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Javaheripour A, Saatloo MV, Vahed N, Gavgani LF, Kouhsoltani M. Evaluation of HER2/neu expression in different types of salivary gland tumors: a systematic review and meta-analysis. J Med Life 2022; 15:595-600. [PMID: 35815077 PMCID: PMC9262268 DOI: 10.25122/jml-2021-0394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 01/24/2022] [Indexed: 11/17/2022] Open
Abstract
This study is a systematic review and meta-analysis to assess the overexpression rate of HER2 in patients with salivary gland tumors. We included peer-reviewed publications from 1995 to 2020, indexed in medical databases, using search terms such as "human epidermal growth factor receptor 2 (HER2)" and "salivary gland tumors", and extracted relevant data. The extracted data were analyzed with RevMan 5.3 software. Intra-and intergroup post hoc analyses of outcome variables were performed using t-tests, and the rates of HER2 positivity among studies were evaluated. 80 studies were included in the analysis. The positive rates of HER2 ranged from 3.3% to 84.0% and 1% to 9% in malignant and benign subtypes, respectively. The highest HER2 overexpression rate among malignant tumors was in salivary ductal carcinomas (SDC), with a 45% positive rate (CI 95%: 21.9-70.3%). Mucoepidermoid carcinoma (MEC) had the highest positive rate of 84% (CI 95%: 74.1-90.0%). Among benign salivary gland tumors, the highest rate was found in myoepithelioma, with a positive rate of 9% (CI 95%: 1.7-33.6%). The highest rate of HER2 overexpression is present in malignant subtypes of salivary gland tumors, more specifically in salivary ductal carcinoma, mucoepidermoid carcinomas, salivary duct carcinoma in situ, and carcinoma ex pleomorphic adenoma.
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Affiliation(s)
- Aylar Javaheripour
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maedeh Vakili Saatloo
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, South Carolina, United States of America
| | - Nafiseh Vahed
- Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leili Faraji Gavgani
- Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Kouhsoltani
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran,Corresponding Author: Maryam Kouhsoltani, Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Tabriz University of Medical sciences, Tabriz, Iran. E-mail:
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Meng Y, Yang P, Ma L. Prognostic and clinical implications of c-erbB-2 expression in patients with oral cancer: A meta-analysis. Medicine (Baltimore) 2020; 99:e20575. [PMID: 32502026 PMCID: PMC7306320 DOI: 10.1097/md.0000000000020575] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Recently, many studies have suggested that the aberrant expression of c-erbB-2 existed in oral cancer (OC) patients and had a correlation with poor clinical features across OC patients. Considering the inconsistent results among published articles, we performed the meta-analysis to assess the prognostic and clinical effect of c-erbB-2 expression on oral tumors. METHODS Web of Science, Embase, and PubMed were retrieved to acquire relevant publications based on selection criteria, up to February 8, 2020. Pooled odds ratios (OR) and hazard ratios (HR) with 95% confidence intervals (CI) were applied to evaluate the associations between c-erbB-2 expression and overall survival (OS), disease specific survival, disease-free survival as well as clinicopathology of OC. RESULTS A total of 30 literatures with 1499 patients for survival of OC were enrolled in this meta-analysis. The results indicated that c-erbB-2 overexpression was significantly associated with poor OS (HR = 2.40, 95% CI = 1.53-2.55, P < .05), disease specific survival (HR = 2.60, 95% CI = 1.11-4.10, P < .05) and disease-free survival (HR = 2.22, 95% CI = 1.46-2.99, P < .05). Subgroup analysis based on race showed that the significant prognostic value of c-erbB-2 in OC was found both in Caucasians and Asians (OS of Caucasians, HR = 2.90, 95% CI = 1.50-4.31, P < .05; OS of Asians, HR = 1.90, 95% CI = 1.27-2.53, P < .05). Moreover, OC patients with enhanced c-erbB-2 expression were prone to male (OR = 1.97, 95% CI = 1.22-3.19, P < .05), advanced TNM stage (OR = 1.84, 95% CI = 1.17-2.88, P < .05), lymph node metastasis (OR = 2.23, 95% CI = 1.47-3.36, P < .05) and advanced grade (OR = 1.98, 95% CI = 1.30-3.01, P < .05), but not associated with distant metastasis (OR = 1.65, 95% CI = 0.98-3.04, P > .05). CONCLUSIONS c-erbB-2 may be a potential indicator in the prediction of prognosis and clinicopathological features in OC patients.
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Kim Y, Lee SJ, Lee JY, Lee SH, Sun JM, Park K, An HJ, Cho JY, Kang EJ, Lee HY, Kim J, Keam B, Kim HR, Lee KE, Choi MY, Lee KH, Ahn MJ. Clinical trial of nintedanib in patients with recurrent or metastatic salivary gland cancer of the head and neck: A multicenter phase 2 study (Korean Cancer Study Group HN14-01). Cancer 2017; 123:1958-1964. [PMID: 28102887 DOI: 10.1002/cncr.30537] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 11/18/2016] [Accepted: 11/21/2016] [Indexed: 01/17/2023]
Abstract
BACKGROUND Salivary gland cancers (SGCs) are uncommon and account for less than 5% of all head and neck cancers, but they are histologically heterogeneous. No specific therapy, including targeted agents, has consistently improved clinical outcomes in recurrent/metastatic SGC. Recent studies suggest that vascular endothelial growth factor receptor (VEGFR) and platelet-derived growth factor receptor (PDGFR) play important roles in SGC. Nintedanib is a potent small-molecule, triple-receptor tyrosine kinase inhibitor (VEGFR1, VEGFR2, and VEGFR3; fibroblast growth factor receptor 1 [FGFR1], FGFR2, and FGFR3; and PDGFRα and PDGFRß). This study sought to determine the antitumor activity of nintedanib in patients with recurrent or metastatic SGC. METHODS This open-label, multicenter, phase 2, single-arm study was conducted at 11 hospitals in South Korea. Patients with pathologically confirmed recurrent and/or metastatic SGC for whom at least 1 line of systemic chemotherapy had failed were enrolled. Nintedanib was given orally at 200 mg twice a day until disease progression or unacceptable toxicity. The primary endpoint was the response rate. The secondary endpoints were progression-free survival, overall survival, toxicity, and the disease-control rate. The Simon 2-stage minimax design was used. RESULTS The median age of the patients was 54 years, 60% were female, and 95% had an Eastern Cooperative Oncology Group performance status of 0 or 1. The majority of the patients had adenoid cystic carcinoma (65%), and 40% received at least 2 prior rounds of chemotherapy. After 20 patients were enrolled, the study was stopped because no responders were observed at stage I. There were no partial responses, but the disease-control rate was 75% (15 of 20). The median duration of stable disease was 8.2 months (range, 1.76-12.36 months). At the time of the data cutoff, with a median follow-up of 9.5 months, the median overall survival had not been reached, and the progression-free survival rate at 6 months was 60% (95% confidence interval, 0.34-0.79). Grade 3 adverse events included liver enzyme elevation (25%) and nausea/vomiting (5%). Four patients who required a dose reduction because of a grade 3 liver enzyme elevation showed no further grade 3 events. CONCLUSIONS Single-agent nintedanib did not yield a partial response but did achieve a 75% disease-control rate with long-term stabilization in SGC patients. Because of the high rate and long duration of disease control with a good safety profile, further investigation is warranted. Cancer 2017;123:1958-1964. © 2017 American Cancer Society.
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Affiliation(s)
- Youjin Kim
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Su Jin Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Yun Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Se-Hoon Lee
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong-Mu Sun
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Keunchil Park
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ho Jung An
- St Vincent's Hospital, Catholic University, Suwon, South Korea
| | - Jae Yong Cho
- Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Joo Kang
- Guro Hospital, Korea University Medical Center, Seoul, Korea
| | - Ha-Young Lee
- Dongnam Institute of Radiological and Medical Sciences, Busan, Korea
| | - Jinsoo Kim
- Boramae Medical Center, Seoul National University Hospital, Seoul, Korea
| | - Bhumsuk Keam
- Seoul National University Hospital, Seoul, Korea
| | - Hye Ryun Kim
- Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | | | | | - Ki Hyeong Lee
- Chungbuk National University Hospital, Cheongju, Korea
| | - Myung-Ju Ahn
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Chintakuntlawar AV, Okuno SH, Price KA. Systemic therapy for recurrent or metastatic salivary gland malignancies. CANCERS OF THE HEAD & NECK 2016; 1:11. [PMID: 31093341 PMCID: PMC6460835 DOI: 10.1186/s41199-016-0011-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 08/09/2016] [Indexed: 11/10/2022]
Abstract
Salivary gland carcinomas are notoriously resistant to therapy and no standard of care exists. Due to the rarity of these malignancies, various histologies, and wide ranging clinical behavior it has been difficult to standardize systemic therapy. We have reviewed clinical prospective studies in the last 15 years with salivary gland malignancies involving cytotoxic chemotherapy and biologic agents including targeted therapies such as anti-HER-2, anti-EGFR therapies, and therapies directed at c-kit. Although the results of most trials are modest at best, there has been an increase in studies for salivary cancer in recent years and there are several promising treatment approaches in evolution. Every effort should be made to treat salivary gland malignancies under a clinical protocol and/or at a large multidisciplinary practice with clinicians experienced in treating these malignancies.
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Affiliation(s)
- Ashish V. Chintakuntlawar
- Division of Medical Oncology, Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 USA
| | - Scott H. Okuno
- Division of Medical Oncology, Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 USA
| | - Katharine A. Price
- Division of Medical Oncology, Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 USA
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Martin V, Cappuzzo F, Mazzucchelli L, Frattini M. HER2 in solid tumors: more than 10 years under the microscope; where are we now? Future Oncol 2015; 10:1469-86. [PMID: 25052756 DOI: 10.2217/fon.14.19] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
HER2 is a well-recognized mediator of the cancerogenic process. It is dysregulated in a wide range of solid tumors, mainly via protein overexpression and/or gene amplification, thus making HER2 an attractive target for tailored treatment. The anti-HER2 therapy trastuzumab was approved for the treatment of HER2-positive metastatic breast cancer patients more than 10 years ago. Since then, trastuzumab and other HER2-inhibitors have been entered into clinical practice for the treatment of breast cancer and, more recently, have been approved to treat HER2-positive metastatic gastric cancers. Currently, HER2-targeted therapies are under evaluation in other tumor types. Due to the relevance of proper patient selection, the accurate assessment of HER2 status is fundamental. This review will discuss the established knowledge and novel insights into the HER2 story, mainly focusing on breast, gastric and colorectal cancers, as well as providing a brief overview of salivary gland, bladder, ovarian and lung tumors.
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Affiliation(s)
- Vittoria Martin
- Institute of Pathology, Via in Selva 24, 6600 Locarno, Switzerland
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Alotaibi AM, Alqarni MA, Alnobi A, Tarakji B. Human Epidermal Growth Factor Receptor 2 (HER2/neu) in Salivary Gland Carcinomas: A Review of Literature. J Clin Diagn Res 2015; 9:ZE04-8. [PMID: 25859537 PMCID: PMC4378820 DOI: 10.7860/jcdr/2015/11289.5572] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 12/24/2014] [Indexed: 11/24/2022]
Abstract
The aim of our study is to assess the relation of human epidermal growth factor receptor 2 or HER2/neu with the development of salivary gland carcinomas and use of Herceptin in the treatment of these cancers. A literature search was conducted using MEDLINE accessed via the National Library of Medicine PubMed interface searching for articles from 1994 up to 2014 relating to the existence of HER-2 protein and gene in salivary gland carcinomas and HER2/neu targeted therapy, written in English language. Almost all the studies in literature reported a frequent over expression and amplification of HER2/nue in salivary duct carcinomas (SDC) compared to other salivary gland cancers. Herceptin given as a monotherapy was not effective. The data on Herceptin combined chemotherapy are potentially promising but inadequate to evaluate drug activity, as patients also received a variety of cytotoxic agents. Therefore, Herceptin contribution to tumour response outcomes could not be precisely determined and the total number of cases is not sufficient. It is recommended that further work involves a large series of HER2/neu positive salivary gland cancers (randomized control trial) treated with chemotherapy with and without Herceptin. This might need multi-institutional cooperation.
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Affiliation(s)
- Abdullah Mislat Alotaibi
- Undergraduate Student, Department of Oral Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing, Riyadh, Saudi Arabia
| | - Mohammed Ali Alqarni
- Undergraduate Student, Department of Oral Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing, Riyadh, Saudi Arabia
| | - Abdelrahman Alnobi
- Undergraduate Student, Department of Oral Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing, Riyadh, Saudi Arabia
| | - Bassel Tarakji
- Head of Department, Department of Oral Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing, Riyadh, Saudi Arabia
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Lagha A, Chraiet N, Ayadi M, Krimi S, Allani B, Rifi H, Raies H, Mezlini A. Systemic therapy in the management of metastatic or advanced salivary gland cancers. Oral Oncol 2012; 48:948-957. [PMID: 22698431 DOI: 10.1016/j.oraloncology.2012.05.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 05/02/2012] [Indexed: 11/17/2022]
Abstract
Salivary gland cancers are very rare tumors. They are characterized by a histologic heterogeneity and a poor outcome. According to this rarity, few prospective data are available to date. No standard recommendations could be held for the use of systemic therapy in these tumors. Several case reports and small studies have investigated the contribution of different agents of chemotherapy. With the extension of molecular biology approach in oncology several signaling pathways have been discovered in different cancers including salivary gland cancers; thus a number of targeted therapies have been investigated. This paper reviewed exhaustively the studies investigating the role of systemic therapies (chemotherapy, targeted therapy, hormone therapy) in salivary gland cancers.
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Affiliation(s)
- Aymen Lagha
- Department of Medical Oncology, Salah Azaiez Institute, Tunis, Tunisia.
| | - Nesrine Chraiet
- Department of Medical Oncology, Salah Azaiez Institute, Tunis, Tunisia
| | - Mouna Ayadi
- Department of Medical Oncology, Salah Azaiez Institute, Tunis, Tunisia
| | - Sarra Krimi
- Department of Medical Oncology, Salah Azaiez Institute, Tunis, Tunisia
| | - Bassem Allani
- Department of Medical Oncology, Salah Azaiez Institute, Tunis, Tunisia
| | - Hela Rifi
- Department of Medical Oncology, Salah Azaiez Institute, Tunis, Tunisia
| | - Henda Raies
- Department of Medical Oncology, Salah Azaiez Institute, Tunis, Tunisia
| | - Amel Mezlini
- Department of Medical Oncology, Salah Azaiez Institute, Tunis, Tunisia
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Systemic therapy in the management of metastatic or advanced salivary gland cancers. HEAD & NECK ONCOLOGY 2012; 4:19. [PMID: 22558945 PMCID: PMC3414773 DOI: 10.1186/1758-3284-4-19] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 05/04/2012] [Indexed: 11/10/2022]
Abstract
Salivary gland cancers are very rare tumors. They are characterized by a histologic heterogeneity and a poor outcome. According to this rarity, few prospective data are available to date. No standard recommendations could be held for the use of systemic therapy in these tumors. Several case reports and small studies have investigated the contribution of different agents of chemotherapy. With the extension of molecular biology approach in oncology several signaling pathways have been discovered in different cancers including salivary gland cancers; thus a number of targeted therapies have been investigated. This paper reviewed exhaustively the studies investigating the role of systemic therapies (chemotherapy, targeted therapy, hormone therapy) in salivary gland cancers.
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Novel therapeutic strategies for malignant salivary gland tumors: lessons learned from breast cancer. Int J Otolaryngol 2011; 2011:187623. [PMID: 22164169 PMCID: PMC3227505 DOI: 10.1155/2011/187623] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Revised: 08/26/2011] [Accepted: 08/27/2011] [Indexed: 01/29/2023] Open
Abstract
Malignant salivary gland tumors (MSGTs) account for 2–6% of all head and neck cancers. Despite the rarity, MSGTs have been of great interest due to a wide variety of pathological features and high metastasis rates resulting in poor prognosis. Surgical resection followed by radiation therapy represents the main treatment of this malignancy. Adjuvant therapy is reserved for the management of local recurrence, no longer amenable to additional local therapy, and for metastasis. Based on the studies from other types of tumors, particularly breast cancer, the expression and function of sex steroid hormone receptors in cancer have been extensively studied and applied to diagnosis and treatment. Although a number of studies in MSGTs have been published, the rationale for hormone therapy is still controversial due to the disparate results and insufficient number of cases. However, some recent reports have demonstrated that certain salivary gland neoplasms are similar to breast cancer, not only in terms of the pathological features, but also at the molecular level. Here, we shed light on the biological similarity between MSGTs and certain types of breast cancer, and describe the potential use of hormone and additional therapies for MSGTs.
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THERKILDSEN MARIANNEHAMILTON. Epithelial salivary gland tumours. An immunohistological and prognostic investigation. APMIS 2011. [DOI: 10.1111/j.1600-0463.1999.tb05379.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Triantafillidou K, Iordanidis F, Psomaderis K, Kalimeras E. Acinic cell carcinoma of minor salivary glands: a clinical and immunohistochemical study. J Oral Maxillofac Surg 2010; 68:2489-96. [PMID: 20678839 DOI: 10.1016/j.joms.2009.09.065] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2009] [Revised: 07/22/2009] [Accepted: 09/16/2009] [Indexed: 10/19/2022]
Abstract
PURPOSE Acinic cell carcinoma is a rare malignant tumor of salivary glands. The purpose of this study is to evaluate the clinical outcome of acinic cell carcinoma in a group of 11 patients, who were treated in our clinic, and to discuss the management as well as the immunohistochemical features and prognosis of this carcinoma. MATERIALS AND METHODS The study included 11 patients with acinic cell carcinoma of the minor salivary glands who were treated in our clinic. The patients were 7 women and 4 men. The patients' age ranged from 46 to 83 years. The distribution of the primary sites was buccal mucosa (4) maxilla/maxillary sinus, etc, (2), hard palate (1), junction of soft/hard palate (1), lower lip (1), labio marginal sulcus (1), and vestibular sulcus and mandible (1). All patients were treated with surgery. Adjuvant radiotherapy was used in 3 patients. Immunohistochemical assay of expression of Ki-67, p53, EGFR, and c-erbB-2/neu markers was performed on specimens of all tumors. RESULTS The mean follow-up range was 2 to 15 years. Of the 11 patients, 7 were alive (2, 3, 4, 5, and 15 years after the initial therapy). Two patients died of another cause free of the disease 9 and 10 years after the initial treatment, and 2 patients died of the disease (local recurrence, distant metastases 2 and 3 years later). Overexpression of immunohistochemical markers was evident for tumors with widespread metastases. CONCLUSIONS Acinic cell carcinoma is a rare malignant tumor of the salivary glands, characterized by an indolent clinical course with the potential for both local recurrence and distant metastases. The immunohistochemical analysis of proliferation markers provides additional prognostic information for this tumor.
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Affiliation(s)
- Katherine Triantafillidou
- Department of Oral and Maxillofacial Surgery, General Hospital G. Papanikolaou, Thessaloniki, Greece.
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Liu X, Zhang Y, Ren W, Cao T, Zhu Y. RNAi knockdown of C-erbB2 expression inhibits salivary gland adenoid cystic carcinoma SACC-83 cell growth in vitro. J Biomed Res 2010; 24:215-22. [PMID: 23554633 PMCID: PMC3596557 DOI: 10.1016/s1674-8301(10)60031-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2009] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To knockdown the C-erbB2 gene in salivary gland adenoid cystic carcinoma SACC-83 cells using RNA interference, and determine the effect of silencing C-erbB2 on cell proliferation. METHODS C-erbB2-siRNA was transfected into SACC-83 cells. RT-PCR and immunohistochemistry were used to detect C-erbB2 expression in SACC-83 cells. Cell proliferation was measured by the MTT assay and gene knockdown was achieved by RNA interference. Apoptosis was analyzed by flow cytometry. RESULTS Compared with the control, C-erbB2 mRNA expression was decreased in the C-erbB2-siRNA transfection group, and immunohistochemical analysis indicated that C-erbB2 protein expression was decreased. After C-erbB2-siRNA was transfected for 48 h, absorbance at 570 nm (MTT) was 0.185±0.021 compared with 0.354±0.034, 0.299±0.053, and 0.314±0.049 in the blank control, liposome control and negative control siRNA groups, respectively. The differences were statistically significant (P < 0.05) between the C-erbB2-siRNA group and the control groups. Following the C-erbB2 knockdown, the percentage of apoptotic cells was 5.63% compared with 2.04%, 2.85%, and 2.98% in the three control groups, respectively. Proliferation of SACC-83 cells was inhibited, and early apoptotic cells were increased. CONCLUSION RNA interference can effectively silence C-erbB2 gene expression and inhibit growth of SACC-83 cells, which indicates the potential of targeting this gene as a novel gene therapy approach for the treatment of salivary gland adenoid cystic carcinoma.
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Affiliation(s)
- Xiaohua Liu
- Department of Oral and Maxillofacial Surgery, Xi'an Jiaotong University Stomatology Hospital, Xi'an 710004, Shaanxi Province, China
| | - Yincheng Zhang
- Department of Oral and Maxillofacial Surgery, Xi'an Jiaotong University Stomatology Hospital, Xi'an 710004, Shaanxi Province, China
- *Corresponding author E-mail address:
| | - Wenhao Ren
- Department of Oral and Maxillofacial Surgery, Xi'an Jiaotong University Stomatology Hospital, Xi'an 710004, Shaanxi Province, China
| | - Tengteng Cao
- Department of Oral and Maxillofacial Surgery, Xi'an Jiaotong University Stomatology Hospital, Xi'an 710004, Shaanxi Province, China
| | - Yongjin Zhu
- Department of Center Research, Xi'an Jiaotong University Stomatology Hospital, Xi'an 710004, Shaanxi Province, China
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pcDNA3.1(-)-mediated ribozyme targeting of HER-2 suppresses breast cancer tumor growth. Mol Biol Rep 2009; 37:1597-604. [PMID: 19444644 DOI: 10.1007/s11033-009-9569-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2009] [Accepted: 05/01/2009] [Indexed: 01/11/2023]
Abstract
The HER-2 proto-oncogene (also called c-erbB-2/neu) encodes the protein, p185, which is closely related to the growth and metastasis of adenocarcinoma, and is overexpressed in 25-30% of human breast cancers. In this study, we attempt to reverse the malignant phenotype of the breast cancer cell line, MCF-7, using a HER-2-specific hammerhead ribozyme. Two anti-HER-2 hammerhead ribozymes, RZ1 and RZ2, were synthesized, inserted separately into the nonviral eukaryotic expression vector, pcDNA3.1(-), and transfected into MCF-7 cells. Analyses showed that the HER-2 mRNA and p185, as well as oncogene k-ras were down-regulated remarkably in the ribozyme-transfected cells, while the onco-suppressor gene, p53, was up-regulated. Furthermore, the tumorigenicity of the RZ1-stably transfected MCF-7 cells was decreased dramatically in nude mice. These results demonstrate that the use of anti-HER-2 ribozymes may be a beneficial strategy for gene therapy of breast cancer.
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Abstract
Salivary gland tumors are a rare and clinically diverse group of neoplasms that represent less than 1% of all malignancies. In locoregional recurrent or metastatic disease, systemic therapy is the standard approach. Numerous phase II studies with small sample sizes have assessed the activity of different cytotoxic agents, either alone or in combination. For these agents, the objective response rates are generally modest, ranging from 15% to 50%. Duration of response is typically cited in the range of 6 to 9 months. Further evaluation of novel therapies is mandated in this disease. With the emergence of molecular targeted therapy, these tumors become optimal candidates for trials of investigational drugs and established drugs for new indications. Often, salivary gland carcinomas are indolent. As such, one should wish only to treat patients with progressive disease. Study designs must incorporate stringent inclusion criteria to enable accurate reporting of disease response and stabilization, especially in the evaluation of new drugs and novel combinations. Salivary gland-focused cooperative groups are necessary in order to accrue patients to these clinical trials and establish new treatment guidelines for these patients.
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Affiliation(s)
- Sujani G Surakanti
- Division of Hematology/Oncology, Northwestern University Feinberg School of Medicine, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL 60611, USA
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Agulnik M, Cohen EWE, Cohen RB, Chen EX, Vokes EE, Hotte SJ, Winquist E, Laurie S, Hayes DN, Dancey JE, Brown S, Pond GR, Lorimer I, Daneshmand M, Ho J, Tsao MS, Siu LL. Phase II Study of Lapatinib in Recurrent or Metastatic Epidermal Growth Factor Receptor and/or erbB2 Expressing Adenoid Cystic Carcinoma and Non–Adenoid Cystic Carcinoma Malignant Tumors of the Salivary Glands. J Clin Oncol 2007; 25:3978-84. [PMID: 17761983 DOI: 10.1200/jco.2007.11.8612] [Citation(s) in RCA: 185] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PurposeExpression of erbB2 and/or epidermal growth factor receptor (EGFR) is associated with biologic aggressiveness and poor prognosis in malignant salivary gland tumors (MSGTs). This phase II study was conducted to determine the antitumor activity of lapatinib, a dual inhibitor of EGFR and erbB2 tyrosine kinase activity, in MSGTs.Patients and MethodsPatients with progressive, recurrent, or metastatic adenoid cystic carcinoma (ACC) immunohistochemically expressing at least 1+ EGFR and/or 2+ erbB2 were treated with lapatinib 1,500 mg daily, in a two-stage cohort. Patients with non-ACC MSGTs were treated as a separate single-stage cohort.ResultsOf 62 patients screened, 29 of 33 (88%) ACC and 28 of 29 (97%) non-ACC patients expressed EGFR and/or erbB2. Forty patients with progressive disease were enrolled onto the study. Among 19 assessable ACC patients, there were no objective responses, 15 patients (79%) had stable disease (SD), nine patients (47%) had SD ≥ 6 months, and four patients (21%) had progressive disease (PD). For 17 assessable non-ACC patients, there were no objective responses, eight patients (47%) had SD, four patients (24%) had SD ≥ 6 months, and nine patients (53%) had PD. The most frequent adverse events were grade 1 to 2 diarrhea, fatigue, and rash. Eight paired tumor biopsies for correlative studies were procured; results did not correlate with clinical outcome.ConclusionAlthough no responses were observed, lapatinib was well tolerated, with prolonged tumor stabilization of ≥ 6 months in 36% (95% CI, 21% to 54%) of assessable patients. The antitumor effects of lapatinib in MGSTs appear mainly cytostatic, hence evaluation of other molecular targeted agents, or combinations with lapatinib, may be considered. Continued efforts should be made to gain better understanding into the biology of this heterogeneous group of malignancies.
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MESH Headings
- Adaptor Proteins, Signal Transducing/antagonists & inhibitors
- Adaptor Proteins, Signal Transducing/metabolism
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/metabolism
- Carcinoma, Adenoid Cystic/drug therapy
- Carcinoma, Adenoid Cystic/metabolism
- Carcinoma, Adenoid Cystic/pathology
- Carcinoma, Adenoid Cystic/secondary
- Disease-Free Survival
- Epidermal Growth Factor/antagonists & inhibitors
- Epidermal Growth Factor/metabolism
- Female
- Follow-Up Studies
- Humans
- Lapatinib
- Male
- Middle Aged
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/metabolism
- Protein-Tyrosine Kinases/antagonists & inhibitors
- Quinazolines/therapeutic use
- Salivary Gland Neoplasms/drug therapy
- Salivary Gland Neoplasms/metabolism
- Salivary Gland Neoplasms/pathology
- Treatment Outcome
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Affiliation(s)
- Mark Agulnik
- Princess Margaret Hospital Phase II Consortium, Toronto, Ontario, Canada
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18
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Agulnik M. Malignancies of the head and neck: the role for molecular targeted agents. Expert Opin Ther Targets 2007; 11:207-17. [PMID: 17227235 DOI: 10.1517/14728222.11.2.207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Although cancers arising in the head and neck region are a diverse group of malignancies, a unifying thread remains a poor overall survival for patients with advanced, recurrent or metastatic disease. Treatment strategies need to evolve and improve upon established therapeutic practices. As the process of cancer evolution is understood to be derived from aberrations in genetic and epigenetic processes, molecularly targeted agents offer attractive therapeutic options by restoring normal control of oncogenic processes. The direct role for the treatment of squamous cell carcinoma of the head and neck, nasopharynx and salivary gland carcinomas with these novel, molecularly targeted agents are reviewed and their potential to improve on the existing standard of care is further explored.
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Affiliation(s)
- Mark Agulnik
- Northwestern University, Feinberg School of Medicine, Division of Hematology/Oncology, 676 North St. Clair Street, Suite 850, Chicago, IL 60611, USA.
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19
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Milano A, Longo F, Basile M, Iaffaioli RV, Caponigro F. Recent advances in the treatment of salivary gland cancers: emphasis on molecular targeted therapy. Oral Oncol 2007; 43:729-34. [PMID: 17350323 DOI: 10.1016/j.oraloncology.2006.12.012] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2006] [Revised: 12/21/2006] [Accepted: 12/21/2006] [Indexed: 12/12/2022]
Abstract
Salivary gland cancers include tumors of different histologic characteristics and biological behavior. Radical surgery, followed or not by radiation therapy, represents the main treatment approach for this disease. The role of systemic chemotherapy is less clearly defined since trials of single-agent chemotherapy have consistently shown low response rates. Polychemotherapy is likely to induce a higher response rate, but does not improve survival. The determination of the molecular abnormalities underlying the different subtypes of salivary gland cancers might lead to more active targeted therapies. C-kit is overexpressed in a wide percentage of salivary gland carcinomas, but clinical trials with single-agent imatinib have been negative. ErbB1 and ErbB2 are also frequently overexpressed in salivary gland cancers and this has provided the rationale for clinical trials with trastuzumab, cetuximab, gefitinib, lapatinib. Finally, new pathways, such as vascular endothelial growth factor, might be worth targeting and clinical trials with anti-angiogenic agents are ongoing.
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Affiliation(s)
- Amalia Milano
- Medical Oncology B, Istituto Nazionale Tumori "Fondazione G. Pascale", Via Mariano Semmola, 80131 Napoli, Italy.
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20
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Allon I, Vered M, Buchner A, Dayan D. Stromal differences in salivary gland tumors of a common histopathogenesis but with different biological behavior: a study with picrosirius red and polarizing microscopy. Acta Histochem 2006; 108:259-64. [PMID: 16899283 DOI: 10.1016/j.acthis.2006.05.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2006] [Revised: 05/01/2006] [Accepted: 05/12/2006] [Indexed: 11/29/2022]
Abstract
Salivary gland neoplasms - pleomorphic adenoma, polymorphous low-grade adenocarcinoma, and adenoid cystic carcinoma - share a common histogenetic trait, but differ markedly in their biological properties. The objective of the study was to assess the polarization colors of picrosirius red-stained stromal collagen fibers in these salivary gland neoplasms to evaluate their possible role in the histopathogenesis of the tumors and to evaluate the potential usefulness of this approach as a diagnostic tool. Ten cases of each tumor type and 10 cases of mucous extravasation phenomenon (control) were examined using picrosirius red staining and polarizing microscopy. In each case, at least 50 thin ( approximately 0.8 microm) and 50 thick (1.6-2.4 microm) collagen fibers were counted and classified as green-yellow or yellow-orange, the mean percentage was calculated and statistical differences analyzed by one-way ANOVA. Results showed a similar thin fiber distribution in all tumor types and controls (82-88% green-yellow, 12-18% yellow-orange, p>0.05). Thick fibers showed a different distribution in polymorphous low-grade adenocarcinoma and adenoid cystic carcinoma (approximately 50% green-yellow) compared to pleomorphic adenoma and mucous extravasation phenomenon (approximately 13% green-yellow) (p=0.001). Thick fiber distribution was similar in polymorphous low-grade adenocarcinoma and adenoid cystic carcinoma (p>0.05). We conclude that with picrosirius red staining and polarizing microscopy, stromal collagen fibers differ significantly in pleomorphic adenoma from those in polymorphous low-grade adenocarcinoma and adenoid cystic carcinoma, but not from mucous extravasation phenomenon. Similarity between polymorphous low-grade adenocarcinoma and adenoid cystic carcinoma may indicate that these tumor types represent a single entity with a broad spectrum of biological behavior.
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Affiliation(s)
- Irit Allon
- Department of Oral Pathology and Oral Medicine, The Maurice and Gabriella Goldschleger School of Dental Medicine, Tel Aviv University, Ramat Aviv 69978, Israel
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21
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Laurie SA, Licitra L. Systemic therapy in the palliative management of advanced salivary gland cancers. J Clin Oncol 2006; 24:2673-8. [PMID: 16763282 DOI: 10.1200/jco.2005.05.3025] [Citation(s) in RCA: 202] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Cancers of the salivary glands are unusual lesions that vary widely in their histologic appearance and molecular characteristics. Likewise, there is a wide spectrum of biologic behavior, ranging from low-grade, minimally invasive tumors, to highly lethal malignancies. There are few data on the role of systemic therapies in the management of these cancers, and chemotherapy is generally reserved for the palliative management of advanced disease that is not amenable to local therapies such as surgery and/or radiation. The majority of patients for whom systemic therapy is considered will have either adenoid cystic carcinoma, mucoepidermoid carcinoma, or high-grade adenocarcinoma. This article will review the available literature regarding the use of palliative chemotherapy for patients with advanced salivary gland cancer of these histologies, with an emphasis on the potential role of targeted agents. There is a need for a determined, coordinated effort to conduct high-quality clinical trials in patients with these rare cancers.
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MESH Headings
- Adenocarcinoma/drug therapy
- Adenocarcinoma/pathology
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Antineoplastic Agents/therapeutic use
- Boronic Acids/therapeutic use
- Bortezomib
- Carcinoma, Adenoid Cystic/drug therapy
- Carcinoma, Adenoid Cystic/pathology
- Carcinoma, Mucoepidermoid/drug therapy
- Carcinoma, Mucoepidermoid/pathology
- Clinical Trials as Topic
- Deoxycytidine/analogs & derivatives
- Deoxycytidine/therapeutic use
- Humans
- Lapatinib
- Neoplasm Metastasis
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/pathology
- Palliative Care
- Pyrazines/therapeutic use
- Quinazolines/therapeutic use
- Receptor, ErbB-2/metabolism
- Receptors, Androgen/metabolism
- Salivary Ducts
- Salivary Gland Neoplasms/drug therapy
- Salivary Gland Neoplasms/pathology
- Trastuzumab
- Gemcitabine
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Affiliation(s)
- Scott A Laurie
- Ottawa Hospital Regional Cancer Centre, the University of Ottawa, Ottawa, Canada
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22
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Jaehne M, Roeser K, Jaekel T, Schepers JD, Albert N, Löning T. Clinical and immunohistologic typing of salivary duct carcinoma: a report of 50 cases. Cancer 2005; 103:2526-33. [PMID: 15900577 DOI: 10.1002/cncr.21116] [Citation(s) in RCA: 199] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Due to the low incidence of salivary duct carcinoma (SDC), only limited data in regard to the biologic behavior of this tumor and its immunohistochemical characteristics are available. The authors analyzed the clinical, molecular, and genetic profile of SDC and identified prognostic factors. METHODS The follow-up of 50 patients with SDC was obtained and paraffin-embedded tumor samples were examined immunohistochemically. In all samples, the expression of Ki-67, HER-2, and the oncoproteins p16 and p53 was examined immunohistochemically, followed by a mutation analysis of p16 and p53. The survival rate was calculated by the Kaplan-Meier method and prognostic variables were analyzed with the log-rank test. RESULTS SDC predominantly effected male patients (66%) in their 7th decade of life. SDC mainly occurred in the parotid gland (78%; submandibular gland, 12%; minor salivary glands, 10%). Approximately two-thirds of the patients (33 of 50) presented with a T3/T4 tumor. In 28 patients (56%), cervical lymph node metastasis was present at the time of diagnosis. Local disease recurrence was observed in 48% of patients an average of 17.4 months after initial treatment. Distant disease metastasis developed in 48% of patients an average of 29 months after initial treatment. The average overall survival period was 56.2 months. In the current study, 20.6% of the probes with positive HER-2/neu expression were (+++) positive. p53 was expressed in 83.9% of the tumor samples. In 11.8% of the tumor samples, there was a lack of p16 expression. CONCLUSIONS Mutations of the p53 gene were more frequent in tumor samples with (++) and (+++) immunoreactivity and mainly affected exons 7 and 8. A mutation of the p16 gene was only found in 1 tumor sample. Expression of HER-2/neu and p53 was statistically linked (P < 0.05) to early local disease recurrence, distant disease metastasis, and survival rates.
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Affiliation(s)
- Michael Jaehne
- Ear, Nose and Throat Department, University-Hospital Hamburg-Eppendorf, Hamburg, Germany.
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23
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Rivero ERC, Caliari MV, Tarquínio SBC, Loyola AM, de Aguiar MCF. Proliferative activity in oral salivary gland tumors: the role of PCNA and AgNOR assessed by a double staining technique. J Oral Sci 2004; 46:87-92. [PMID: 15287541 DOI: 10.2334/josnusd.46.87] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The aim of this study was to evaluate the role of PCNA and AgNOR in the assessment of salivary gland tumor proliferation using a double staining technique. Ten cases of pleomorphic adenoma (PA) and seventeen cases of adenoid cystic carcinoma (ACC) were examined. Numeric and morphometric parameters of AgNOR were evaluated and compared in PCNA-positive and PCNA-negative nuclei. There were statistically significant differences in AgNOR numbers, perimeters and contour indices between PCNA-positive and -negative nuclei in the PA samples. The ACC samples demonstrated significant differences only in the AgNOR areas. Our results show that in salivary gland tumors there is not always a relationship between proliferative activity evaluated by AgNOR numeric and morphometric parameters and PCNA immunostaining.
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Affiliation(s)
- Elena Riet Correa Rivero
- Department of Oral Pathology, School of Dentistry, Minas Gerais Federal University, Belo Horizonte, Brazil
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24
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Glisson B, Colevas AD, Haddad R, Krane J, El-Naggar A, Kies M, Costello R, Summey C, Arquette M, Langer C, Amrein PC, Posner M. HER2 Expression in Salivary Gland Carcinomas. Clin Cancer Res 2004; 10:944-6. [PMID: 14871971 DOI: 10.1158/1078-0432.ccr-03-0253] [Citation(s) in RCA: 138] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Previous evaluation of HER2 overexpression in salivary gland cancers indicated an incidence varying between 7 and 56%, with no clear difference among three histologically different subtypes. As part of a Phase II trial of trastuzumab for treatment of incurable salivary gland cancer, we screened 137 tumors for HER2 expression. EXPERIMENTAL DESIGN Unstained sections of paraffin-embedded tumor samples were stained with p185/HER2 receptor antibody. Tumors with moderate (2+) to strong (3+) complete membrane staining in at least 10% of the tumor cells were scored as positive for overexpression. RESULTS The overall frequency of overexpression for HER2 was 17% (23 of 137), whereas it was only 8% in the three most common histological subtypes screened. Overexpression was distinctly rare in the most common subtype screened, adenoid cystic carcinoma (4%, 3 of 70). Overexpression was very common in salivary duct cancers; 10 (83%) of 12 were positive for HER2. This observation is consistent with the typical high-grade histological features and aggressive behavior of this subtype as well as with its histogenetic similarity to breast cancer. Analysis based on histogenesis (intercalated duct versus excretory duct) indicated a higher frequency of overexpression in the latter (55%) than in the former (7%). CONCLUSIONS Our overall results suggest that trastuzumab will not have a major role in treatment of salivary gland cancers of intercalated duct origin. Further systematic evaluation of trastuzumab in subtypes of excretory duct origin could be supported.
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Affiliation(s)
- Bonnie Glisson
- Thoracic/Head & Neck Department, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
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25
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Haddad R, Colevas AD, Krane JF, Cooper D, Glisson B, Amrein PC, Weeks L, Costello R, Posner M. Herceptin in patients with advanced or metastatic salivary gland carcinomas. A phase II study. Oral Oncol 2003; 39:724-7. [PMID: 12907212 DOI: 10.1016/s1368-8375(03)00097-6] [Citation(s) in RCA: 195] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Phase II study of Herceptin (Trastuzumab) in patients with advanced salivary gland tumors overexpressing Her2/neu. Patients with advanced, incurable salivary gland tumors and 2(+) or 3(+) Her2/neu expression in their tumors were enrolled in the study. After an initial dose of 4 mg/kg, patients received 2 mg/kg weekly. Patients were treated until they experienced progression of disease or unacceptable toxicity. The study was closed early when it has become clear that the majority of tumors screened did not overexpress Her2/neu. Fourteen patients were enrolled in the study. A total of 86 cycles of Herceptin were delivered with a median of three cycles per patient (range 1-40). Median time to progression was 4.2 months. One patient with metastatic mucoepidermoid carcinoma has received 40 cycles of Herceptin to date with a documented partial response. Herceptin given as a single agent has a low activity in salivary gland tumors overexpressing Her2/neu. New agents are still needed.
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Affiliation(s)
- Robert Haddad
- Dana Farber Cancer Institute, Department of Adult Oncology, SW430G, 44 Binney Street, Boston, MA 02115, USA.
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26
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Dori S, Vered M, David R, Buchner A. HER2/neu expression in adenoid cystic carcinoma of salivary gland origin: an immunohistochemical study. J Oral Pathol Med 2002; 31:463-7. [PMID: 12220353 DOI: 10.1034/j.1600-0714.2002.00017.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Adenoid cystic carcinoma (ACC) is a malignant tumor of salivary gland origin, which is characterized by a high rate of local recurrence and distant hematogenous metastasis. Despite aggressive surgical treatment and radiotherapy, the patient's long-term prognosis is dismal. Prompted by recent studies on the amplification of the oncogene HER2/neu in salivary gland tumors, we analyzed the immunohistochemical overexpression of HER2/neu in salivary glands ACC. If the tumor exhibits overexpression of HER2/neu, then treating it with the anti-HER2/neu therapeutic agent, Herceptin (Trastuzumab, Genentech, CA), could be considered. METHODS The study comprised of 32 samples of formalin-fixed, paraffin-embedded specimens. All laboratory procedures and scoring criteria were performed according to currently approved FDA methods. RESULTS HER2/neu overexpression was found in only five (16%) cases. Four cases (13%) scored 1+ and one case (3%) scored 2+. CONCLUSIONS The low prevalence of HER2/neu overexpression in ACC limits the clinical utility of Herceptin therapy for salivary gland ACC.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Antineoplastic Agents/therapeutic use
- Carcinoma, Adenoid Cystic/genetics
- Carcinoma, Adenoid Cystic/pathology
- Cell Membrane/metabolism
- Cell Membrane/pathology
- Coloring Agents
- Female
- Gene Expression Regulation, Neoplastic/genetics
- Humans
- Immunohistochemistry
- Male
- Middle Aged
- Parotid Neoplasms/genetics
- Parotid Neoplasms/pathology
- Receptor, ErbB-2/antagonists & inhibitors
- Receptor, ErbB-2/genetics
- Salivary Gland Neoplasms/genetics
- Salivary Gland Neoplasms/pathology
- Salivary Glands, Minor/metabolism
- Salivary Glands, Minor/pathology
- Trastuzumab
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Affiliation(s)
- Shai Dori
- Department of Oral and Maxillofacial Surgery, Chaim Sheba Medical Center, Tel Hashomer, Israel
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27
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Frade González C, García-Caballero T, Lozano Ramírez A, Labella Caballero T. [Cell proliferation in salivary gland tumors]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2001; 52:456-60. [PMID: 11692959 DOI: 10.1016/s0001-6519(01)78236-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Previous studies on cell proliferation in salivary gland tumors have shown the utility of immunostain with MIB1 in the differential diagnosis and prognosis of these neoplasms. We have carried out a study of 39 salivary gland tumors (17 benign), from different histological lineages. The immunocytochemical method used was the streptavidin--biotin--peroxidase complex which used the MIB1 monoclonal antibody. Benign tumors showed a low cell proliferation rates, below 5% with an overall average of 1.9%. The malignant tumors presented higher rates, with a middle value of 17.85%. Epidermoid carcinomas had the higher cell proliferation rates, with an average of 43%. In adenoid cystic carcinomas, we have observed that proliferation was greater at the peripheral level of tumor nests and cell surrounding the cystic structures. Neoplasms of low grade of malignancy presented lower cell proliferation rates. The MIB1 immunostain allowed to reach a differential diagnosis between pleomorphic adenoma and adenoid cystic carcinoma, specially in those cases in which there could be any doubt.
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Affiliation(s)
- C Frade González
- Servicio de O.R.L., Hospital Clínico de Santiago, Santiago de Compostela, La Coruña
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28
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Khan AJ, DiGiovanna MP, Ross DA, Sasaki CT, Carter D, Son YH, Haffty BG. Adenoid cystic carcinoma: a retrospective clinical review. Int J Cancer 2001; 96:149-58. [PMID: 11410883 DOI: 10.1002/ijc.1013] [Citation(s) in RCA: 205] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Adenoid cystic carcinoma (ACC) are uncommon tumors, representing about 10% to 15% of head and neck tumors. We compare the survival and control rates at our institution with those reported in the literature, and examine putative predictors of outcome. All patients registered with the tumor registry as having had ACC were identified. Demographic and survival variables were retrieved from the database. Additionally, a chart review of all patients was done to obtain specific information. Minor gland tumors were staged using the American Joint Committee on Cancer's criteria for squamous cell carcinomas in identical sites. Histopathologic variables retrieved included grade of the tumor, margins, and perineural invasion. Treatment modalities, field sizes, and radiation doses were recorded in applicable cases. An effort to retrieve archival tumor specimens for immunohistochemical analysis was undertaken. A total of 69 patients were treated for ACC from 1955 to 1999. One patient, who presented with fatal brain metastasis, was excluded from further analysis. Of the remaining 68 patients, 30 were men and 38 were women. The average age at diagnosis was 52 years, and mean follow-up was 13.2 years. Mean survival was 7.7 years. Overall survival (OS) rates at 5, 10, and 15 years were 72%, 44%, and 34%, and cause-specific survival was 83%, 71%, and 55%, respectively. Recurrence-free survival rates were 65%, 52%, and 30% at 5, 10, and 15 years, with a total of 29 of 68 (43%) eventually suffering a recurrence. Overall survival was adversely affected by advancing T and AJCC stage. Higher tumor grades were also associated with decreased OS, although the numbers compared were small. Primaries of the nasosinal region fared poorly when compared with other locations. Total recurrence-free survival, local and distant recurrence rates were distinctly better in primaries of the oral cavity/oropharynx when compared with those in other locations. Reduced distant recurrence-free survival was significantly associated with increasing stage. No other variables were predictive for recurrence. Additionally, we found that nasosinal tumors were more likely to display higher stage at presentation, and were more often associated with perineural invasion. Also of interest was the association of perineural invasion with margin status, with 15 of 20 patients with positive margins displaying perineural invasion, while only 5 of 17 with negative margins showed nerve invasion (P = 0.02). On immunohistochemistry, 2 cases of the 29 (7%) tumor specimens found displayed HER-2/neu positivity. No correlation between clinical behavior and positive staining could be demonstrated. Our data concur with previous reports on ACC in terms of survival and recurrence statistics. Stage and site of primary were important determinants of outcome. Grade may still serve a role in decision making. We could not demonstrate any differences attributable to primary modality of therapy, perhaps due to the nonrandomization of patients into the various treatment tracks and the inclusion of palliative cases. Similarly, perineural invasion, radiation dose and field size, and HER-2/neu positivity did not prove to be important factors in our experience.
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Affiliation(s)
- A J Khan
- Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut 06520-8040, USA
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29
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Lui VW, He Y, Huang L. Specific down-regulation of HER-2/neu mediated by a chimeric U6 hammerhead ribozyme results in growth inhibition of human ovarian carcinoma. Mol Ther 2001; 3:169-77. [PMID: 11237673 DOI: 10.1006/mthe.2000.0241] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
The U6 expression system was explored for efficient expression of a ribozyme against the human proto-oncogene c-neu. A hammerhead ribozyme (neuRz) and the control mutant ribozyme (MRz) were targeted to cleave c-neu mRNA at the tyrosine kinase domain. In vitro cleavage showed that neuRz was very active while MRz was not. Near-maximal target cleavage observed at a low ribozyme:target ratio (0.1) suggests that neuRz has good activity and turnover capability under physiological conditions, i.e., <5 mM MgCl(2) and 37 degrees C. Chimeric U6 ribozyme was expressed at about 5 x 10(6) copies/cell at 48 h in the ovarian carcinoma cell line SKOV-3.ip1. Partial down-regulation of c-neu mRNA and protein was observed in a dose-dependent manner in cells transiently transfected with U6neuRz- but not with MRz-containing plasmid. Sorted transient transfectants demonstrated dramatic growth inhibition with the neuRz-expressing cells. Our results demonstrate that the U6 expression system is very efficient and suitable for the expression of a hammerhead ribozyme. Moreover, nonviral delivery of the neuRz-expressing plasmid resulted in specific down-regulation of c-neu and, subsequently, growth inhibition of ovarian cancer cells overexpressing c-neu.
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Affiliation(s)
- V W Lui
- Center for Pharmacogenetics, School of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA
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30
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Hicks J, Flaitz C. Mucoepidermoid carcinoma of salivary glands in children and adolescents: assessment of proliferation markers. Oral Oncol 2000; 36:454-60. [PMID: 10964053 DOI: 10.1016/s1368-8375(00)00033-6] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Malignant neoplasms represent one-third of all pediatric salivary gland tumors. Mucoepidermoid carcinoma (MEC) composes 51% of malignant tumors and 16% of all salivary gland neoplasms in pediatrics. Prognostic factors in MEC in pediatric patients have not been well defined. Histopathologic features, clinical outcomes and proliferation markers in 26 pediatric patients (median age 11 years; 19F:7M) with salivary gland MECs were evaluated retrospectively. MEC histocytologic grading used a three-tiered system. Proliferation was assessed by determining the percentage of tumor cells immunoreactive for PCNA and Ki-67. Tumor site was 16 parotid, eight submandibular, one base of tongue and one maxillary lip. Median tumor size was 2.5 cm (range 1.5-5 cm). MEC grade was nine low grade (LG), 15 intermediate grade (IG) and two high grade (HG). Metastatic disease and capsular invasion occurred in five cases, while perineural invasion was noted in three cases. Mean percentage of tumor cells immunoreactive for proliferation markers is as follows: PCNA: LG 9%, IG 17%, HG 32%; and Ki-67: LG 7%, IG 12%, HG 26%. Treatment was surgical in 21 cases, and surgery with chemotherapy and radiotherapy in five cases. Two patients with high grade MECs died of disease (21, 44 months). Twenty-four patients had no evidence of disease at a median follow-up of 104 months (range 30-298 months). MECs were second malignancies in two children with prior radiotherapy and chemotherapy for leukemia and histiocytosis. Low and intermediate grade salivary gland MECS in a pediatric population may have a favorable outcome when compared with high grade MECs. Proliferation markers appear to be linked to histocytologic MEC grade and may provide information regarding biologic behavior of salivary gland MECs in children and adolescents.
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Affiliation(s)
- J Hicks
- Department of Pathology, Texas Children's Hospital and Baylor College of Medicine, MC1-2261, 6621 Fannin Street, Houston, TX 77030-2399, USA.
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Takeda Y. An immunohistochemical study of bizarre neoplastic cells in pleomorphic adenoma: its cytological nature and proliferative activity. Pathol Int 1999; 49:993-9. [PMID: 10594846 DOI: 10.1046/j.1440-1827.1999.00968.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The cytological nature and proliferative activity of bizarre neoplastic cells, widely scattered in pleomorphic adenomas of salivary gland origin were studied. Pleomorphic adenomas containing numerous bizarre neoplastic cells were found in four cases, and were equal to 2.9% of all pleomorphic adenomas examined. All four cases presented as well-circumscribed, firm masses measuring less than 1.5 cm in size, located in the palate, and were of 7 months to 4 years duration. Histopathologically, these pleomorphic adenomas were cell rich type, and were well demarcated from surrounding tissues, although their fibrous capsules were partially defective. In addition to characteristic histopathological findings of pleomorphic adenoma, numerous neoplastic cells with bizarre appearance were scattered throughout the lesion, excepting for tubuloductal structures. These bizarre neoplastic cells had irregular-shaped and large nuclei with or without hyperchromatism, although their nucleoli were small and mitotic figures were few. Furthermore, there were many multinucleated giant cells, some of which showed multilobulated nuclei. Neither necrosis nor infarct was seen in the tumors. Immunohistochemically, bizarre neoplastic cells scattered in solid-proliferating areas and myxoid areas were neoplastic myoepithelial cells in nature. There was no statistical significance of MIB-1 labeling indices between pleomorphic adenomas with bizarre neoplastic cells and usual pleomorphic adenomas. The p53 labeling indices were quite low. Although the benign nature of pleomorphic adenomas with numerous bizarre neoplastic cells and hypercellularity, distinguishing such pleomorphic adenomas from various stages of malignant transformation in pleomorphic adenomas and other carcinomas should be made by histological section of submitted biopsy specimen or aspirated content for cytological diagnosis. The present paper suggests that the term 'bizarre cell pleomorphic adenoma' is an appropriate name for this neoplasm, in that it is distinguished from the usual benign pleomorphic adenoma which is easily diagnosed by routinely prepared histological or cytological stainings.
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Affiliation(s)
- Y Takeda
- Department of Oral Pathology, School of Dentistry, Iwate Medical University, Morioka, Japan
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Cho KJ, Lee SS, Lee YS. Proliferating cell nuclear antigen and c-erbB-2 oncoprotein expression in adenoid cystic carcinomas of the salivary glands. Head Neck 1999; 21:414-9. [PMID: 10402521 DOI: 10.1002/(sici)1097-0347(199908)21:5<414::aid-hed6>3.0.co;2-m] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Adenoid cystic carcinoma (ACC) of the salivary gland shows a variable clinical course. It would be helpful to discover reliable biologic markers in the management of patients with ACC. METHODS We examined proliferating cell nuclear antigen (PCNA) and c-erbB-2 oncoprotein expression on 30 cases of ACC of the salivary glands. The immunohistochemical results, and size, location, and histologic grade of the tumors were compared with the clinical outcome of the patients. RESULTS Mean PCNA positivity of ACCs was 15%, and was higher in solid than in cribriform/tubular areas. High PCNA value was significantly correlated with shorter disease-free and overall survival of the patients with ACC. c-erbB-2 overexpression was observed in only five cases, focally in cribriform/tubular areas. High histologic grade, which was determined by the presence of solid components, showed a trend toward shorter survival. Size and location of ACC were not associated with patient outcome. CONCLUSIONS The present study indicates that PCNA score may be one of the most useful prognostic factor of ACC.
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Affiliation(s)
- K J Cho
- Department of Anatomic Pathology, Korea Cancer Center Hospital, 215-4 Gongneung-dong, Nowon-ku, Seoul 139-706, Korea
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Hirabayashi S. Immunohistochemical detection of DNA topoisomerase type II alpha and Ki-67 in adenoid cystic carcinoma and pleomorphic adenoma of the salivary gland. J Oral Pathol Med 1999; 28:131-6. [PMID: 10069542 DOI: 10.1111/j.1600-0714.1999.tb02011.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Immunohistochemical detection of cell proliferation-associated antigens was investigated in 28 cases of adenoid cystic carcinoma (ACC) and 20 cases of pleomorphic adenoma (PA), using antibodies against DNA topoisomerase type II alpha (topo-II) (Ki-S1) and Ki-67 (MIB-1). The correlation of staining indices with clinicopathological data, histological features and prognosis was also studied. The topo-II value was significantly higher in ACC than in PA (P<0.0001), and highest in the solid growth pattern of ACC. In addition, significant relationships were found between topo-II values and clinical features such as local recurrence, surgical margins, and distant metastases. By log-rank test, the topo-II index was also correlated significantly with patient survival (P<0.01). The values of topo-II index paralleled those of Ki-67 index in ACC, and a correlation coefficient of 0.97 was obtained. Topo-II may be considered an additional marker for estimating the proliferating fraction of cells and for predicting the short-term prognosis for patients with salivary gland tumors.
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Affiliation(s)
- S Hirabayashi
- Department of Pathology, Gunma University School of Medicine, Japan
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Klapper LN, Kirschbaum MH, Seta M, Yarden Y. Biochemical and Clinical Implications of the ErbB/HER Signaling Network of Growth Factor Receptors. Adv Cancer Res 1999. [DOI: 10.1016/s0065-230x(08)60784-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Perez-Ordonez B, Linkov I, Huvos AG. Polymorphous low-grade adenocarcinoma of minor salivary glands: a study of 17 cases with emphasis on cell differentiation. Histopathology 1998; 32:521-9. [PMID: 9675591 DOI: 10.1046/j.1365-2559.1998.t01-2-00410.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS The diagnosis of polymorphous low-grade adenocarcinoma (PLGA) of salivary glands remains difficult for general surgical pathologists. In an effort to understand the morphological heterogeneity of these neoplasms and facilitate their recognition we reviewed the architectural patterns, cell differentiation and immunohistochemical features of 17 case of PLGA. METHODS AND RESULTS There were 11 females and six males with a mean age of 58 years. Twelve tumours were located in the palate, two in the posterior third of the tongue, and one each in the upper lip, buccal mucosa and retromolar triangle. Two patients presented with neck metastases. The mean tumour size was 20 mm (range 6-50 mm). The tumour cells were arranged in five architectural patterns: tubules and small duct-like structures; cords and trabeculae; solid nests; cribriform areas and papillae. Twelve (71%) cases were composed of a combination of tubules and small duct-like structures, cords and trabeculae, and solid nests. Cribriform areas with pseudoluminal spaces were seen in six (35%) cases. A focal papillary pattern was evident in three cases and constituted 40% of the tumour in one. Perineural invasion was seen in 13 cases (76%). All cases studied were positive for CAM5.2, 34BE12, vimentin and S100 protein and showed overexpression of bcl-2 protein. Rb protein was present in 13 cases whereas p53 expression was absent in all cases. The average proliferation index (PI) was 7% (range 1-17%). Three patients developed local recurrences with cervical lymph node metastases but no patient died as result of tumour. No morphological features were found to be prognostic for the development of local recurrences or lymph nodes metastases. CONCLUSIONS PLGA is a distinctive neoplasm of salivary glands formed by luminal and nonluminal tumour cells with limited patterns of architectural differentiation. The relative proportion of these cells seems to play a significant role in the morphogenesis of these tumours. The overexpression of the bcl-2 protein and the low PI suggest that inhibition of programmed cell death may be involved in the oncogenesis of PLGA.
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Affiliation(s)
- B Perez-Ordonez
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA
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Therkildsen MH, Reibel J, Schiødt T. Observer variability in histological malignancy grading of adenoid cystic carcinomas. APMIS 1997; 105:559-65. [PMID: 9269302 DOI: 10.1111/j.1699-0463.1997.tb05053.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The value of malignancy grading of adenoid cystic carcinomas (ACC) is controversial. Some studies have shown that tumours with a solid growth component have a rapid fatal course, compared to tumours without a solid growth component, in which recurrences develop even many years after initial treatment. Other studies have failed to correlate growth patterns with clinical course. No universally accepted grading system exists and no reproducibility studies of the existing grading systems have been performed. The aim of this study was to examine the reproducibility of grading based on semi-quantitative assessment of the solid growth pattern in ACC. Two different grading systems were assessed by 3 observers on a material of 59 ACC. Interobserver agreement was evaluated using the kappa statistic. The reproducibility of grading was poor, except for the category "solid component constituting 50% or more of the tumour" (kappa = 0.52). It is concluded that quantitative methods are necessary if grading is to be used in prognostic evaluation of ACC. The rarity of the tumours, however, combined with difficulties in diagnosis will impede such investigations unless multicentre studies are undertaken.
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Nordgård S, Franzén G, Boysen M, Halvorsen TB. Ki-67 as a prognostic marker in adenoid cystic carcinoma assessed with the monoclonal antibody MIB1 in paraffin sections. Laryngoscope 1997; 107:531-6. [PMID: 9111386 DOI: 10.1097/00005537-199704000-00019] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The monoclonal antibody MIB1 recognizing the Ki-67 antigen in formalin-fixed, paraffin-embedded tissue was used to study the proliferative activity in 44 adenoid cystic carcinomas of the salivary glands. The antigen expression was compared with clinical factors, histopathological grading, and prognosis. The Ki-67 value was significantly higher in tumors from patients suffering from treatment failure than in nonfailures (P<0.001). The Ki-67 expression was also higher in tumors exhibiting areas more than 30% of the solid growth pattern and higher in sinonasal tumors than in other locations. By Cox regression analysis, Ki-67 more than 4% was the strongest prognostic indicator (P<0.005). Clinical stage and violation of surgical margins were also found to be independent significant prognostic indicators. We conclude that Ki-67 expression estimated by the use of MIB1 is a powerful tool for predicting the short-term prognosis for patients with adenoid cystic carcinoma.
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Affiliation(s)
- S Nordgård
- Department of Otolaryngology, University Hospital, University of Trondheim, Norway
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Mixed Tumor, Polymorphous Low-grade Adenocarcinoma and Adenoid Cystic Carcinoma of the Salivary Gland. ACTA ACUST UNITED AC 1997. [DOI: 10.1097/00022744-199703000-00002] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Felix A, El-Naggar AK, Press MF, Ordonez NG, Fonseca I, Tucker SL, Luna MA, Batsakis JG. Prognostic significance of biomarkers (c-erbB-2, p53, proliferating cell nuclear antigen, and DNA content) in salivary duct carcinoma. Hum Pathol 1996; 27:561-6. [PMID: 8666365 DOI: 10.1016/s0046-8177(96)90162-8] [Citation(s) in RCA: 77] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Salivary duct carcinoma (SDC), a rare neoplasm of the major salivary glands, is a high-grade carcinoma with a predilection for elderly men. The authors investigated the prognostic role of p53, c-erbB2, proliferating cell nuclear antigen (PCNA), and DNA flow cytometry in a pathobiological evaluation of a cohort of 30 patients with these neoplasms. The patient group comprised 24 men and 6 women, with ages ranging from 22 to 87 years (mean = 61 years). Twenty-eight tumors were located in the parotid gland and two in the submandibular gland. Tumor size ranged from 1.0 to 8.0 cm (mean = 3.48 cm). Regional metastases were found in 73.3% (22 patients), systemic metastases in 43.3% (13 patients), and recurrences in 8 (26.6%) patients. DNA aneuploidy was found in 18 tumors (58.0%) and DNA diploidy in 12 (42%), with proliferative fractions ranging from 8.60% to 15.5 (mean = 10.6%). p53 protein nuclear immunostaining was positive in 56.6% and c-erbB2 overexpression was observed in 63% of the tumors. PCNA positivity ranged from 16.5% to 91.0%, with a mean of 49.5%. p53 immunopositivity, DNA aneuploidy, high growth, and proliferative fractions by PCNA and flow cytometry did not correlate with patient outcome. These results indicate that tumor size (P = .05), distant metastasis (P = .006), and C-erbB2 amplification (P = .04) are independent prognostic parameters in patients with salivary duct carcinoma.
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Affiliation(s)
- A Felix
- Department of Pathology, University of Texas, M.D. Anderson Cancer Center, Houston 77030, USA
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