CAJ | 학술논문

目的：探讨MYB蛋白表达在腺样囊性癌诊断及与其他涎腺源性肿瘤鉴别诊断中的意义，并进一步研究MYB基因拷贝数的改变情况。方法收集北京协和医院2000至2014年近15年间活检或手术切除且资料完整的涎腺源性肿瘤89例，其中腺样囊性癌34例，多形性腺瘤10例，基底细胞腺瘤10例，上皮肌上皮癌10例，基底细胞腺癌9例，黏液表皮样癌8例，癌在多形性腺瘤中4例，多形性低度恶性腺癌4例。采用免疫组织化学EnVision法检测34例腺样囊性癌和55例非腺样囊性癌中MYB蛋白的表达情况，并对MYB阳性表达的病例通过荧光原位杂交（ FISH）方法检测MYB基因拷贝数。结果 MYB在34例腺样囊性癌和55例非腺样囊性癌中阳性表达率分别为82.4％（28／34）和9.1％（5／55），差异有统计学意义（P＜0.01）。2例（2／18）腺样囊性癌发现MYB基因拷贝数增加，非腺样囊性癌组病例未发现该基因拷贝数改变，差异无统计学意义（ P ＝0.435）。结论MYB蛋白表达对腺样囊性癌的诊断及鉴别诊断具有一定价值，可通过MYB免疫组织化学法帮助确诊腺样囊性癌。此外，在少数腺样囊性癌病例中发现有MYB基因扩增，不是导致MYB蛋白过表达的主要因素。
목적：탐토MYB단백표체재선양낭성암진단급여기타연선원성종류감별진단중적의의，병진일보연구MYB기인고패수적개변정황。방법수집북경협화의원2000지2014년근15년간활검혹수술절제차자료완정적연선원성종류89례，기중선양낭성암34례，다형성선류10례，기저세포선류10례，상피기상피암10례，기저세포선암9례，점액표피양암8례，암재다형성선류중4례，다형성저도악성선암4례。채용면역조직화학EnVision법검측34례선양낭성암화55례비선양낭성암중MYB단백적표체정황，병대MYB양성표체적병례통과형광원위잡교（ FISH）방법검측MYB기인고패수。결과 MYB재34례선양낭성암화55례비선양낭성암중양성표체솔분별위82.4％（28／34）화9.1％（5／55），차이유통계학의의（P＜0.01）。2례（2／18）선양낭성암발현MYB기인고패수증가，비선양낭성암조병례미발현해기인고패수개변，차이무통계학의의（ P ＝0.435）。결론MYB단백표체대선양낭성암적진단급감별진단구유일정개치，가통과MYB면역조직화학법방조학진선양낭성암。차외，재소수선양낭성암병례중발현유MYB기인확증，불시도치MYB단백과표체적주요인소。
Objective To explore the diagnostic value of MYB protein expression for adenoid cystic carcinoma and its differential diagnosis from other salivary gland tumors ,and to further investigate the status of MYB gene copy number .Methods MYB expression was studied by immunohistochemistry in 34 adenoid cystic carcinomas , 55 non-adenoid cystic carcinomas ( other salivary gland tumors ) including 10 pleomorphic adenomas, 10 basal cell adenomas , 10 epithelial-myoepithelial carcinomas , 9 basal cell adenocarcinomas , 8 mucoepidermoid carcinomas , 4 carcinoma in pleomorphic adenomas , and 4 polymorphous low-grade adenocarcinoma.MYB gene copy number status was detected by FISH in MYB protein-positive cases.Results 82.4%(28/34) of adenoid cystic carcinomas were MYB protein-positive, compared with 9.1%(5/55) of non-adenoid cystic carcinomas, and the difference between the two groups was statistically significant ( P<0.01).2/18 of adenoid cystic carcinomas had duplication of MYB gene by FISH , and all non-adenoid cystic carcinomas were negative although the difference was not statistically significant ( P=0.435).Conclusions MYB protein expression is a useful diagnostic marker for adenoid cystic carcinomas in its separation from other salivary gland tumors.In addition , duplication of MYB gene is no a major mechanism for the MYB protein overexpression .