Immunohistochemical differentiation of proliferative activity in Warthin's tumor &amp; different types of adenoid cystic carcinoma (p53, PCNA &amp; CD34)

Kamal Kamal,Mohamed Mohamed,Magdi Alazazi,Amr Abdoalwahab

doi:10.21608/adjc.2019.6936.1006

Abstract

Aim: To study the expression of p53, PCNA & CD34 and differentiate the proliferative activity and angiogenesis of Warthin’s tumor & different types of adenoid cystic carcinoma. Methods: Hematoxylin and Eosin (H&E) and immunohistochemical staining techniques were used to detect p53, PCNA & CD34 proteins in 20 cases of Warthin's tumor & different types of adenoid cystic carcinoma (solid, tubular & cribriform pattern). Evaluation of immunostaining was done using computer image analyzer system & all data were statistically analyzed. Results: There was a statistically significant difference (P<0.05) in means of expression of p53, PCNA & CD34 between Warthin's tumor & different types of adenoid cystic carcinoma. Conclusion: The expression of p53, PCNA & CD34 have been associated with aggressive tumor progression and thus has been implicated as a predictive and prognostic marker and could provide useful prognostic markers for proliferative activity and good prognostic indicators for recurrence rate of adenoid cystic carcinoma.

Highlights

The salivary glands are exocrine organs comprising ducto-acinar units that produce and secrete saliva
P53 and Proliferating cell nuclear antigen (PCNA) expression for Warthin’s tumor tissue sections showed weak positive staining in nucleus of neoplastic epithelial cells and in the lymphoid cells, similar results were obtained by Yang et al,(22) who reported that Warthin's tumor had actively dividing cells in the lymphoid follicles in addition to a proliferating fraction of cuboidal cells in the basal epithelial component
There were significant differences among the mean numbers of p53 and PCNA in all types of Adenoid cystic carcinoma (ACC) compared to Warthin's tumor (p ≤ 0.05), these results regarding PCNA and p53 expression confirms that Warthin's tumor has a slower proliferation rate compared to that of ACC and cell proliferation is related to tumor aggressiveness and prognosis

Summary

Introduction

The salivary glands are exocrine organs comprising ducto-acinar units that produce and secrete saliva. Tumors commonly arise in the salivary glands, and these comprise approximately 1% of all neoplasms in the whole body [1]. Papillary cyst adenolymphoma is the second most common benign cystic tumor of the salivary gland. This tumor was first described by Hilderbrand in 1895 as a form of congenital cyst of the neck. Warthin’s tumors occur almost exclusively in the parotid glands, in its superficial lobe and rarely in the deeper lobe (10%). It presents as a slow growing node, firm or fluctuant at palpation, with indolent mass, multicentric (12%–20%), and bilateral (5%–14%) [3]. According to the 2005 World Health Organization classification of tumors, Warthin’s tumor can be defined as a tumor composed of glandular and often cystic structures, sometimes with a papillary cystic arrangement, lined with characteristic bilayered epithelium, comprising inner columnar eosinophilic or

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