Mucoepidermoid carcinoma: a five-decade journey
Mucoepidermoid carcinoma: a five-decade journey
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DOI：
10.1007/s00428-011-1040-y
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发表时间：
2011-02-01
期刊：
影响因子：
3.5
通讯作者：
Chiosea, Simion I.
中科院分区：
文献类型：
--
作者：
Chenevert, Jacinthe;Barnes, Leon E.;Chiosea, Simion I.
在对黏液表皮样癌（MEC）进行了几十年的全面描述后，尚无统一接受的分级系统。最近关于MECs组织学分级的争论集中在高级别（HG） MECs中环AMP反应元件结合蛋白（CREB）调控的转录辅助激活因子（CRTC1-MAML2）重排的广泛报道。我们假设形态学分类的困难可能部分解释了mec分级的问题。我们认为，在过去几十年中诊断出的HG mes代表了真正的mes与不相关的临床病理实体的混合。为了研究这一问题的历史方面，并确定最常见的类似“高级”MEC的肿瘤，我们回顾了1956年至1974年在我科诊断的46例MEC病例。22例确诊为MEC， 24例改变诊断。与确诊的MEC病例相比，改变诊断的病例有更高的淋巴结转移发生率，神经周围侵袭，总生存期更短。腺鳞状癌、鳞状细胞癌和唾液管癌是HG MEC最常见的模拟物。在这些病例中，最常见的诊断问题是MEC可接受的角化水平。对20例确诊MEC进行CRTC1-MAML2重排检测，5例低级别MEC易位阳性，7例中级MEC易位阳性，2例HG MEC易位阳性。
Several decades after a comprehensive description of mucoepidermoid carcinoma (MEC), there is no uniformly accepted grading system. The most recent debate regarding the histologic grading of MECs, centers on the wide range of reported prevalence of cyclic AMP response element-binding protein (CREB)-regulated transcription coactivator (CRTC1-MAML2) rearrangement in high-grade (HG) MECs. We hypothesize that difficulties in morphologic classification may partially explain problems in grading MECs. We believe that HG MECs, as diagnosed over the last several decades, represent a blend of true MECs with unrelated clinicopathologic entities. To examine the historic aspects of this problem, and to identify neoplasms that most commonly mimic "high-grade" MEC, we reviewed 46 cases of alleged MEC diagnosed in our department from 1956 to 1974. The diagnosis of MEC was confirmed in 22 cases and was changed in 24 cases. Compared to cases of confirmed MEC, cases with changed diagnoses had higher incidence of lymph node metastases, perineural invasion, and shorter overall survival. Adenosquamous carcinoma, squamous cell carcinoma, and salivary duct carcinoma emerged as the most common mimics of HG MEC. The single most common diagnostic issue in these cases is the level of keratinization acceptable for MEC. Twenty cases of confirmed MEC were tested for CRTC1-MAML2 rearrangement and 5 low-grade MECs, 7 intermediate grade MECs, and 2 cases of HG MEC were translocation-positive.