BSND蛋白检测在唾液腺嗜酸细胞性肿瘤鉴别诊断初筛中的价值评估

doi:10.19438/j.cjoms.2026.04.006

摘要/Abstract

摘要： 目的：评估BSND（Barttin CLCNK type accessory subunit beta）蛋白作为唾液腺嗜酸细胞性肿瘤鉴别诊断初筛指标的可行性,初步探索BSND表达与其基因突变的关联。方法：收集136例唾液腺肿瘤组织样本,采用免疫组织化学法检测BSND蛋白表达,评估其在嗜酸细胞瘤、Warthin瘤、嗜酸细胞型黏液表皮样癌（mucoepidermoid carcinoma,MEC）及Warthin瘤样型MEC等肿瘤中的表达差异。通过受试者工作特征（receiver operating characteristic,ROC）曲线分析BSND的鉴别诊断性能,选取其中 58 例样本开展二代测序（next-generation sequencing,NGS）,检测 BSND 基因突变情况。结果：BSND在嗜酸细胞瘤中阳性表达率为100%（20/20）,在Warthin瘤中为93.75%（15/16）,而在其他嗜酸细胞亚型唾液腺肿瘤中的阳性率仅为2%（2/100）。在鉴别伴嗜酸细胞分化的唾液腺良、恶性肿瘤时,BSND的特异度为98.8%,曲线下面积（area under the curve,AUC）为0.792。在嗜酸细胞瘤与嗜酸细胞型MEC的鉴别中,灵敏度与特异度分别为95.0%与88.2%,AUC为0.992。在Warthin瘤与Warthin瘤样型MEC的鉴别中,灵敏度与特异度分别为87.5%与90.0%,AUC为0.963。NGS检测显示,BSND蛋白表达与基因突变无显著相关性。ROC分析进一步提示,以2.5%作为Warthin瘤的阳性诊断阈值、35%作为嗜酸细胞瘤的阳性诊断阈值具有较高的诊断效能。结论：BSND可作为鉴别唾液腺嗜酸细胞瘤与嗜酸细胞型MEC、Warthin瘤与Warthin瘤样型MEC的蛋白标志物,是嗜酸细胞性肿瘤鉴别诊断中有用的初筛指标。基因突变并非唾液腺肿瘤中BSND高表达的分子机制。

关键词: 嗜酸细胞瘤, Warthin瘤, 黏液表皮样癌, 唾液腺, BSND, 免疫组织化学, 鉴别诊断

Abstract: PURPOSE: To evaluate the feasibility of Barttin CLCNK type accessory subunit beta (BSND) protein as a preliminary screening marker for the differential diagnosis of salivary gland oncocytic tumors, and to preliminarily explore the association between BSND expression and gene mutations. METHODS: A total of 136 salivary gland tumor tissue samples were collected. Immunohistochemistry was performed to detect BSND protein expression and to assess its differential expression among tumors, including oncocytoma, Warthin tumor, oncocytic mucoepidermoid carcinoma (MEC), and Warthin-like MEC. The diagnostic performance of BSND was evaluated using receiver operating characteristic (ROC) curve analysis. Next-generation sequencing (NGS) was conducted on 58 samples to detect BSND gene mutations. RESULTS: The positive rate of BSND expression was 100% (20/20) in oncocytoma and 93.75% (15/16) in Warthin tumor, whereas it was only 2% (2/100) in other salivary gland tumors with oncocytic subtypes. In distinguishing benign from malignant salivary gland tumors with oncocytic differentiation, BSND demonstrated a specificity of 98.8% and an area under the curve (AUC) of 0.792. For differentiating oncocytoma from oncocytic MEC, the sensitivity and specificity were 95.0% and 88.2%, respectively, with an AUC of 0.992. For differentiating Warthin tumor from Warthin-like MEC, the sensitivity and specificity were 87.5% and 90.0%, respectively, with an AUC of 0.963. NGS results revealed no significant correlation between BSND protein expression and gene mutations. ROC analysis further suggested that a diagnostic threshold of 2.5% for Warthin tumor and 35% for oncocytoma yielded high diagnostic efficacy. CONCLUSIONS: BSND can serve as a protein marker for differentiating salivary gland oncocytoma from oncocytic MEC, and Warthin tumor from Warthin-like MEC. It represents a useful preliminary screening indicator for the differential diagnosis of oncocytic tumors. Gene mutation is not the molecular mechanism underlying BSND overexpression in salivary gland tumors.

Key words: Oncocytoma, Warthin tumor, Mucoepidermoid carcinoma, Salivary gland, BSND, Immunohistochemistry, Differential diagnosis

中图分类号:

R739.8

冷楠楠, 王敏, 孙晶晶, 顾挺, 胡宇华, 夏荣辉, 张春叶, 李江, 田臻. BSND蛋白检测在唾液腺嗜酸细胞性肿瘤鉴别诊断初筛中的价值评估[J]. 中国口腔颌面外科杂志, 2026, 24(4): 353-360.

Leng Nannan, Wang Min, Sun Jingjing, Gu Ting, Hu Yuhua, Xia Ronghui, Zhang Chunye, Li Jiang, Tian Zhen. Evaluation of the diagnostic value of BSND protein for preliminary screening of salivary gland oncocytic tumors[J]. China J Oral Maxillofac Surg, 2026, 24(4): 353-360.

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