Assessment of MEF2C as a novel myoepithelial marker using normal salivary gland and pleomorphic adenoma: An immunohistochemical study

Abstract

The myoepithelium of the salivary gland demonstrates smooth muscle properties, and the myoepithelium-rich pleomorphic adenomas (PA) exhibit various cytological guises and frequently produce chondroid tissues. We recently reported that gene expression of myocyte enhancer factor 2 C (MEF2C) was up-regulated in myoepithelial cell lines established from mouse salivary glands. This transcription factor is known to regulate the development of smooth muscle cells and chondrocytes. These findings have led us to postulate that MEF2C may be a new marker of the myoepithelium and thus be of help for exploring myoepithelial participation in PA. The immunoreactivity of MEF2C was semi-quantitatively analyzed in normal salivary glands and in different types of cell in PA. The pattern of staining was also compared with that of α-smooth muscle actin (αSMA) and calponin. In the parenchyma of mouse and human submandibular glands, MEF2C expression was exclusive to the nuclei of myoepithelial cells. In the neoplastic myoepithelium of PA, epithelioid and stellate cells were consistently positive, but spindle and plasmacytoid cells exhibited selective staining. Although variability/loss of expression was evident, αSMA tended to show limited expression, whereas calponin tended to show extensive expression. Intense and uniform immunoreactivity for MEF2C was observed in lacunar cells in chondroid areas of PA. This is the first reported study to have demonstrated MEF2C immunoexpression in normal and neoplastic myoepithelial cells. Among the heterogeneously differentiated elements, MEF2C may be useful to define the myoepithelial/mesenchymal phenotypes of PA cells. Along with other relevant immunohistochemical markers, it may become another standard.