Perineural invasion and Schwann cell-like phenotypic changes in head and neck adenoid cystic carcinoma: A systematic review and meta-analysis.
Weslay Rodrigues da Silva, Jonathan França da Silva Cavalcanti, Júlia Vanessa Bezerra Lima et al.
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In 30 seconds
This systematic review and meta-analysis examined perineural invasion (PNI) and Schwann cell-like phenotypic changes in head and neck adenoid cystic carcinoma (ACC). Across 25 studies, 1437 patients from five countries were evaluated. Immunoexpression of NGF (p < 0.0001), N-CAM (p = 0.0002), S100/S100A4 (p = 0.0163), and TrkA (p = 0.0175) was higher in ACCs with PNI. NGF expression was also higher in cribriform/tubular patterns, while N-CAM expression was higher in solid-pattern tumours. The findings identify markers associated with PNI and tumour patterns, rather than establishing their causal role.
Key findings
- NGF, N-CAM, S100/S100A4, and TrkA immunoexpression was higher in ACCs with PNI (p < 0.0001, p = 0.0002, p = 0.0163, and p = 0.0175, respectively).
- NGF expression was higher in ACCs with cribriform/tubular patterns (p = 0.0237).
- N-CAM expression was higher in ACCs with a solid pattern (p = 0.0379).
Why it matters
PNI is a relevant feature of head and neck ACC, and these pooled findings indicate that several markers of Schwann cell-like phenotypic change are associated with its presence. The results help characterise the immunohistochemical profile reported in PNI and show that marker expression may also vary with tumour pattern. They do not establish whether these changes drive PNI or affect clinical outcomes.
What to keep in mind
The review pooled evidence from 25 studies using varied markers and methods; the abstract does not report pooled effect sizes or clinical outcomes.