Prognostic factors of palatal mucoepidermoid carcinoma: a retrospective analysis based on a double-center study

Wenguang Xu,Zhiyong Wang,Zheng Wei,Junqi Xie,Xiaofeng Qi,Yufeng Wang,Xiteng Yin,Wei Han,Jian Meng

doi:10.1038/srep43907

Wenguang Xu, Zhiyong Wang + Show 7 more

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https://doi.org/10.1038/srep43907

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Abstract

Mucoepidermoid carcinoma (MEC) of the palate is a common malignancy of minor salivary glands. This study was designed to identify the prognostic factors for MEC of the palate. The medical records of patients diagnosed with MEC of the palate who visited the Department of Oral and Maxillofacial Surgery at Nanjing Stomatological Hospital and the Department of Stomatology at Central Hospital of Xuzhou were retrospectively studied. The prognostic factors were determined using a Cox proportional hazards model. Furthermore, the expression of cancer stem cell (CSC) markers CD44, CD133, Nanog and Sox2 were detected in neoplastic samples of these patients by immunohistochemistry. As a result, both univariate analysis and multivariate analysis proved a high histological grade and an advanced tumor stage as negative prognostic factors for overall survival. By immunohistochemistry staining and survival analysis, a combination of CD44/CD133/SOX2 was found to have the strongest prognostic value for palatal MEC patients. In conclusion, the proposed nomogram which include histological grade and tumor stage along with cancer stem cell markers provides a more accurate long-term prediction for palatal MEC patients.

Highlights

Cancer, pancreatic cancer and head and neck cancer[20,21,22]
A total of 75 patients diagnosed with Mucoepidermoid carcinoma (MEC) of the palate were eligible for inclusion, including 51 patients treated at the Department of Oral and Maxillofacial Surgery of Nanjing Stomatological Hospital and 24 patients at the Department of Stomatology of Central Hospital of Xuzhou
The findings showed that MEC of the palate was more frequent in women in the fifth decade of life (Supplementary Figure S1)

Summary

Introduction

Cancer, pancreatic cancer and head and neck cancer[20,21,22]. For MEC of salivary gland, cancer stem cells may play a functional role in the pathobiology of the disease indicated by some studies[23,24]. The surface markers of cancer stem cells include CD133, CD44, Oct[4], SOX2, Nanog, ALDH1, Bmi-1 and so on[25]. Maria and co-workers correlated the expression of several stem cell markers with histological and clinical parameters and found that Oct[4] and Nanog correlated with perineural invasion in mucoepidermoid carcinoma tissues[26]. To the best of our knowledge, few studies directly validated the prognostic value of stem cell markers for patients with MEC. Further investigations are needed to select the appropriate cancer stem cell markers as possible prognostic factors for MEC patients. We attempted to evaluate the expression of cancer stem cell markers in neoplastic tissues to determine whether these markers have the potential to predict the outcomes and identify appropriate prognostic markers for patients with MEC of the palate

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