| Salivary gland tumor is one of the most common neoplastic diseases in the oral and maxillofacial areas.Salivary gland tumor has many types,complex and diverse shapes,and the histological structure of each tumor is crossed,which makes the pathological diagnosis challenging.Tumor genesis is regulated by a variety of factors,and a number of key molecular changes recently identified in various salivary gland tumors have significantly increased our understanding of their molecular pathology and improved the classification and diagnosis of salivary gland tumors.MYB is a proto-oncogene that plays a key role in regulating cell proliferation,differentiation and angiogenesis.According to the latest edition of WHO(2017)Classification of head and neck salivary gland tumors,changes in MYB expression are more common in salivary gland adenoid cystic carcinoma(adenoid cystic carcinoma,ACC)and are involved in NFIB gene fusion.Ataxia telangiectasia mutant Rad3 associated protein(ataxia-telangiectasia mutated and Rad 3 related protein,ATR)is an important regulator of DNA damage repair response mechanism,and is closely related to the stability of the cell genome and the occurrence of tumors.Recent studies have found that ATR is the first actionable target downstream of MYB and is overexpressed in ACC,which can be further studied as personalized targeted therapy.MYB and ATR may become new molecular markers for the diagnosis and precision treatment of salivary gland tumors in the future.ObjectiveThe expression of MYB and ATR in common salivary gland tumors was analyzed.To investigate the relationship between the expression of MYB and ATR in salivary gland tumors and pathological diagnosis,as well as the significance for clinical treatment.Methods1.Screen a total of 233 cases of salivary gland tumors from 2014 to 2020 in the First Affiliated Hospital of Zhenzhou University.Including malignant tumors:87 cases of adenoid cystic carcinoma,45 cases of mucoepidermoid carcinoma,29 cases of acinar cell carcinoma,12 cases of epithelial myoepithelial carcinoma;benign tumors:30 cases of pleomorphic adenoma and 30 cases of basal cell adenoma.2.Detect and analyze the expression of MYB and ATR protein in salivary gland tumors by immunohistochemistry.The relationship between the expression of MYB and ATR protein and clinicopathological diagnosis and the correlation between them.3.Statistical analysis:SPSS25.0 statistical software was used for data analysis and four-grid chi-square test.The results with the minimum theoretical frequency less than 5 were corrected by continuity.When P<0.05,the difference was considered to be statistically significant.Spearman correlation test was used to analyze the correlation between them.Results1.The positive rate of MYB in adenoid cystic carcinoma,mucoepidermoid carcinoma,acinar cell carcinoma,epithelial myoepithelial carcinoma,pleomorphic adenoma,and basal cell adenoma is 94.25%(82/87),13.33%(6/45),3.45%(1/29),0(0/12),3.3%(1/30),16.7%(5/30).The expression of MYB in adenoid cystic carcinoma is higher than that of the other 5 tumors,with specificity,and the difference is statistically significant;there is no difference in expression in other tumors.In adenoid cystic carcinoma,the degree of positive expression was compared according to histological grade,and the results showed that there was no difference between grade Ⅰ and grade Ⅱ,and the difference between grade Ⅰ and Ⅲ,and between grade Ⅱ and Ⅲ was statistically significant(P<0.05),the high expression of MYB in grade I and grade Ⅱ is higher than that in grade Ⅲ.2.The positive rate of ATR in adenoid cystic carcinoma,mucoepidermoid carcinoma,acinar cell carcinoma,epithelial myoepithelial carcinoma,pleomorphic adenoma,and basal cell adenoma is 100%(87/87),77.78%(35/45),86.21%(25/29),83.33%(10/12),76.67%(23/30),90.00%(27/30).The expression of ATR in adenoid cystic carcinoma is higher than other tumors,and the difference is statistically significant.In adenoid cystic carcinoma,according to histological grade,there is no difference in the degree of expression,and the results are not statistically significant.The selected salivary gland tumors were divided into two categories:malignant and benign.The difference was statistically significant(P<0.05).The expression of ATR in malignant tumors was higher than that in benign tumors.3.The correlation between MYB and ATR:Spearman correlation analysis showed that the expression levels of MYB and ATR protein in 87 cases of salivary gland cystic carcinoma showed a high positive correlation(γ=0.597,P<0.001).Conclusion1.This study verified the expression of MYB in salivary gland tumors.At the protein level,MYB is highly specific and sensitive in salivary adenoid cystic carcinoma,and can be used as a powerful indicator for the diagnosis of adenoid cystic carcinoma,and its expression varies in different grades of adenoid cystic carcinoma.It is speculated that there may be gene fusions other than MYB-NFIB in high-grade adenoid cystic carcinoma.2.This study found that ATR is highly expressed in salivary adenoid cystic carcinoma and is positively correlated with MYB.At the same time,the expression of ATR in malignant tumors of salivary glands is higher than that in benign tumors.MYB and ATR may play a role in the development of adenoid cystic carcinoma.ATR inhibitors are likely to cooperate with the existing chemotherapeutics and molecular mechanisms of adenoid cystic carcinoma,and are expected to become new targets for clinical treatment. |
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