as a growth factor receptor because of its considerable homology with epidemial growth factor receptor Nguyen et al. The c-erbB-2 oncoprotein is involved in matrix degradation and proteolitic activity as well as in the increase in vessel permeability, endothelial cell growth, proliferation, migration, and differentiation Verbeek et al.
Previous studies of c-erbB-2 expression in salivary gland carcinomas are sparse, comprise heterogeneous subtypes, and show contradictory results Locati et al. Mucoepidermoid carcinoma MEC is the most common malignant neoplasm of major and minor salivary glands Lopes et al, MEC is reported to manifest variable biologic aggressiveness, basically showing correlation with its histological features and is graded by a 3-tiered system Auclair et al, Different conclusions may be attributed to the varying techniques used, criteria applied to determine positive c-erbB-2 expression, the diversity of lesions and the limited number evaluated in some studies.
Few papers evaluating only one type of oral salivary gland tumors are available. Thus, the aim of this study was to analyze a series of intraoral MEC for expression of the c-erbB-2 oncoprotein and its possible association with the clinicopathologic features of the sample.
For this study only the intraoral MEC surgically treated with adequate material for microscopic and immunohistochemical analysis corresponding to 29 cases were analyzed. Sinonasal and maxillary tumors were not included in the sample. Clinical information about age, gender, and site were obtained from the biopsy records. Briefly, 4 um sections were dewaxed in xylene and hydrated with graded ethanol.
Carcinoma mucoepidermoide de glándulas salivales en Brasil: relación clinicopatológica
Blocking of endogenous peroxidase and avidin-biotin activity were performed Miller et al. The mucoe;idermoide were revealed by applying 0. In situ intraductal carcinoma of the breast was used as a c-erbB-2 positive control and negative controls were obtained by the omission of the primary antibody.
Evaluation of the immunohistochemical staining.
Discrepancies were solved by consensus. From oral biopsies submitted during period between and ,40 0.
Tumors were more common in the third and fourth decades of life The palate was the most commonly affected site, with 21 cases The majority of MECs 27 cases were classified as low grade of malignancy. All positive cases also expressed cytoplasmic staining. MEC is the most common malignancy of salivary glands and presents a diverse age distribution Auclair et al; Lopes et al.
However, there are few articles with a significative number of cases Lopes et al. In our series, patients demonstrated an earlier average age of occurrence, with a peak of incidence in the third and fourth decades of life, whereas previous studies described a prevalence in fifth and sixth decades of life Auclair et al. However, as the MEC is the most common malignant tumor of salivary glands in young people this observation is in accordance with the literature as also the female dr Auclair et al.
Most sxlivales the studies show that the palate is the most common site of ocurrence Lopes et al. In our series the results were similar with 21 Sinonasal and maxillary tumors were not included in this study as intraoral salivary gland tumors since that in these locations mucoepidermoid carcinoma presents different origin rather than glandular Ellis et al.
Microscopically, most intraoral MEC were classified as low grade of mucoepidermoidde 27cases – Studies on intra-oral MEC have shown similar results with a higher percentage of low grade tumors Kokemueller et al.
Low grade tumors seem to arise more often in minor salivary glands, which according to some authors are detected at earlier stages, probably due to the less aggressive growth in addition to a better visible tumor site. High grade tumors, on the other hand, seem to arise more often in major salivary glands Kokemueller et al.
Data regarding the positivity for c-erbB-2 on salivary gland tumors fe very variable. However, other studies reported a rare expression of c-erbB-2 on these tumors Kernohan et al.
Concerning MEC, there had been only individual case descriptions of c-erbB-2 expression Kernohan et al. We suppose that reasons for this contradictory mucoepldermoide are associated with the immunohistochemistry technique, in special with the primary antibody employed and with the subjective interpretation and semiquantitative nature of the results.
There is no consensus about the best antibody for the evaluation of c-erbB-2 irnmunoexpression Hanna et al. This antibody although less sensitive than the polyclonal antibody used in other reports Lopes et al.
Besides, in the present study a standardized method was employed for evaluation of positivity. The high percentage of previously observed positive cases 21 cases, Cytoplasmic expression was also observed but not considered in this carcinlma as reported in diverse salivary gland tumors Kernohan et al.
Although the significance of this cytoplasmic staining remains unknown, Cheng et al. Further studies in order to clarify this point are warranted. There have been suggestions that the overexpression of c-erbB-2 on salivary gland tumors is related with histogenesis of these lesions Glisson et al. MEC is composed of varying proportions of mucous, epidermoid, columnar, intermediate and clear cells Auclair et al. MEC than that from intercalated duct.
However, many studies zalivales that benign and malignant salivary gland neoplasms with evidence of myoepithelial lineage do not overexpress c-erbB-2 protein which support the view that this growth receptor is not involved in their pathogenesis Rosa et al.
Although the latter may present myoepitelial derivation, carcinoma ex pleomorphic adenoma probably adquired a particular biological behavior in the longstanding process of malignant transformation. Moreover, Gibbons et al. This provides further support to the existence of distinct mucoepider,oide mechanisms in salivary gland carcinogenesis associated with the overexpression of mucoepider,oide Despite the small sample studied our results demonstrated no association among glahdulas expression and demographic or histological grades of MEC.
Thus, our findings may suggest the lack of association among clinicopathological features and the immunoexpression of c-erbB Considering the results in the appraised sample, our findings suggest that some mucoepidermoid carcinoma overexpress c-erbB-2 independent of glandulqs features such as patient age and gender and site or histological grades of the lesions.
Mucoepidermoode overexpression may be due to the process envolving histogenesis and celular differentiation. Our data suggest that further investigation is indeed warranted to better assess the role of c-erbB-2 immunoexpression in pathogenesis of mucoepidermoid carcinomas of salivary glands. The majority of MEC in minor salivary glands are histologically classified as low grade of malignancy and an association with the c-erbB-2 immunopositivity could be not demonstrated.
However, in the study of Lopes et al. Mucoepidermoid carcinoma of intraoral salivary glands. Evaluation and application of grading criteria in cases. Cytoplasmic expression of c-erbB2 in non-small cell lung cancers. Salivary gland tumors in children and adolescents: Surgical Pathology ofthe salivary glands.
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