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Han D, Cho ES, Park J, Kim D. Case Report: Papillary Lesions at the Mouth Floor May Mimic Sialadenoma Papilliferum. Pathol Oncol Res 2022; 28:1610352. [PMID: 35911440 PMCID: PMC9329833 DOI: 10.3389/pore.2022.1610352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 06/23/2022] [Indexed: 11/13/2022]
Abstract
Salivary gland tumor Sialadenoma papilliferum (SialP) clinically resembles papillary epithelial lesions, such as squamous papilloma (SqP) or verrucous leukoplakia. Pathological sampling including an adequate depth of both the mucosa and submucosa layer is required for discrimination between the diseases. Though ductal proliferation in the submucosa is characteristic in SialP, papillary lesions arising at the mouth floor, specifically near the ductal orifice, are more problematic. Salivary gland ductal ectasia, along with the overlying papillary hyperplasia, may mimic the biphasic tumorous growth pattern of SialP, making discrimination extremely difficult. Further cellular dysplasia in the papillary mucosal lesion raises the possibility of malignant transformation in a known benign lesion, SialP. Herein, we present a case of SqP at the mouth floor which mimicked both clinical and pathological features of SialP and compared it with a definite case of SialP. Moreover, we discuss major differential points that clinicians and pathologists should consider during diagnosis of oral papillary lesions arising near the salivary glands.
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Affiliation(s)
- Dawool Han
- Department of Oral Pathology, Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, South Korea
| | - Eunae Sandra Cho
- Department of Oral Pathology, Oral Cancer Research Institute, Yonsei University College of Dentistry, Seoul, South Korea
| | - Jiho Park
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, South Korea
| | - Dongwook Kim
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, South Korea
- *Correspondence: Dongwook Kim, , orcid.org/0000-0001-6167-6475
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Atarbashi-Moghadam S, Salehizalani S, Mokhtari S, Yazdani F. Expression of Ki-67, P63, P40, and alpha-smooth muscle actin in salivary gland carcinomas with or without myoepithelial differentiation. JOURNAL OF MEDICAL SCIENCES 2022. [DOI: 10.4103/jmedsci.jmedsci_204_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Proliferation in pleomorphic adenoma: Lights and shadow on this parameter, in a neoplasm showing unpredictable behavior-An immunohistochemical study and review of the literature. Pathol Res Pract 2021; 232:153748. [PMID: 35094844 DOI: 10.1016/j.prp.2021.153748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 12/18/2021] [Accepted: 12/20/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Pleomorphic adenoma accounts for the majority of benign tumors of the salivary gland. It is also called mixed tumor because it is composed by ductal epithelial and myoepithelial cells, variably intermixed within a chondromyxoid stroma. The recurrence rate is around 3.4% and 6.3%, respectively at 5 and 10 years and, to date, there are no valuable predictive factors. Aim of our study was to assess the role of Ki67 proliferative index in our cases and through meta-analysis. METHODS Immunohistochemistry with Ki67 antibody was performed on 28 cases. A manual count of the signal was performed, to establish the proliferative activity. Statistical tests were applied to assess the correlation between the score and clinico-pathologic parameters. Further data were extrapolated from studies published on Pubmed, Cochrane and Web of Science database. RESULTS Higher values of Ki67 were found among cases with larger size (p value = 0.0061) and showing greater cellularity (p value=0.0004). 19 papers were selected from the bibliographic search, concerning a total of 1187 patients affected by pleomorphic adenoma. In most of them, a higher Ki67 was detected among relapsing forms but results were controversial. In each study, several count methods were applied. CONCLUSION The role of Ki67 in pleomorphic adenoma of the salivary glands remains unclear. The lack of homogeneity of the data makes it very difficult to standardize them in order to draw a conclusion. It would therefore be desirable to carry out a comparison study of the various possible methods of Ki67 counting.
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Alaizari NA, Tarakji B, Al-Maweri SA, Al-Shamiri HM, Darwish S, Baba F. p53 expression in pleomorphic adenoma of salivary glands: A systematic review and meta-analysis. Arch Oral Biol 2015; 60:1437-41. [PMID: 26163983 DOI: 10.1016/j.archoralbio.2015.06.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 05/29/2015] [Accepted: 06/15/2015] [Indexed: 01/10/2023]
Abstract
OBJECTIVE There are conflicting data regarding immunohistochemical expression of p53 in pleomorphic adenoma. This systematic review and meta-analysis aimed to examine whether p53 expression has a role in the pathogenesis of pleomorphic adenoma. DESIGN A comprehensive literature search for relevant studies published from 2000 up to end of 2014 was performed using PubMed, EMBASE and the Cochrane Library Databases. Only articles in which p53 detected by immunohistochemical staining were included. The meta-analysis was done using Comprehensive Meta-Analysis software. RESULTS Eighteen eligible studies were included in this meta-analysis. Heterogeneity measures showed a statistically significant Cochrane Q value (P-value<0.001). The random effects model showed an effect size of 0.254 with a 95% CI (0.139-0.417). The overall p53 positivity is 25.4%. CONCLUSION Mutant p53 has to be detected by more precise techniques to emphasize on its role in development of pleomorphic adenoma of salivary gland.
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Affiliation(s)
- Nader Ahmed Alaizari
- Department of Oral Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing, Riyadh, Saudi Arabia; Department of Oral Medicine and Pathology, Faculty of Dentistry, Sana'a University, Yemen.
| | - Bassel Tarakji
- Department of Oral Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing, Riyadh, Saudi Arabia
| | - Sadeq Ali Al-Maweri
- Department of Oral Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing, Riyadh, Saudi Arabia; Department of Oral Medicine and Pathology, Faculty of Dentistry, Sana'a University, Yemen
| | - Hashem Motahir Al-Shamiri
- Department of Oral Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing, Riyadh, Saudi Arabia
| | - Shourouk Darwish
- Department of Oral Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing, Riyadh, Saudi Arabia
| | - Feras Baba
- Aleppo University, Faculty of Dentistry, Syria
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Bagulkar BB, Gawande M, Chaudhary M, Gadbail AR, Patil S, Bagulkar S. XIAP and Ki-67: A Correlation Between Antiapoptotic and Proliferative Marker Expression in Benign and Malignant Tumours of Salivary Gland: An Immunohistochemical Study. J Clin Diagn Res 2015; 9:EC01-4. [PMID: 25859460 DOI: 10.7860/jcdr/2015/11690.5604] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 01/14/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Impaired balance between cell proliferation and apoptosis is crucial to the development of malignant neoplasm. The purpose of this study was to evaluate and compare the expression of X-Linked inhibitor of apoptotic protein (XIAP) (antiapoptotic marker) and Ki-67 (proliferative marker) expression in benign and malignant salivary gland (SG) tumours. MATERIALS AND METHODS The study consisted of 40 cases of benign SG tumours and 50 cases of malignant SG tumours. The immunohistochemistry was carried out by using Ki-67 antibody (clone MIB-1) and XIAP antibody in all the groups. RESULTS XIAP expression was significantly higher in malignant SG tumours than benign SG tumours (p = 0.016). Ki-67 LI was significantly higher in malignant SG tumours than benign SG tumours (p = 0.0002). Statistically significant positive correlation between Ki-67 count and XIAP expression was noted in benign and malignant SG tumours (p = 0.000). CONCLUSION As the expression of an antiapoptotic marker (XIAP) increases, the expression of a proliferative marker (Ki-67) also increases from benign to malignant SG tumours. Thus, targeted therapy of XIAP may play a future role in the management of SG malignancy.
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Affiliation(s)
- Bhupesh Bhayyaji Bagulkar
- Assistant Professor, Department of Oral and Maxillofacial Pathology and Microbiology, Sri Aurobindo College of Dentistry , Indore, Madhya Pradesh, India
| | - Madhuri Gawande
- Professor, Department of Oral and Maxillofacial Pathology & Microbiology, Sharad Pawar Dental College & Hospital, Datta Meghe Institute of Medical Sciences , Sawangi (M), Wardha, Maharashtra, India
| | - Minal Chaudhary
- Professor and Head, Department of Oral and Maxillofacial Pathology & Microbiology, Sharad Pawar Dental College & Hospital, Datta Meghe Institute of Medical Sciences , Sawangi (M), Wardha, Maharashtra, India
| | - Amol Ramchandra Gadbail
- Associate Professor, Department of Oral and Maxillofacial Pathology & Microbiology, Sharad Pawar Dental College & Hospital, Datta Meghe Institute of Medical Sciences , Sawangi (M), Wardha, Maharashtra, India
| | - Swati Patil
- Professor, Department of Oral and Maxillofacial Pathology & Microbiology, Sharad Pawar Dental College & Hospital, Datta Meghe Institute of Medical Sciences, Sawangi (M) , Wardha, Maharashtra, India
| | - Smita Bagulkar
- Lecturer, Department of Oral and Maxillofacial Surgery, Sri Aurobindo College of Dentistry , Indore, Madhya Pradesh, India
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Rooper L, Sharma R, Bishop JA. Polymorphous low grade adenocarcinoma has a consistent p63+/p40- immunophenotype that helps distinguish it from adenoid cystic carcinoma and cellular pleomorphic adenoma. Head Neck Pathol 2014; 9:79-84. [PMID: 24969705 PMCID: PMC4382474 DOI: 10.1007/s12105-014-0554-4] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 06/21/2014] [Indexed: 11/30/2022]
Abstract
Polymorphous low grade adenocarcinoma (PLGA) is a tumor of minor salivary glands that exhibits considerable morphologic overlap with adenoid cystic carcinoma and cellular pleomorphic adenoma, especially in small biopsy specimens. Unlike these other tumor types. PLGAs do not harbor a myoepithelial component, yet their frequent positivity for p63 diminishes the usefulness of this particular myoepithelial marker as a discriminating immunostain. p40 is an antibody that recognizes ΔNp63, a p63 isoform that is more specific for true myoepithelial differentiation. As such, p40 immunostaining could help distinguish PLGAs from adenoid cystic carcinomas and pleomorphic adenomas. In this study, p63 and p40 immunohistochemistry was performed on paraffin embedded, formalin fixed tissue from 11 PLGAs, 101 adenoid cystic carcinomas, and 31 pleomorphic adenomas. All 11 PLGAs (100 %) were positive for p63 but completely negative for p40. Among adenoid cystic carcinomas, 91 of 101 (90 %) were positive for p63 and 90/101 (89 %) were positive for p40. The single discordant p63+/p40- adenoid cystic carcinoma exhibited solid architecture and high grade features not typically seen in PLGA. Among pleomorphic adenomas, 21/31 (68 %) were positive for p63 and 13/31 (42 %) were positive for p40. For the pleomorphic adenomas, the discordant p63+/p40- staining pattern was seen only in the overtly mesenchymal chondromyxoid stroma. The cellular epithelial component of the pleomorphic adenomas demonstrated concordant p63+/p40+ or p63-/p40- immunophenotypes. PLGA consistently exhibits a p63+/p40- immunophenotype that can help distinguish it from adenoid cystic carcinoma and cellular pleomorphic adenoma, tumors that characteristically demonstrate concordant p63 and p40 immunostaining patterns. A p63/p40 immunohistochemical panel can provide a valuable tool for making the distinction between these morphologically similar but clinically divergent entities.
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Affiliation(s)
- Lisa Rooper
- />Departments of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD USA
| | - Rajni Sharma
- />Departments of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD USA
| | - Justin A. Bishop
- />Departments of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD USA , />Departments of Otolaryngology/Head and Neck Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD USA , />The Johns Hopkins University School of Medicine, 401 N. Broadway, Weinberg 2249, Baltimore, MD 21231 USA
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Ferreira JCB, Morais MO, Elias MRA, Batista AC, Leles CR, Mendonça EF. Pleomorphic adenoma of oral minor salivary glands: An investigation of its neoplastic potential based on apoptosis, mucosecretory activity and cellular proliferation. Arch Oral Biol 2014; 59:578-85. [PMID: 24681706 DOI: 10.1016/j.archoralbio.2014.03.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 02/13/2014] [Accepted: 03/10/2014] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the neoplastic potential of the PA of minor oral salivary glands measured by apoptosis (Bcl-2, Bax and p53), mucosecretory activity (MUC1), and cellular proliferation (Ki-67). DESIGN Thirty-one cases of PA of the oral cavity and four controls (C) taken from normal oral minor salivary glands were analyzed using the immunohistochemistry technique. The proteins were detected utilizing a semi-quantitative method (scores) as follows: (-) negative ≤5%, (+) low 6-25%, (++) moderate 26-50% and (+++) high >50% of positive tumour cells. The apoptotic indices were evaluated by the ratio Bcl-2/Bax. Non-parametric comparison and correlation tests were used for analysis. RESULTS The data showed high staining of anti-apoptotic protein Bcl-2 in both groups (PA=57.9%; C=67.7%) and a significantly lower expression of pro-apoptotic protein Bax (PA=22.7%; C=97.7%) and MUC1 (PA=14%; C=82.3%) in PA than in C (p<0.001). On the other hand, a similar expression of Ki-67 and p53 proteins (≤5%) was seen in both PA and C. In PA, only 2/31 cases showed the ratio Bcl-2/Bax<1.There was no difference in cellular expression with regard to clinical variables or clinical outcome (p>0.05). CONCLUSION The neoplastic potential of PA could be associated with an imbalance in apoptotic processes and a lower index of cellular proliferation. Mucosecretory activity does not play a significant role in primary PA.
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Affiliation(s)
| | - Marília Oliveira Morais
- Department of Oral Medicine (Oral Pathology), Dental School, Federal University of Goiás, Goiânia, Brazil
| | | | - Aline Carvalho Batista
- Department of Oral Medicine (Oral Pathology), Dental School, Federal University of Goiás, Goiânia, Brazil
| | - Claudio Rodriguês Leles
- Department of Oral Medicine (Oral Pathology), Dental School, Federal University of Goiás, Goiânia, Brazil
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Rani V, McCullough M, Chandu A. Assessment of laminin-5 in oral dysplasia and squamous cell carcinoma. J Oral Maxillofac Surg 2013; 71:1873-9. [PMID: 23891017 DOI: 10.1016/j.joms.2013.04.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Revised: 04/25/2013] [Accepted: 04/27/2013] [Indexed: 11/20/2022]
Abstract
PURPOSE Laminin-5 is an important protein in the establishment of an intact basement membrane. The aims of this study were to assess the expression of laminin-5 (γ2 chain) using cyclin D1 and Ki-67 in hyperplastic oral mucosal lesions, oral dysplasia, and squamous cell carcinoma (SCC). MATERIALS AND METHODS Paraffin-embedded tissue blocks of 134 patients were stained for laminin-5, cyclin D1, and Ki-67 using immunohistochemistry and assessed by virtual microscopy. Statistical analysis was performed using Kruskal-Wallis tests and Mann-Whitney U tests for post hoc assessment. RESULTS Laminin-5, cyclin D1, and Ki-67 were found to have significant differences in expression for the different categories of dysplasia, SCC, and hyperplasia (P < .001). Cyclin D1 and Ki-67 expression levels were significantly increased in moderate and severe dysplasia and SCC, with no significant difference in expression between hyperplasia and mild dysplasia or between biopsies of severe dysplasia and SCC. Laminin-5 expression was only significantly increased in SCC, confirming it as a marker of malignant transformation and invasion. CONCLUSIONS The results of this study indicate that overexpression of laminin-5 is found only in SCC and not dysplastic lesions. Therefore, laminin-5 has potential as a marker for the intraoperative assessment of cancer excision margins and could be used as a target for chemotherapeutic agents.
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Affiliation(s)
- Vidya Rani
- Research Fellow, Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
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Strub GM, Georgolios A, Graham RS, Powers CN, Coelho DH. Massive transcranial parotid pleomorphic adenoma: recurrence after 30 years. J Neurol Surg Rep 2013; 73:1-5. [PMID: 23946917 PMCID: PMC3658653 DOI: 10.1055/s-0032-1329189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Pleomorphic adenoma, also known as benign mixed tumor, is the most common tumor affecting the parotid gland and can reach massive size; however, intracranial invasion is rare. Recurrence of pleomorphic adenoma after excision is a well-known phenomenon and can present decades after resection of the primary tumor. Here we present the case of a 53-year-old man who presented to our clinic with ear fullness, otalgia, and hearing loss 30 years after undergoing total parotidectomy and external beam radiotherapy for pleomorphic adenoma. Magnetic resonance imaging revealed a massive transcranial tumor invading the mastoid cavity, the dura of the posterior fossa, the fallopian and semicircular canals, the jugular foramen, the lateral infratemporal fossa skull base, the sigmoid and transverse sinuses, and the superior parapharyngeal region. Gross examination and histopathological studies confirmed that the mass was a recurrent pleomorphic adenoma. Here we discuss the features of recurrent pleomorphic adenoma and review the current literature.
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Affiliation(s)
- Graham M Strub
- Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, Virginia
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Miranda Viana ADC, Ribeiro DC, Florêncio TNG, Santos VT, Sousa AA, Aguiar MCF. Immunohistochemical expression of metallothionein in pleomorphic adenoma of minor salivary glands: a role in the control of apoptosis? Acta Histochem 2013; 115:564-8. [PMID: 23332881 DOI: 10.1016/j.acthis.2012.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 12/10/2012] [Accepted: 12/11/2012] [Indexed: 12/12/2022]
Abstract
Pleomorphic adenoma is the most common benign neoplasm of both the major and minor salivary glands. The histological features are diverse and are characterized by the involvement of epithelial-myoepithelial structures. Metallothionein is a cysteine-rich protein present in myoepithelial cells of several benign and malignant neoplasms. The function of metallothionein is associated with DNA protection, oxidative stress and apoptosis. The purpose of this study was to evaluate the expression of metallothionein in pleomorphic adenoma of the minor salivary glands. Additionally, we investigated the association of the clinicopathological features of the lesions with metallothionein, specifically its association with Bcl-2, in an attempt to evaluate the role of metallothionein in the control of apoptosis. Thirty-five cases of pleomorphic adenoma were selected and immunohistochemistry was performed for metallothionein and Bcl-2 proteins. The proteins were quantified by the Quickscore method. The samples showed epidemiological characteristics similar to those described in the literature. We did not find an association between the clinicopathological characteristics of pleomorphic adenomas and the proteins studied, but an association between metallothionein and Bcl-2 was demonstrated. The results suggest that metallothionein may have a role in the control of apoptosis in pleomorphic adenoma.
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Dultra FKAA, Barros AC, Schaer-Barbosa H, Figueiredo AL, Gurgel CAS, Ramos EAG, da Silva Carvalho AM, dos Santos JN. Immunohistochemical assessment of CD1a-positive Langerhans cells and their relationship with E-cadherin in minor salivary gland tumors. J Oral Pathol Med 2011; 41:47-53. [DOI: 10.1111/j.1600-0714.2011.01052.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Lo J, McNaughtan J, Rani V, Maric D, Smith A, McCullough M, Chandu A. An immunohistochemical analysis of cell cycle markers in oral mucosal dysplastic lesions treated by laser therapy. A pilot study. J Maxillofac Oral Surg 2011; 10:190-4. [PMID: 22942585 DOI: 10.1007/s12663-011-0211-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Accepted: 03/20/2011] [Indexed: 10/18/2022] Open
Abstract
INTRODUCTION Over the past 15 years, dysplastic oral mucosal lesions have been treated by laser ablation with variable success. A recent study have shown that the type of laser utilized may be important for patient outcome, however, it may also be changes at a cellular level that could be an important factor in determining recurrence outcome. The aims of this study were to assess cellular markers related to oral dysplastic lesions treated by two different laser types. METHODS AND MATERIALS Twenty patients with a histopathological diagnosis of dysplasia treated with laser ablation between the years 1992 and 2003 were assessed. Tissue blocks of the original diagnostic biopsy specimens were stained with specific cell cycle markers (Cyclin-D1 and Ki67) via immunohistochemistry and presence of the marker were analysed by virtual microscopy. Patients were assessed according to grade of dysplasia [(mild vs. moderate vs. severe) and the type of laser used (Potassium Titanyl Phosphate (KTP) vs. Carbon Dioxide (CO(2))]. RESULTS No significant difference in Cyclin-D1 and Ki67 levels were found between the two groups with different grades of dysplasia, however, decreased Cyclin-D1 was found in those patients treated with KTP laser (P = 0.028). CONCLUSIONS The findings of the present study may indicate cell cycle makers such as Cyclin-D1, may be responsible for the behaviour of dysplastic lesions treated with laser therapy, rather than the type of laser itself, which was reported in previous studies.
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do Prado RF, da Silva Machado AL, Colombo CED, Carvalho YR. Immunohistochemical study of the expression of fatty acid synthase and Ki-67 in salivary gland tumors. J Oral Pathol Med 2011; 40:467-75. [DOI: 10.1111/j.1600-0714.2011.01023.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Orita Y, Hamaya K, Miki K, Sugaya A, Hirai M, Nakai K, Nose S, Yoshino T. Satellite tumors surrounding primary pleomorphic adenomas of the parotid gland. Eur Arch Otorhinolaryngol 2009; 267:801-6. [PMID: 19898859 DOI: 10.1007/s00405-009-1149-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2009] [Accepted: 10/22/2009] [Indexed: 12/29/2022]
Abstract
The occasional local recurrence of benign pleomorphic adenoma (PA) has generally been attributed to the vulnerability of the tumor capsule. Although some reports have also noted the presence of satellite tumors associated with PA recurrence, only few reports have focused on this issue. We paid special attention to the satellite lesions apart from the main tumors and discussed their frequency, origin, nature and the ways of treating them. A total of 108 specimens of primary parotid gland PA resected at the Okayama Saiseikai General Hospital from 1988 to 2008 were microscopically reviewed. Four (3.7%) patients displayed a main mass with satellite tumors in a single parotid gland. The immunohistochemical analysis of p53 and Ki-67 index showed no distinct difference between PAs with satellite tumors and those without. Satellite tumors surrounding the main mass of parotid PA is relatively rare. In most cases, such satellite tumors will arise from capsular perforation of the primary tumor cells. Preoperative evaluation to recognize the existence of satellite tumors would be important and capsular dissection should be discouraged. We could not find any evidence suggesting that primary PA with satellite tumors could be more biologically aggressive than those without.
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Affiliation(s)
- Yorihisa Orita
- Department of Otolaryngology Head and Neck Surgery, Okayama Saiseikai General Hospital, 1-17-18, Ifuku-Cho, Okayama 700-8511, Japan.
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Gadbail AR, Chaudhary M, Patil S, Gawande M. Actual Proliferating Index and p53 protein expression as prognostic marker in odontogenic cysts. Oral Dis 2009; 15:490-8. [PMID: 19563416 DOI: 10.1111/j.1601-0825.2009.01590.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND The purpose of this study was to evaluate the biological aggressiveness of odontogenic keratocyst/keratocystic odontogenic tumour (KCOT), radicular cyst (RC) and dentigerous cyst (DC) by observing the actual proliferative activity of epithelium, and p53 protein expression. METHODS The actual proliferative activity was measured by Ki-67 Labelling Index and argyrophilic nucleolar organizing regions (AgNOR) count per nucleus. The p53 protein expression was also evaluated. RESULTS Ki-67 positive cells were observed higher in suprabasal cell layers of KCOT with uniform distribution, a few of them were predominantly observed in basal cell layer in RC and DC. The AgNOR count was significantly higher in suprabasal cell layers of KCOT. The actual proliferative activity was noted to be higher in suprabasal cell layers of KCOT. The p53 immunolabelling was dense and scattered in basal and suprabasal cell layers in KCOT. The weakly stained p53 positive cells were observed diffusely distributed in KCOT, whereas they were mainly seen in basal cell layer of RC and DC. CONCLUSION The quantitative and qualitative differences of the proliferative activity and the p53 protein expression in sporadic KCOT may be associated with intrinsic growth potential that could play a role in its development and explain locally aggressive biological behaviour. AgNOR count and p53 protein detection in odontogenic lesions can be of great consequence to predict the biological behaviour and prognosis.
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Affiliation(s)
- A R Gadbail
- Department of Oral and Maxillofacial Pathology & Microbiology, Sharad Pawar Dental College & Hospital, Datta Meghe Institute of Medical Sciences, Sawangi (M), Wardha, Maharashtra 442001, India.
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Wegner A, Waśniewska E, Jarmołowska-Jurczyszyn D, Golusiński W, Biczysko W. Rola badań immunohistochemicznych (białka p53, cykliny D1) w prognozowaniu raka gruczołowato-torbielowatego (carcinoma adenoides cysticum) ślinianek. Otolaryngol Pol 2007; 61:423-7. [DOI: 10.1016/s0030-6657(07)70455-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Dodd RL, Slevin NJ. Salivary gland adenoid cystic carcinoma: A review of chemotherapy and molecular therapies. Oral Oncol 2006; 42:759-69. [PMID: 16757203 DOI: 10.1016/j.oraloncology.2006.01.001] [Citation(s) in RCA: 176] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2005] [Revised: 12/29/2005] [Accepted: 01/04/2006] [Indexed: 01/28/2023]
Abstract
Adenoid cystic carcinoma (ACC) accounts for about 1% of all head and neck malignancies. It has a tendency for a prolonged clinical course, with local recurrences and distant metastases sometimes occurring many years after presentation. Standard treatment for salivary gland ACC is surgery and post-operative radiotherapy. The aim of this review was to examine the reported efficacy of various chemotherapy regimens and molecular therapies on recurrent/metastatic salivary gland ACC. One hundred and fourteen publications were reviewed on chemotherapy as well as possible molecular targets of therapy, including KIT, epidermal growth factor receptor (EGFR), human epidermal growth receptor-2 (HER-2), oestrogen and progesterone receptors, proliferating cell nuclear antigen (PCNA), Ki-67 and the p53, bcl-2 and SOX-4 genes. Reported response rates to combination chemotherapy are low and response duration generally short lived. The response to molecular therapies is low also. More research into novel molecular targets is needed.
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Affiliation(s)
- R L Dodd
- Manchester University Medical School, UK
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Beltran D, Faquin WC, Gallagher G, August M. Selective Immunohistochemical Comparison of Polymorphous Low-Grade Adenocarcinoma and Adenoid Cystic Carcinoma. J Oral Maxillofac Surg 2006; 64:415-23. [PMID: 16487803 DOI: 10.1016/j.joms.2005.11.027] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Polymorphous low-grade adenocarcinoma (PLGA) is a salivary gland malignancy characterized by indolent growth and a low rate of metastasis. PLGA shares histological features with adenoid cystic carcinoma (ACC), including infiltrating solid and cribriform patterns, presence of cystic spaces, and neurotropism. The degree of polymorphism of PLGA presents diagnostic challenges, particularly in small biopsy specimens. Immunohistochemical reactions to differentiate PLGA from the more aggressive ACC would be extremely valuable but controversy exists in the current literature regarding their utility. This study examines the potential use of c-kit, Ki-67, smooth muscle actin (SMA), and muscle-specific actin (MSA) as ancillary markers for distinguishing PLGA from ACC. PATIENTS AND METHODS Medical records of 20 cases of PLGA treated at the Massachusetts General Hospital were reviewed. Patient demographic data and tumor-specific information were elicited. Formalin-fixed paraffin-embedded sections from 10 of these cases and 12 comparison cases of ACC were accessed. The histologic diagnoses were confirmed and immunohistochemical staining using antibodies to c-kit, Ki-67, SMA, and MSA was employed to determine differences in staining. RESULTS PLGA showed a significantly weaker immunohistochemical expression of c-kit compared with ACC (P = < .001). Ki-67, correlating with proliferative behavior, was more weakly expressed in PLGA (P = .091). The exuberant myoepithelial component of ACC resulted in stronger staining with SMA and MSA (P = .047; P = .065, respectively). CONCLUSIONS Statistically significant immunohistochemical staining patterns using c-kit and SMA in this study support their potential use as markers to differentiate PLGA from ACC in cases where the diagnosis can be challenging.
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Affiliation(s)
- David Beltran
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA 02114, USA
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Carlinfante G, Lazzaretti M, Ferrari S, Bianchi B, Crafa P. p53, bcl-2 and Ki-67 expression in adenoid cystic carcinoma of the palate. A clinico-pathologic study of 21 cases with long-term follow-up. Pathol Res Pract 2005; 200:791-9. [PMID: 15792122 DOI: 10.1016/j.prp.2004.08.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Adenoid cystic carcinoma (ACC) is an indolent tumor that pursues a protracted clinical course with recurrences and late metastases. The aim of this study was to investigate immunohistochemically the expression of p53, bcl-2 protein, and Ki-67 in 21 cases of ACC of the palate, all with a minimum of 10 years and a maximum of 22 years of clinical follow-up. These results were also analyzed with regard to different clinical prognoses of the histologic subtypes of ACC. High expression of p53 and bcl-2 was noted in 19 out of 21 ACC cases (90%), in which most tumor cells (from 66% to 99%) proved to be immunopositive. A relation to the histologic types, clinical staging, and survival was not found. Therefore, the high immunoreactivity against these oncoproteins in the same tumor cells suggests that these two oncogenes may be involved since the early stage of carcinogenesis. Loss of function of the p53 protein combined with bcl-2 upregulation might give the tumor cells a double growth advantage, because uncontrolled proliferation is combined with a reduced cell death rate. The interaction with other oncogenes may then trigger a multistep process able to promote tumor progression. The low labeling index Ki-67 was detected in nine out of 21 cases (42%), with a low percentage of tumor cells (from 3% to 15%) being positive, whereas the remaining 12 cases were negative. We found no relation to the histologic types, clinical staging, and survival; however, the low proliferation rate could explain the natural course of tumor.
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Affiliation(s)
- Gabriele Carlinfante
- Servizio di Anatomia Patologica, Azienda Istituti Ospitalieri di Cremona, Università degli Studi di Parma, via Gramsci 14, Parma 43100, Italy
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Said S, Campana J. Myoepithelial carcinoma ex pleomorphic adenoma of salivary glands: A problematic diagnosis. ACTA ACUST UNITED AC 2005; 99:196-201. [PMID: 15660092 DOI: 10.1016/j.tripleo.2003.11.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We report the case of a 77-year-old woman who presented with a 6-year history of pleomorphic adenoma with multiple recurrences. Despite the clinical suspicion of a malignant process, the detection of myoepithelial carcinoma ex pleomorphic adenoma was not achieved by means of a preoperative biopsy or a frozen section removed intraoperatively, as the lesion only showed mild cytological atypia with no frank malignant features. Only a thorough evaluation of the resected tumor enabled the diagnosis of a malignancy. We discuss the difficulties that may be encountered in attempting to diagnose these rare myoepithelial lesions by means of small biopsy specimens.
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Affiliation(s)
- Sherif Said
- Pathology Department, University of Colorado Health Sciences Center, Denver, CO 80262, USA.
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21
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Alves FA, Pires FR, De Almeida OP, Lopes MA, Kowalski LP. PCNA, Ki-67 and p53 expressions in submandibular salivary gland tumours. Int J Oral Maxillofac Surg 2004; 33:593-7. [PMID: 15308260 DOI: 10.1016/j.ijom.2004.01.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2004] [Indexed: 10/26/2022]
Abstract
Salivary gland tumours are uncommon with a broad heterogeneity. The most common benign tumour is the pleomorphic adenoma, whereas mucoepidermoid carcinoma and adenoid cystic carcinoma predominate among the malignancies. Most salivary gland tumours occur in the parotid, and consequently clinical and biological data are normally derived from this site. This work describes the expressions of PCNA, Ki-67 and p53 in 15 pleomorphic adenomas, 15 mucoepidermoid carcinomas and 15 adenoid cystic carcinomas of the submandibular gland. Our results showed that all pleomorphic adenomas were negative for p53 and Ki-67 with 66.6% being positive for PCNA. Conversely, p53 was positive in 53% of the mucoepidermoid carcinomas and in 20% of the adenoid cystic carcinomas. Ki-67 was expressed in 47.7% of the mucoepidermoid carcinomas and 40% of the adenoid cystic carcinomas. All malignant tumours were positive for PCNA. These results indicate that the proliferative rate analysed with PCNA and Ki-67 and the expression of p53 in pleomorphic adenoma and adenoid cystic carcinoma of the submandibular gland were similar to those described in the parotid and minor salivary glands. However, mucoepidermoid carcinomas showed higher expression of these markers than those of other salivary glands. This work is the first describing the expression of these immunohistochemical markers exclusively in submandibular salivary gland tumours.
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Affiliation(s)
- F A Alves
- Department of Oral Pathology and Semiology, School of Dentistry of Piracicaba, University of Campinas-UNICAMP, São Paulo, Brazil.
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22
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da Cruz Perez DE, Pires FR, Alves FA, Almeida OP, Kowalski LP. Salivary gland tumors in children and adolescents: a clinicopathologic and immunohistochemical study of fifty-three cases. Int J Pediatr Otorhinolaryngol 2004; 68:895-902. [PMID: 15183580 DOI: 10.1016/j.ijporl.2004.02.004] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2003] [Accepted: 02/10/2004] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Salivary gland tumors in children and adolescents are rare. Most papers are case reports or short series of cases. The aim of this study was to analyze clinicopathological and immunohistochemical data from a large series of salivary gland tumors affecting youngsters from a single institution. METHODS From 1953 to 1997, 53 patients 18 years old or less with epithelial salivary gland tumors from the Hospital do Cancer A.C. Camargo were studied. Clinical and treatment data were obtained from the medical records and histological features were reviewed. Paraffin-embedded tissues were immunohistochemically analyzed for p53, PCNA, Ki-67, bcl-2, c-erbB-2, and CEA. RESULTS Twenty-seven tumors (51%) were benign and 26 (49%) malignant. Pleomorphic adenoma (PA) was the most common tumor type (49%), followed by mucoepidermoid carcinoma (MEC, 39.6%). The tumors were more common in female and 50.9% of the cases affected the parotid, followed by 26.4% of intraoral involvement. Immunohistochemical analysis did not show correlation with prognosis of the tumors. Twenty (74%) of the 27 patients with benign tumors were alive without evidence of disease after a mean of 16.5 years of follow up; 6 were lost of follow up and 1 died by causes not related to the disease. Nineteen (73%) of the 26 patients with malignant tumors did not show tumoral recurrence after a mean follow up of 14.3 years, and 3 (11.5%) patients died of the disease. CONCLUSIONS In 53 cases of epithelial salivary gland tumors in youngsters, half were malignant, with favorable prognosis. On this series, immunohistochemical expression of p53, PCNA, Ki-67, c-erbB-2, bcl-2, and CEA, were not correlated with prognosis.
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MESH Headings
- Adenoma, Pleomorphic/chemistry
- Adenoma, Pleomorphic/genetics
- Adenoma, Pleomorphic/pathology
- Adolescent
- Carcinoma, Mucoepidermoid/chemistry
- Carcinoma, Mucoepidermoid/genetics
- Carcinoma, Mucoepidermoid/pathology
- Child
- Female
- Follow-Up Studies
- Genes, bcl-2/genetics
- Genes, erbB-2/genetics
- Genes, p53/genetics
- Humans
- Immunohistochemistry
- Ki-67 Antigen/genetics
- Male
- Proliferating Cell Nuclear Antigen/genetics
- Receptors, Cell Surface/genetics
- Salivary Gland Neoplasms/chemistry
- Salivary Gland Neoplasms/genetics
- Salivary Gland Neoplasms/pathology
- Survival Rate
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23
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Weber A, Langhanki L, Schütz A, Wittekind C, Bootz F, Tannapfel A. Alterations of the INK4a-ARF gene locus in pleomorphic adenoma of the parotid gland. J Pathol 2002; 198:326-34. [PMID: 12375265 DOI: 10.1002/path.1210] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Pleomorphic adenomas of the parotid gland are benign tumours composed of epithelial and mesenchymal cells. The INK4a-ARF (CDKN2A) locus on chromosome 9p21 encodes two tumour suppressor proteins, p16(INK4a) and p14(ARF), which act as upstream regulators of the Rb-CDK4 and p53 pathways. To study the contribution of each pathway in pleomorphic adenomas, this study analysed alterations of p14(ARF), p16(INK4a), p53, and pRb in these tumours. After microdissecting the different histological components, 42 pleomorphic adenomas of the parotid gland were analysed for INK4a-ARF inactivation by DNA sequence analysis, methylation-specific PCR (MSP), restriction enzyme-related polymerase chain reaction (RE-PCR), mRNA expression, microsatellite analysis, and immunohistochemistry. In addition, microdeletion of p14(ARF) and p16(INK4a) were assessed by differential PCR. The status of p53 and Rb was examined by direct sequencing and immunohistochemistry. Using microdissection, it was possible to examine the tumour components, i.e. epithelial, mesenchymal, and transitional, separately after immunohistochemical identification. Methylation of p14(ARF) was found in 1/42 cases and alterations of p16(INK4a) occurred in 12/42 of pleomorphic adenomas, which correlated with loss of mRNA transcription. Microdeletions or specific mutations of either exon were not detected. Methylation was detected exclusively in the epithelial and transitional components and not within the mesenchymal part of the tumour. p53 mutations were detected in 4/42 adenomas, also occurring solely in the epithelial components of the tumours. pRb was detected immunohistochemically in 40/42 adenomas. In normal, corresponding parotid tissue, p14(ARF), p16(INK4a), p53, and pRb alterations were not observed. The observation that alterations of p14(ARF) and p16(INK4a), and also p53 mutations, occurred exclusively in the epithelial and transitional components of pleomorphic adenoma supports the theory that these areas are prone to malignant transformation to carcinoma in adenoma.
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Affiliation(s)
- Anette Weber
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Leipzig, Liebigstrasse 18a, Germany
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Abstract
Salivary gland tumours are a relatively rare and morphologically diverse group of lesions. Although most clinicians and pathologists will have encountered the more common benign neoplasms, few have experience of the full range of salivary cancers, which are best managed in specialist centres. This review considers some current areas of difficulty and controversy in the diagnosis and management of these neoplasms. The classification of these lesions is complex, encompassing nearly 40 different entities, but precise classification and terminology is essential for an accurate diagnosis and for the allocation of tumours to prognostic groups. For many salivary tumours diagnosis is straightforward but the wide range of morphological diversity between and within tumour types means that a diagnosis may not be possible on small incisional biopsies and careful consideration of the clinical and pathological features together is essential. Although tumour grading is important and helpful, it is not an independent prognostic indicator and must be considered in the context of stage. Large malignancies tend to have a poor prognosis regardless of grade and even high-grade neoplasms may do well when they are small. A helpful guide to management of salivary cancers is the '4 cm rule'.
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MESH Headings
- Adenocarcinoma/classification
- Adenocarcinoma/diagnosis
- Adenocarcinoma/pathology
- Adenoma, Pleomorphic/classification
- Adenoma, Pleomorphic/diagnosis
- Adenoma, Pleomorphic/pathology
- Carcinoma, Adenoid Cystic/classification
- Carcinoma, Adenoid Cystic/diagnosis
- Carcinoma, Adenoid Cystic/pathology
- Carcinoma, Mucoepidermoid/classification
- Carcinoma, Mucoepidermoid/diagnosis
- Carcinoma, Mucoepidermoid/pathology
- Humans
- Immunohistochemistry
- Neoplasm Staging
- Neoplasms, Multiple Primary/diagnosis
- Neoplasms, Multiple Primary/pathology
- Prognosis
- Salivary Gland Neoplasms/classification
- Salivary Gland Neoplasms/diagnosis
- Salivary Gland Neoplasms/pathology
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Affiliation(s)
- P M Speight
- Department of Oral and Maxillofacial Pathology, Eastman Dental Institute for Oral Health Care Sciences, University College London, UK.
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Actis AB, Lampe PD, Eynard AR. Cellular basis and clinical implications of biological markers in salivary tissues: their topological distribution in murine submandibular gland. Oral Oncol 2002; 38:441-9. [PMID: 12110338 DOI: 10.1016/s1368-8375(01)00091-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Cell proliferation and apoptosis as well as cell-cell adhesion and communication are essential processes that assure cell survival, renewal and coordination. Since junctional proteins have a tumor suppressor activity, their immunohistochemical characterization has diagnostic and prognostic value. The purpose of this report is to review the role played by junctional and proliferation-related proteins in the salivary glands and to illustrate their immunohistochemical localisation in normal murine submandibular gland. Normal salivary gland tissue was obtained from normal adult male BALB/c mice. After immediate fixation in formalin and ethanol, the samples were immunohistochemically stained for E-cadherin (HECD-1), Bcl-2, Ki67 (MIB-1), connexin26 and connexin 32, beta-catenin and gamma-catenin. Their topological distribution and reactivity were evaluated by light microscopy. The nuclei of submandibular acinar cells exhibited low to moderate staining for Ki67, but no reaction was observed in ductal cells. Murine Bcl-2 was light to moderately expressed in the latero-basal domain of cells of submandibular acini but was only lightly expressed in striated and eosinophilic ducts. The lateral domain of acinar cells were heavily stained with anti-E-cadherin, while only low levels were expressed at the cellular surface of ducts. beta-Catenin was consistently and evenly distributed along the latero-apical boundaries of eosinophilic secretory duct cells as well as on the lateral domain of acinar cells. On the contrary, gamma-catenin was generally expressed at lower levels than beta-catenin, was not expressed in ductal cells and was only lightly stained on the lateral membranes of acinar cells. No expression of connexin 32 was observed in ducts but it was significantly expressed in a spotted pattern along the plasma membrane of acinic cells. Connexin 26 showed similar localization to that of connexin 32 but the staining was much more intense. Since these proteins have been reported to play key roles in maintaining homeostasis via control of cell growth, differentiation and death, their analysis in normal salivary tissue will hopefully contribute to the study of salivary tumorigenesis.
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Affiliation(s)
- A B Actis
- Instituto de Biología Celular, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Casilla de Correos No, 220, Argentina.
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