Abstract

BackgroundThe etiology of inflammatory myofibroblastic tumors (IMTs) is controversial and the prognosis is unpredictable. Previous studies have not investigated the expression of hypoxia-related markers in IMTs.MethodsBetween 2002 and 2012, 12 consecutive patients with histologically proven IMTs were enrolled in the study. Immunohistochemistry was used to detect GLUT-1, HIF-1α, PI3K, and p-Akt expression in paraffin-embedded tumor specimens. Associations among GLUT-1, HIF-1α, PI3K, and p-Akt protein expression and clinical parameters were investigated.ResultsThe mean duration of follow-up was 52.1 months (range, 11 to 132 months). Six patients had local recurrence. GLUT-1, HIF-1α, PI3K, and p-Akt expression were detected in 41.7%, 50.0%, 33.3%, and 41.7% of patients, respectively. Fisher’s exact test revealed significant correlations between recurrence of IMT and PI3K expression (P = 0.01) and p-Akt expression (P = 0.015). Univariate analyses revealed significant correlations between survival and GLUT-1 expression (P = 0.028), PI3K expression (P = 0.006), and p-Akt expression (P = 0.028). Multivariate analysis did not show a significant relationship between survival and GLUT-1, HIF-1α, PI3K, or p-Akt. Spearman rank correlation analysis showed significant correlations between HIF-1α and PI3K expression (r = 0.707, P = 0.01) and between p-Akt and PI3K expression (r = 0.837, P = 0.001).ConclusionsAlthough our results are inconclusive owing to the small sample size, they suggest that PI3K and p-Akt expression may play a role in the recurrence of IMTs of the head and neck.

Highlights

  • The etiology of inflammatory myofibroblastic tumors (IMTs) is controversial and the prognosis is unpredictable

  • computed tomography (CT), magnetic resonance imaging (MRI), or FDG-positronemission tomography (PET)/CT scans were available for nine patients

  • Contrast-enhanced CT images were available for four patients: one case of IMT of the tonsil showed no enhancement, mild enhancement was found in one case of hypopharynx IMT, mild to moderate enhancement was detected in one of the maxillary sinus cases, and the IMT of the tongue showed strong enhancement

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Summary

Introduction

The etiology of inflammatory myofibroblastic tumors (IMTs) is controversial and the prognosis is unpredictable. Previous studies have not investigated the expression of hypoxia-related markers in IMTs. Inflammatory myofibroblastic tumor (IMT) is an intermediatedgrade tumor, according to the World Health Organizationclassification, and has a potential for recurrence and rare metastasis [1]. HIF-1α is degraded by the von Hippel-Lindau-dependent ubiquitin-proteasome pathway [13]. It is rapidly stabilized under hypoxic conditions. GLUT-1 expression increases under hypoxia, which is consistent with findings of increased glucose uptake, increased adaptive changes to glycolytic metabolism, and increased cellular proliferation in cancer cells

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