IMMUNOHISTOCHEMICAL EXPRESSION OF HUMAN EPIDERMAL GROWTH FACTOR RECEPTOR-2 (HER-2) IN COMMON SALIVARY GLAND CARCINOMAS

Authors

  • Zunaira Saeed Department of Histopathology, Oral and Maxillofacial Pathology, Armed Forces Institute of Pathology, Rawalpindi
  • Nadeem Zafar Department of Histopathology, Oral and Maxillofacial Pathology, Armed Forces Institute of Pathology, Rawalpindi
  • Nighat Ara Army Medical College (NUMS), Rawalpindi
  • Saadia Muneer Army Medical College (NUMS), Rawalpindi
  • Zainab Asif Department of Histopathology, Oral and Maxillofacial Pathology, Armed Forces Institute of Pathology, Rawalpindi
  • Azka Haroon Department of Histopathology, Oral and Maxillofacial Pathology, Armed Forces Institute of Pathology, Rawalpindi
  • Zahra Saeed CMH Medical College and Institute of Dentistry, (NUMS) Lahore

DOI:

https://doi.org/10.55519/JAMC-02-11647

Keywords:

Keywords: Adenoid cystic carcinoma; Human epidermal growth factor receptor 2; Immunohistochemistry; Mucoepidermoid carcinoma; Salivary duct carcinoma; Salivary gland

Abstract

Background: Carcinomas of the salivary gland are known to be aggressive in nature, making them difficult to manage. The therapeutic options offered include excision of the gland (maxillectomy in cases of palatal tumours), with or without lymph node dissection, proceeded with radiotherapy. Chemotherapy has not produced promising outcomes and has a minimal impact as a therapeutic alternative. Targeted therapy against human epidermal growth factor receptor 2 (HER-2), which is a commonly used treatment modality for their mammary analogues, is not being offered to these patients since scant literature is available showing its usefulness and no promising evidence is present regarding their efficacy and efficiency in such cases. The study aimed to evaluate and quantify the immunohistochemical expression of HER-2 in cases of adenoid cystic carcinoma (AdCC), mucoepidermoid carcinoma (MEC) and salivary duct carcinoma (SDC), which are analogues of similar tumours arising in breast tissue. Methods: A retrospective, cross-sectional study was carried out in the department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, duration of which was six months. A total of 45 cases (15 of each tumour) were taken, and sampled using non-probability convenience technique. The immunohistochemical marker, monoclonal HER-2 antibody (Leica microsystem Germany) was applied on appropriate blocks of all included cases. The staining pattern and intensity were recorded after visualizing the slides under a light microscope. Results: Seven cases of salivary duct carcinoma and a single case of mucoepidermoid carcinoma expressed positivity for HER-2, while no expression could be seen in the case of adenoid cystic carcinoma. A statistically significant difference was seen when HER-2 expression was compared among the aforementioned tumours. Conclusion: The use of targeted therapy against HER-2 is limited to patients of salivary duct carcinoma and a fraction of patients suffering from mucoepidermoid carcinoma.

References

Pakistan - International Agency for Research on Cancer [Internet]. [cited 2023 Jan 11]. Available from: https://gco.iarc.fr/today/data/factsheets/populations/586-pakistan-fact-sheets.pdf

Lin CY, Carneal EE, Lichtensztajn DY, Gomez SL, Clarke CA, Jensen KC, et al. Regional Variability in Percentage of Breast Cancers Reported as Positive for HER2 in California. Am J Clin Pathol 2017;148(3):199–207.

Oh DY, Bang YJ. HER2-targeted therapies, a role beyond breast cancer. Nat Rev Clin Oncol 2019;17(1):33–48.

Son E, Panwar A, Mosher CH, Lydiatt D. Cancers of the Major Salivary Gland. J Oncol Pract 2018;14(2):99–108.

Longo FR, Sabatino G, Aquino NS, Losito M, Cantile F. Ionna and G. Botti. Pleomorphic adenoma of salivary gland and synchronous/metachronous invasive ductal breast cancer: a casual coincidence or a clinical presentation resulting from common genetic events? Int J Clin Exp Pathol 2018;11(3):1712–4.

Pesoli C, Youssef M, Wei S. Salivary Gland Type Carcinomas of the Breast: A Review and Update With Emphasis on Molecular Advances and Differential Diagnosis. Arch Pathol Lab Med 2022;146(11):1319–28.

Hirai H, Tada Y, Nakaguro M, Kawakita D, Sato Y, Shimura T, et al. The clinicopathological significance of the adipophilin and fatty acid synthase expression in salivary duct carcinoma. Virchows Arch 2020 Feb 26;477(2):291–9.

Aquino G, Collina F, Sabatino R, Cerrone M, Longo F, Ionna F, et al. Sex Hormone Receptors in Benign and Malignant Salivary Gland Tumours: Prognostic and Predictive Role. Int J Mol Sci 2018;19(2):399.

El-Naggar AK, Chan JKC, Grandis JR, Takashi Takata, Pieter Johannes Slootweg, Al E. WHO classification of head and neck tumours. Lyon: International Agency for Research On Cancer Iarc; 2017.

Gill S, Mohan A, Aggarwal S, Varshney A. Mucoepidermoid carcinoma of hard palate. Indian J Pathol Microbiol 2018;61(3):397–8.

Cantù G. Adenoid cystic carcinoma. An indolent but aggressive tumour. Part A: from aetiopathogenesis to diagnosis. Acta Otorhinolaryngol Ital 2021;41(3):206–14.

Belulescu IC, Margaritescu C, Dumitrescu CI, DĂguci L, Munteanu C, Margaritescu OC. Adenoid Cystic Carcinoma of Salivary Gland: A Ten-Year Single Institute Experience. Curr Health Sci J 2020;46(1):56–65.

Nakaguro M, Tada Y, Faquin WC, Sadow PM, Wirth LJ, Nagao T. Salivary duct carcinoma: Updates in histology, cytology, molecular biology, and treatment. Cancer Cytopathol 2020;128(10):693–703.

Sample size calculator. [Internet]. WHO.Int. 2023 [cited 2023 Jan 11]. Available from: https://cdn.who.int/media/docs/default-source/ncds/ncd-surveillance/steps/sample-size-calculator.xls?sfvrsn=ee1f4ae8_2

Magaki S, Hojat SA, Wei B, So A, Yong WH. An Introduction to the Performance of Immunohistochemistry. Methods Mol Biol 2019;1897:289–98.

Iqbal B, Buch A. Hormone receptor (ER, PR, HER 2/neu) status and proliferation index marker (Ki-67) in breast cancers: Their onco-pathological correlation, shortcomings and future trends. Med J Dr DY Patil Univ 2016;9(6):674–9.

Cao G, Chen K, Chen B, Xiong M. Positive prognostic value of HER2-HER3 co-expression and p-mTOR in gastric cancer patients. BMC Cancer 2017;17(1):841.

Żurek M, Jasak K, Jaros K, Daniel P, Niemczyk K, Rzepakowska A. Clinico-Epidemiological Analysis of Most Prevalent Parotid Gland Carcinomas in Poland over a 20-Year Period. Int J Environ Res Public Health 2022;19(16):10247.

Asif M, Malik S, Khalid A, Anwar M, Hafeez Ud Din, Khadim MT. Salivary gland tumours, A seven years study at armed forces institute of pathology Rawalpindi, Pakistan. Pak J Pathol 2020;31(3):64–8.

Suzuki T, Kano S, Suzuki M, Yasukawa S, Mizumachi T, Tsushima N, et al. Enhanced Angiogenesis in Salivary Duct Carcinoma Ex-Pleomorphic Adenoma. Front Oncol 2021;10:603717.

Hanna GJ, Bae JE, Lorch JH, Haddad RI, Jo VY, Schoenfeld JD, et al. The Benefits of Adjuvant Trastuzumab for HER-2-Positive Salivary Gland Cancers. Oncologist 2020;25(7):598–608.

Santana T, Pavel A, Martinek P, Steiner P, Grossmann P, Baněčková M, et al. Biomarker immunoprofile and molecular characteristics in salivary duct carcinoma: clinicopathological and prognostic implications. Human Pathol 2019;93:37–47.

Ryu HJ, Koh YW, Yoon SO. The implications of TrkA and MET aberrations in de novo salivary duct carcinoma. Hum Pathol 2018;81:18–25.

Can NT, Lingen MW, Mashek H, McElherne J, Briese R, Fitzpatrick C, et al. Expression of Hormone Receptors and HER-2 in Benign and Malignant Salivary Gland Tumours. Head Neck Pathol2018;12(1):95–104.

Additional Files

Published

2023-04-16