ABSTRACT
Pleomorphic adenoma is the most common salivary gland neoplasm with a variety of histologic appearances. Due to this diversity, precise preoperative diagnosis through fine needle aspiration cytology is difficult.This study sought to identify the differentially expressed genes in pleomorphic adenoma to aid precise diagnosis and clarify the mechanism of tumorigenesis.Suppressive subtractive hybridization was performed on pleomorphic adenoma tissues and the corresponding normal salivary gland tissues to screen of the differential expression of genes in pleomorphic adenoma.Four known genes (microfibrillar associated protein 4 [MFAP4], dystonin [DST], solute carrier family 35 [SLC35], and potassium channel tetramerization domain containing 15 [KCTD15]) were differentially expressed in the tumors compared with the genes in normal tissues. The expression profiles were further confirmed in 15 pleomorphic adenoma and corresponding normal salivary gland tissues by quantitative real-time reverse transcription-polymerase chain reaction.MFAP4, DST, SLC35, and KCTD15 gene expression could be potential biomarkers of pleomorphic adenoma for precise diagnosis.
Subject(s)
Adenoma, Pleomorphic/metabolism , Salivary Gland Neoplasms/metabolism , Adenoma, Pleomorphic/genetics , Adolescent , Adult , Female , Gene Expression Profiling , Humans , Male , Middle Aged , Salivary Gland Neoplasms/genetics , Young AdultABSTRACT
BACKGROUND AND OBJECTIVES: The incidence of thyroid gland involvement in laryngopharyngeal cancer ranges from 0 to 23%. Therefore, ipsilateral hemithyroidectomy and isthmusectomy are routinely performed with total laryngectomy in many clinics. Hemithyroidectomy causes hypothyroidism in 63% of patients, and if combined with radiotherapy, the incidence increases to 89% of patients. But there is no consensus about using thyroid surgery in the treatment of laryngopharyngeal cancer. The purpose of this study was to identify criteria to use in the decision of whether, in cases of laryngopharyngeal cancer, hemithyroidectomy should be performed with total laryngectomy. MATERIALS AND METHODS: The study group consisted of 28 patients with a mean age of 63.2 years (range 42-77 years). All patients were treated by thyroidectomy with total laryngectomy. We evaluated the incidence of thyroid gland invasion, clinical predisposing factors, pathologic features, and prognosis in cases of laryngopharyngeal cancer. RESULTS: The incidence of thyroid gland invasion was 14% (4/28). Subglottic extension was the only statistically significant factor in thyroid invasion. All cases of laryngopharyngeal cancer that invaded the thyroid gland had vocal cord fixation, anterior commissure invasion, and were advanced stage. The most common mechanism of spread to the thyroid was by direct extension through thyroid cartilage and anterior commissure. While the prognosis of patients with thyroid gland invasion was worse than that of patients with no invasion, the difference was not statistically significant. CONCLUSION: Prophylactic thyroidectomy should be performed in cases of laryngopharyngeal cancer where there is subglottic extension of the tumor.
