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Laryngoscope. 2015 Sep;125(9):E292-9. doi: 10.1002/lary.25356. Epub 2015 May 11.

MYB rearrangement and clinicopathologic characteristics in head and neck adenoid cystic carcinoma.

Author information

1
Department of Otolaryngology-Head and Neck Surgery.
2
Department of Pathology, Johns Hopkins University School of Medicine.
3
Milton J. Dance Jr. Head and Neck Center, Greater Baltimore Medical Center.
4
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, U.S.A.

Abstract

OBJECTIVES:

Salivary gland adenoid cystic carcinoma (ACC) is rare, aggressive, and challenging to treat. Many ACCs have a t(6;9) chromosomal translocation resulting in a MYB-NFIB fusion gene, but the clinical significance is unclear. The purposes of this study were to describe the clinicopathologic factors impacting survival and to determine the prevalence and clinical significance of MYB-NFIB fusion.

STUDY DESIGN:

Case series.

METHODS:

Medical records of patients treated for ACC of the head and neck from 1974 to 2011 were reviewed and clinicopathologic data recorded. Fluorescence in situ hybridization (FISH) was used to detect MYB rearrangement in archival tumor tissue as a marker of MYB-NFIB fusion.

RESULTS:

One hundred fifty-eight patients were included, with median follow-up 75.1 months. Median overall survival was 171.5 months (95% confidence interval [CI] = 131.9-191.6), and median disease-free survival was 112.0 months (95% CI = 88.7-180.4). Advanced stage was associated with decreased overall survival (adjusted ptrend  < 0.001), and positive margins were associated with decreased disease-free survival (adjusted hazard ratio [aHR] = 8.80, 95% CI = 1.25-62.12, P = 0.029). Ninety-one tumors were evaluable using FISH, and 59 (65%) had evidence of a MYB-NFIB fusion. MYB-NFIB positive tumors were more likely than MYB-NFIB negative tumors to originate in minor salivary glands (adjusted prevalence ratios = 1.51, 95% CI = 1.07-2.12, P = 0.019). MYB-NFIB tumor status was not significantly associated with disease-free or overall survival (hazard ratio [HR] = 1.53, 95% CI = 0.77-3.02, P = 0.22 and HR = 0.91, 95% CI = 0.46-1.83, P = 0.80, respectively, for MYB-NFIB positive compared with MYB-NFIB negative tumors).

CONCLUSION:

Stage and margin status were important prognostic factors for ACC. Tumors with evidence of MYB-NFIB fusion were more likely to originate in minor salivary glands, but MYB-NFIB tumor status was not significantly associated with prognosis.

LEVEL OF EVIDENCE:

4.

KEYWORDS:

Adenoid cystic carcinoma; MYB; MYB-NFIB fusion gene; disease-free survival; minor salivary glands; salivary gland neoplasms; survival

PMID:
25963073
PMCID:
PMC4546892
DOI:
10.1002/lary.25356
[Indexed for MEDLINE]
Free PMC Article

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