Expression of Galectin-3, nm-23, and Cyclooxygenase-2 Could Potentially Discriminate Between Benign and Malignant Pheochromocytoma

Abstract

Currently, the only reliable indicator of malignancy in pheochromocytoma is the presence of distant metastasis or extensive local invasion; predicting behavior of pheochromocytoma remains challenging. We aimed to correlate the behavior of pheochromocytoma with its expression of nm-23, cyclooxygenase (COX)-2, and galectin-3 (genes used to predict the course of some neoplastic diseases), evaluated immunohistochemically in 55 paraffin blocks of formalin-fixed pheochromocytoma specimens with confirmed behavior. In 3 (7%) of 44 benign and 7 (64%) of 11 malignant pheochromocytomas, there was negative nm-23 expression (P = .000). COX-2 immunoreactivity was positive in 10 (23%) of benign and 9 (82%) of malignant tumors (P = .000). Galectin-3 was expressed in 5 (11%) of benign and 9 (82%) of malignant pheochromocytomas (P = .000). Negative nm-23, along with positive COX-2 or galectin-3, predicted malignancy with 100% specificity. Dual negativity for galectin-3 and COX-2, along with nm-23 positivity, indicated benign behavior with 100% sensitivity. In early pheochromocytoma, evaluation of nm-23, galectin-3, and COX-2 expression could predict the outcome. Larger studies seem necessary to confirm the potential practical value of our findings.

The expressions and clinical significances of tissue and serum galectin-3 in pancreatic carcinoma

“…In digestive system, higher levels of galectin-3 were reported in colon (Arfaoui-Toumi et al 2010), stomach (Okada et al 2006) and liver cancer (Matsuda et al 2008). Galectin-3 has also been detected overexpressed in other tumors (Chiu et al 2010;Szöke et al 2007;Righi et al 2010;Sakaki et al 2010;Abdou et al 2010;Koo and Jung 2011;Choi et al 2010;SaVar et al 2011;Brustmann 2008;Canesin et al 2010). The mechanisms by which galectin-3 brings into its eVects largely remain unknown.…”

Original paper Morphological and immunohistochemical profile of pancreatic neuroendocrine neoplasms

“…It was widely expressed in up to 82% of medullary thyroid carcinoma, showing statistically significant up-regulation in comparison with benign thyroid tissue [113]. In phaeochromocytoma, COX-2 is associated with malignant behaviour and, along with lack of nm-23 and presence of galectin-3, can be applied to predict malignancy [114]. Immunohistochemical expression of the COX-2 protein has been identified in 54-75% of gastroenteropancreatic [115,116] and 65% of pancreatic NENs [117].…”

Phaeochromocytoma: Strategy to Meet the Challenge

“…9 Unfortunately, no reliable clinical, biochemical or histological features distinguish malignant from a benign phaeochromocytoma. 6 Preoperative evaluation and preparation of the patient, intraoperative management and the postoperative care remain an uphill task for the anaesthesiologist. 25-50% of hospital deaths in phaeochromocytoma occur during induction of anaesthesia or during operative procedures for other cause.…”

“…Direct invasion of surrounding tissue or the presence of metastases determine malignancy. 6 Before resection of tumor, preoperative optimization of the patient is mandatory. Still after adequate optimization, intraoperative haemodynamic instability can occur.…”