Cathepsin-D and tumor associated antigen DF3 in salivary gland neoplasia: Differential diagnostic and prognostic applications

Abstract

Salivary gland tumors pose considerable difficulty in diagnostic and prognostic assessment based on the histopathologic features alone. Cathepsin-D is overexpressed in cancer cells where its concentration in the primary tumor is correlated with increased risk of metastasis. DF3 antigen is a tumor associated glycoprotein that is specific for malignant cells of glandular origin. We examined the distribution patterns of cathepsin-D and DF3 antigens in benign (n = 11) and malignant (n = 44) salivary gland tumors of various histologic types. The frequency of cathepsin-D expression is significantly increased (p < 0.001) in salivary gland carcinomas compared to benign mixed tumors (BMT). High levels of cathepsin-D expression was frequent in carcinomas ex BMT, mucoepidermoid carcinomas, poorly differentiated adenocarcinomas-NOS and adenoid cystic carcinomas (ACC). Acinic cell carcinomas and polymorphous low-grade adenocarcinomas were mostly negative. Intense cytoplasmic staining for DF3 antigen was noted in the tumor cells of mucoepidermoid carcinomas, carcinomas ex BMT and poorly differentiated adenocarcinomas-NOS whereas other types of salivary gland carcinomas exhibited either negative or only focal membrane staining. The noted differences in the reactive patterns of cathepsin-D and DF3 antigen among various histologic types of salivary gland carcinomas may have differential diagnostic and prognostic applications.