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

doi:10.19438/j.cjoms.2024.03.008

Abstract

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

CLC Number:

R739.8

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 Journal of Oral and Maxillofacial Surgery, 2024, 22(3): 249-254.

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