唾液腺腺泡细胞癌中NR4A3基因重排及NOR-1蛋白表达分析

doi:10.19438/j.cjoms.2024.03.008

中国口腔颌面外科杂志 ›› 2024, Vol. 22 ›› Issue (3): 249-254.doi: 10.19438/j.cjoms.2024.03.008

唾液腺腺泡细胞癌中NR4A3基因重排及NOR-1蛋白表达分析

王敏^1,*, 钱佳骏^1,*, 薛俊青¹, 顾挺¹, 胡宇华¹, 陈颖^2#, 夏荣辉^1#

1.上海交通大学医学院附属第九人民医院口腔病理科,上海交通大学口腔医学院,国家口腔医学中心, 国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海 200011;
2.上海交通大学医学院附属第九人民医院病理科,上海 200011

收稿日期:2024-02-07 修回日期:2024-03-20 出版日期:2024-05-20 发布日期:2024-06-11
通讯作者: 夏荣辉,E-mail: xrh335@163.com;陈颖,E-mail: 274362790@qq.com。^#共同通信作者
作者简介:王敏（1997-）,女,硕士,E-mail: 1544906595@qq.com;钱佳骏（1991-）,男,学士,E-mail: 283863474@qq.com。^*并列第一作者
基金资助:
上海市卫生健康委员会卫生行业临床研究专项（202340101）

Analysis of NR4A3 gene rearrangement and NOR-1 protein expression in salivary gland acinic cell carcinoma

WANG Min¹, QIAN Jia-jun¹, XUE Jun-qing¹, GU Ting¹, HU Yu-hua¹, CHEN Ying², XIA Rong-hui¹

1. Department of Oral Pathology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology. Shanghai 200011;
2. Department of Pathology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China

Received:2024-02-07 Revised:2024-03-20 Online:2024-05-20 Published:2024-06-11

摘要/Abstract

摘要： 目的：探讨NR4A3基因重排和NOR-1蛋白表达在唾液腺腺泡细胞癌中的表达及在鉴别诊断中的价值。方法：收集2020年5月—2024年1月于上海交通大学医学院附属第九人民医院口腔病理科诊断的唾液腺癌119例,包括腺泡细胞癌（acinic cell carcinoma, AciCC）63例,黏液表皮样癌（mucoepidermoid carcinoma, MEC）31例,分泌性癌（secretory carcinoma, SC）25例。分别使用荧光原位杂交和免疫组织化学染色检测NR4A3基因重排和NOR-1蛋白表达情况,采用SPSS 18.0软件包对数据进行统计学分析。结果：AciCC主要发生于大唾液腺。与MEC和SC相比,AciCC好发于女性（P=0.006）。NR4A3基因重排在AciCC、MEC和SC中的阳性率分别为76.2%（48/63）、0%（0/10）和0%（0/7）,NOR-1蛋白表达在AciCC、MEC和SC中的阳性率分别为92.1%（58/63）、9.7%（3/31）和0%（0/25）,差异具有统计学意义（P<0.001）。单独使用NR4A3基因重排诊断AciCC时,灵敏度和特异度分别为76.2%和100%。单独使用NOR-1蛋白表达诊断AciCC时,灵敏度和特异度分别为92.1%和94.6%。联合使用NR4A3基因重排和NOR-1蛋白表达诊断AciCC时,灵敏度和特异度分别为96.8%和94.6%,曲线下面积为0.896,诊断价值最优。结论：AciCC好发于女性,主要发病部位为大唾液腺。NR4A3基因重排仅见于AciCC中,在诊断工作中具有100%的特异性,但敏感性较低。NOR-1蛋白表达检测具有很好的灵敏度和特异度,可作为鉴别AciCC、MEC和SC的初筛和替代方法。联合使用NR4A3基因重排和NOR-1蛋白表达检测具有最优的诊断价值。

关键词: 腺泡细胞癌, 唾液腺, NR4A3, 基因重排, NOR-1, 蛋白表达

Abstract: PURPOSE: To explore NR4A3 gene rearrangement and NOR-1 protein expression in salivary gland acinic cell carcinoma and their value in differential diagnosis. METHODS: A total of 119 cases of salivary carcinoma diagnosed in the Department of Oral Pathology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from May 2020 to January 2024 were collected, including 63 cases of acinar cell carcinoma (AciCC), 31 cases of mucoepidermoid carcinoma (MEC), and 25 cases of secretory carcinoma (SC). Fluorescence in situ hybridization and immunohistochemistry were used to detect NR4A3 gene rearrangement and NOR-1 protein expression, respectively. SPSS 18.0 software package was used for data analysis. RESULTS: AciCC mainly occurred in the major salivary glands. Compared with MEC and SC, AciCC showed significant predominance for female patients(P=0.006). The positive rates of NR4A3 gene rearrangement in AciCC, MEC, and SC were 76.2%(48/63), 0%(0/10), and 0%(0/7), respectively. The positive rates of NOR-1 protein expression in AciCC, MEC, and SC were 92.1%(58/63), 9.7%(3/31), and 0%(0/25), respectively. The results showed significant difference (P<0.001). When using NR4A3 gene rearrangement alone to diagnose AciCC, the sensitivity and specificity were 76.2% and 100%, respectively. When using NOR-1 protein expression alone to diagnose AciCC, the sensitivity and specificity were 92.1% and 94.6%, respectively. When using NR4A3 gene rearrangement and NOR-1 protein expression in combination to diagnose AciCC, the sensitivity and specificity were 96.8% and 94.6%, respectively, and the area under the curve was 0.896, indicating the optimal diagnostic value. CONCLUSIONS: AciCC is more common in female patients, with the main involved site being the major salivary gland. NR4A3 gene rearrangement is only presented in AciCC and the specificity has reached 100%, while the sensitivity is relatively low. NOR-1 protein expression detection shows good sensitivity and specificity, and can be used as a preliminary screening and alternative method for distinguishing AciCC from MEC and SC. The combination of NR4A3 gene rearrangement and NOR-1 protein expression detection has the optimal diagnostic value.

Key words: Acinic cell carcinoma, Salivary gland, NR4A3, Gene rearrangement, NOR-1, Protein expression

中图分类号:

R739.8

王敏, 钱佳骏, 薛俊青, 顾挺, 胡宇华, 陈颖, 夏荣辉. 唾液腺腺泡细胞癌中NR4A3基因重排及NOR-1蛋白表达分析[J]. 中国口腔颌面外科杂志, 2024, 22(3): 249-254.

WANG Min, QIAN Jia-jun, XUE Jun-qing, GU Ting, HU Yu-hua, CHEN Ying, XIA Rong-hui. Analysis of NR4A3 gene rearrangement and NOR-1 protein expression in salivary gland acinic cell carcinoma[J]. China J Oral Maxillofac Surg, 2024, 22(3): 249-254.

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唾液腺腺泡细胞癌中NR4A3基因重排及NOR-1蛋白表达分析

Analysis of NR4A3 gene rearrangement and NOR-1 protein expression in salivary gland acinic cell carcinoma

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