Primary pulmonary adenoid cystic carcinoma: A study of clinicopathological features and molecular alterations in twenty-one cases

Abstract

Background

Primary pulmonary adenoid cystic carcinoma (PACC) is a rare malignant tumor. Despite the growing sophistication of ACC research, scant studies have delved into the unique molecular alterations of ACC originating from the lung and the clinical features associations.

Method

Paraffin-embedded specimens of primary PACC tissues pathologically confirmed at the Affiliated Hospital of Qingdao University within the past decade were collected. We comprehensively evaluated the diversity of molecular alterations in PACC using immunohistochemistry (IHC) staining, fluorescence in-situ hybridization (FISH), and next-generation sequencing (NGS). Furthermore, the potential correlations between MYB rearrangement status and clinicopathological features were thoroughly analyzed.

Result

Twenty-one specimens of primary PACC were collected, including eighteen of the typical type and three of the solid-basaloid type. Fifteen (71.4 %) specimens exhibited positive MYB staining and MYB rearrangements. Notably, neither clinicopathological parameters nor MYB rearrangement predicted patients’ overall survival (OS). However, MYB non-rearrangement was associated with a significantly higher rate of lymph node metastasis (75 % vs. 8.3 %, P = 0.027).

Conclusion

Investigating the heterogeneity and multimolecular characteristics of PACC based on different pathological types emerges as a potentially innovative strategy to pinpoint suitable candidates for targeted therapies.