Abstract
Background & Objective:To evaluate usefulness of immunohistochemical marker C-kit (CD117) in differentiating Adenoid cystic carcinoma (AdCC) from Polymorphous low-grade adenocarcinoma (PLGA) in patients of salivary gland carcinomas. AdCC is a malignant salivary gland neoplasm with poor prognosis. PLGA is a salivary gland malignancy with indolent growth pattern. Differentiating between the two entities is a diagnostic challenge. We evaluated the role of C-kit in differentiating the two.Methods:This is a Cross sectional study. Samples of 19 tumors including 12 AdCC and 4 PLGA was evaluated at Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi from December 2015 to August 2016. Immunohistochemical techniques were used to analyze the level of c-kit expression in AdCC (n = 12), polymorphous low-grade adenocarcinoma (PLGA) (n = 6). Samples were stained using monoclonal antibody against C-kit. Statistical analysis of the data was done using SPSS version 21.Results:Strong diffuse cytoplasmic reactivity was observed in more than 50% of the tumor cells of AdCC whereas less than 20% of cells showed negative to weak positivity in PLGA. Hence, the difference in the expression of c-kit between AdCC and PLGA was statistically significant (p value <0.002).Conclusions:CD117 expression itself can be used as a marker in differential diagnosis of salivary gland neoplasms. However, the percentage of the CD117 immunoreactive cells and the staining intensities appeared to be important factors in distinguishing AdCC from PLGA.
Highlights
CD117 (c-kit proto-oncogene) is a Type-III transmembrane receptor tyrosine Kinase that is encoded by the c-kit gene which is placed on the human chromosome segment 4q11.1,2 C-kit leads to activation of specific intracellular signal transduction cascades and plays a key part in normal differentiation and growth of different cell types.[3,4,5]
Inclusion criteria: All specimens of adenoid cystic carcinoma and polymorphous low grade carcinoma of salivary gland detected by immunohistochemistry, and routine histopathology irrespective of age of patient, histological type and grade of the tumor, were included
In case of Plga 71% of cases showed no to weak staining and were graded as 0 whereas only 28 % of cases showed 1+ staining which was mainly cytoplasmic
Summary
Pak J Med Sci November - December 2017 Vol 33 No 6 www.pjms.com.pk 1376 myeloblastic leukemia, small and non-small lung cancers, testicular germ cell tumors like (seminoma), and malignant melanoma. These tumors show an overexpression of C-kit.[6,7,8,9,10]. To evaluate usefulness of immunohistochemical marker C-kit (CD117) in differentiating Adenoid cystic carcinoma (AdCC) from Polymorphous low-grade adenocarcinoma (PLGA) in patients of salivary gland carcinomas. The percentage of the CD117 immunoreactive cells and the staining intensities appeared to be important factors in distinguishing AdCC from PLGA
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