Prognostic Significance of p27Kip1, Ki-67, and CRTC1-MAML2 Fusion Transcript in Mucoepidermoid Carcinoma: A Molecular and Clinicopathologic Study of 101 Cases

Miyabe, Satoru; Okabe, Mitsukuni; Nagatsuka, Hitoshi; Hasegawa, Yasuhisa; Inagaki, Akira; Ijichi, Kei; Nagai, Noriyuki; Eimoto, Tadaaki; Yokoi, Motoo; Shimozato, Kazuo; Inagaki, Hiroshi

doi:10.1016/j.joms.2009.03.021

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 67, Issue 7 , Pages 1432-1441, July 2009

Prognostic Significance of p27^Kip1, Ki-67, and CRTC1-MAML2 Fusion Transcript in Mucoepidermoid Carcinoma: A Molecular and Clinicopathologic Study of 101 Cases

Satoru Miyabe, DMD, PhD
- Research Fellow, Department of Pathology, Nagoya City University Graduate School of Medical Sciences and Research Fellow, Department of Maxillofacial Surgery, Aichi-Gakuin University School of Dentistry, Nagoya, Japan
Mitsukuni Okabe, DMD, PhD
- Research Fellow, Department of Pathology, and Lecturer, Department of Oral and Maxillofacial Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
Hitoshi Nagatsuka, DMD, PhD
- Professor, Department of Oral Pathology and Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
Yasuhisa Hasegawa, MD, PhD
- Head, Department of Head and Neck Surgery, Aichi Cancer Center Central Hospital, Nagoya, Japan
Akira Inagaki, MD, PhD
- Lecturer, Department of Neuro-otolaryngology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Address correspondence and reprint requests to Dr Inagaki: Department of Pathology, Nagoya City University Graduate School of Medical Sciences, Kawasumi, Mizuho-ku, Nagoya 467-8601, Japan
Kei Ijichi, MD, PhD
- Lecturer, Department of Neuro-otolaryngology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
Noriyuki Nagai, DMD, PhD
- Professor Emeritus, Department of Oral Pathology and Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
Tadaaki Eimoto, MD, PhD
- Professor Emeritus, Department of Pathology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
Motoo Yokoi, DMD, PhD
- Professor, Department of Oral and Maxillofacial Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
Kazuo Shimozato, DMD, PhD
- Professor, Department of Maxillofacial Surgery, Aichi-Gakuin University School of Dentistry, Nagoya, Japan
Hiroshi Inagaki, MD, PhD
- Professor, Department of Pathology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

Purpose

Mucoepidermoid carcinoma (MEC) is the most frequently detected primary malignancy of the salivary gland and is characterized by a marked variation in prognosis. In the present study, we investigated the prognostic significance of p27^Kip1, Ki-67, and CRTC1 (also called MECT1, TORC1, and WAMTP1)-MAML2 fusion in MEC.

Materials and Methods

MEC cases (n = 101) were examined for p27^Kip1 and Ki-67 expression using immunohistochemistry and for CRTC1-MAML2 fusion transcript using reverse transcriptase-polymerase chain reaction.

Results

p27^Kip1, Ki-67, and the CRTC1-MAML2 fusion transcript were expressed in 71, 31, and 34 of the 101 cases, respectively. p27^Kip1 and CRTC1-MAML2 fusion were associated with favorable clinicopathologic tumor features and Ki-67 with aggressive clinicopathologic features. Multivariate survival analyses were performed that included the following 10 clinicopathologic factors: age, gender, tumor site, tumor size, nodal metastasis, clinical stage, histologic grade, p27 expression, Ki-67 expression, and CRTC1-MAML2 fusion. For disease-free survival, only p27^Kip1 expression was significant as an independent prognostic factor. For overall survival, p27^Kip1 expression, CRTC1-MAML2 fusion, and tumor size were significant. In each analysis, p27^Kip1 and CRTC1-MAML2 fusion were independent of the clinical stage. Ki-67 expression was not selected in either multivariate analysis.

Conclusions

p27^Kip1 and CRTC1-MAML2 fusion were associated with favorable clinicopathologic tumor features, and both were useful in predicting the overall survival of patients with MEC. For disease-free survival, p27^Kip1 might be the most useful prognostic factor. In contrast, Ki-67 might not be a very powerful prognostic indicator for either survival point.