Factors Of Adenoid Cystic Carcinoma Research Articles

Assessment of the expression of Bcl-2 with clinicopathological factors in adenoid cystic carcinoma of salivary glands: A retrospective study

Background: Adenoid cystic carcinoma (ACC) is a type of salivary gland cancer with a poor long-term survival rate. Understanding the pathophysiology of this type of cancer will expand the available therapy options. The B-cell lymphoma 2 (Bcl-2) protein produces this early component within the Bcl-2 family of regulatory proteins, which can stimulate proapoptotic or inhibit cell death. Aims: The goal of this study was to detect the expression of Bcl-2 in ACC of the salivary glands and relate the results to clinicopathological characteristics. Materials and Methods: This study examined 35 histopathologically verified ACC of the salivary glands in the oral pathology laboratory at Specialist Surgical Hospital for the period (2011–2015). Bcl-2 expressions were investigated using an immunohistochemical analysis method. The expressions were correlated with clinical and histological evidence using the Statistical Package for the Social Sciences (SPSS) software version (20.0). Results: The expression of Bcl-2 revealed the high frequency of tumors with free margin was in the mild score and the high frequency of tumor with neural invasion was in the moderate score. Additionally, the distribution of the location and type elements along with interesting comparisons was provided. The neural invasion group’s distribution of the tumor revealed high significant difference. Conclusion: Adenoid cystic malignancy expresses antiapoptotic Bcl-2. Its expression may be useful in predicting behavior and establishing ACC-specific treatment.

Malignant sublingual gland tumors: A single-center retrospective analysis of 79 patients.

To analyze and summarize the clinicopathological features, risk factors for cervical nodal metastasis, and prognostic factors of malignant sublingual gland tumors (MSLGT). Patients diagnosed with MSLGT were retrospectively reviewed from January 2005 to December 2017 at Shanghai Ninth Hospital. The clinicopathological features were summarized, and the correlations between clinicopathological parameters, cervical nodal metastasis, and local-regional recurrence were evaluated using the Chi-square test. Kaplan-Meier method and Cox regression analysis were performed to assess the survival and independent prognostic factors. Seventy-nine patients were included, and the 5-year overall survival and disease-free survival rates was 85.7% and 71.7%, respectively. Gender and clinical tumor stage were risk factors for cervical nodal metastasis. Tumor size and pathological lymph node (LN) stage were independent prognostic factors for adenoid cystic carcinoma (ACC) of the sublingual gland; while age, pathological LN stage, and distant metastasis were prognostic factors for patients with non-ACC of the sublingual gland. Patients with higher clinical stage were more likely to undergo tumor recurrence. Malignant sublingual gland tumors are rare, and neck dissection should be performed in male MSLGT patients with higher clinical stage. Among patients with both ACC and non-ACC MSLGT patients, pN+ indicate a poor prognosis.

Clinical outcome and prognostic factors in adenoid cystic carcinoma of the external auditory canal: proposal for a refined T-stage classification system.

Although adenoid cystic carcinoma (ACC) of the external auditory canal (EAC) has a different pathophysiology from squamous cell carcinoma, the same staging system is used. The aim of this study was to propose a refined staging system, which is more suitable for ACC of the EAC. A total of 25 patients who were diagnosed with ACC of the EAC were reviewed. The modified Pittsburgh staging system (mPSS) that is universally used for temporal bone malignancy was refined for ACC (rPSS). The limited (< 0.5cm) lateral soft tissue involvement was classified as T1 and extensive (≥ 0.5cm) lateral soft tissue involvement as T2. The disease-free survival rate (DFSR) was assessed in the patients who underwent surgical treatment according to two staging systems; mPSS and rPSS. When staging using mPSS, most patients (96.0%, n = 24) were classified as T4. However, when rPSS was used, T1, T2, T3, and T4 stage occupied 36.0% (n = 9), 40.0% (n = 10), 12.0% (n = 3), 12.0% (n = 3), respectively. There was no difference in DFSR according to the T stage using mPSS (p = 0.466). However, when rPSS was used, the DFSR showed significant correlation with the T stage (p = 0.032). Clinical T stage of mPSS was not sufficient to predict survival rate in ACC of the EAC, and we propose that the information on the lateral soft tissue involvement needs to be added to the existing staging system.

CALCB rs3829222 T/T Genotype and Low Expression of CALCB Are High-Risk Factors for Adenoid Cystic Carcinoma of Salivary Gland.

Objectives To investigate the relationship between polymorphisms of calcitonin-related peptide gene II (beta-calcitonin gene-related peptide (βCGRP), CALCB) and serum CGRP levels in salivary adenoid cystic carcinoma. Materials and Methods Using the polymerase chain reaction (PCR) technique, the full-length amplification and genotype analysis of CALCB genes were performed in 39 patients with adenoid cystic carcinoma of salivary gland and 158 normal controls. The gene frequencies of major genotype of CALCB in adenoid cystic carcinoma of salivary gland and normal control group were analyzed. Enzyme-linked immunosorbent assay (ELISA) was used to evaluate serum calcitonin gene-related peptide (CGRP) and its concentration of alpha and beta subtypes. Results Univariate logistic regression analysis showed that the CALCB rs2839222 T/T genotype was closely related to the occurrence of salivary adenoid cystic carcinoma, with a correlation coefficient of 3.89. Conclusions The serum CGRP concentration in the salivary adenoid cystic carcinoma group was 1.56 times that of the normal control group. The αCGRP subtype was significant, which was 3.02 times that of the normal control. The polymorphism of βCGRP gene is associated with genetic susceptibility to salivary adenoid cystic carcinoma, and serum CGRP and βCGRP can be used as novel markers of salivary adenoid cystic carcinoma.

Clinicopathological Features of Adenoid Cystic Carcinoma: An Institutional Perspective

Introduction: Adenoid cystic carcinoma is a rare salivary gland malignancy that can occur in any part of the body, its clinicopathologic features are scarcely reported in locoregional literature. Therefore, in this study we aimed to evaluate the clinicopathologic features of adenoid cystic carcinoma in our population and to determine the association of age and site of its occurrence with histologic pattern and perineural invasion. Methods: We retrospectively analyzed 30 cases of adenoid cystic carcinoma that underwent surgical resections or biopsies from March 2009 to February 2020 at Liaquat National Hospital and Medical College, Karachi. Clinical and histopathological parameters including age, site, histological pattern and perineural invasion were determined and association between different parameters was analyzed. Results: Mean age of the patients was 30 + 16.1 years. Cribriform pattern was most common histologic pattern (63.3%) while head and neck region was the most common site of occurrence (83.3%). Perineural invasion which is one of the most important prognostic factors in adenoid cystic carcinoma was present in approximately half of the patients (46.7%). No significant association of age and site was found with histologic pattern and perineural invasion. Conclusion: Adenoid cystic carcinoma is a rare malignancy most commonly occurring in head and neck region with a high frequency of perineural invasion. No significant difference of histologic pattern and histologic prognostic parameter like perineural invasion was noted at different ages and different sites in our study.

Study of surgery combined with 125I brachytherapy for adenoid cystic carcinoma of oral and maxillofacial region

To retrospectively analyze the results of treatment outcome by surgery combined with 125I brachytherapy and correlative factors of adenoid cystic carcinoma (ACC). In the study, 75 patients with primary ACC of oral and maxillofacial region were treated by surgery combined with 125I seeds brachytherapy. Radical resection or subtotal resection was applied for the tumor. The brachytherapy treatment planning system was used to create implant plans with the prescribed dose of 60 Gy to 120 Gy. The 125I seeds were implanted intraoperatively or postoperatively. The regular follow-up was required. The Kaplan-Meier method was used to assess the tumor control rate and the patients' survival rates. Meanwhile, the Cox regression analysis was used to find out the prognostic factors. Local control rates at the end of 3 and 5 years were as follows: T1-T2, 92.2% and 82.0%; T3-T4, 82.6% and 82.6%; and overall, 90.0% and 78.8%. The disease-free survival rates were 74.9% and 54.3%, respectively. The overall survival rates for all the patients were 86.0% and 79.6%, respectively at the end of 3 and 5 years and were 91.3% and 91.3% for T1-T2 patients vs. 73.9% and 59.7% for T3-T4 patients. Distant metastasis-free survival rates at the end of 3 and 5 years were 84.4% and 76.7%, respectively. The distant metastasis-free survival rates at the end of 3 and 5 years were 83.4% and 79.6% with T1-T2 lesion compared with 86.0% and 67.8% with T3-T4 lesion. According to the COX univariate analysis and multivariate analysis, the risk of local recurrence would be raised by the age. Tumor stage and tumor site were the prognostic factors of the overall survival rates. 125I brachytherapy conducted as an adjuvant therapy postoperatively of ACC of oral and maxillofacial region can acquire satisfactory localregional control, distant metastasis-free survival, disease-free survival and overall survival. Tumors are prone to recur on the older patients. Patients having advanced tumor stage or tumor located in the nasal cavity or sinuses will suffer lower survival rates.

1080P - Prognostics factors in adenoid cystic carcinoma of the head and neck (ACCHN): Retrospective study of 15 years

1080P - Prognostics factors in adenoid cystic carcinoma of the head and neck (ACCHN): Retrospective study of 15 years

Predictors of Outcome in Adenoid Cystic Carcinoma of Salivary Glands

Adenoid cystic carcinoma (ACC) is the second most common salivary gland malignancy and it has a high rate of recurrences and a poor long-term prognosis. Our aim was to assess the prognostic factors in ACC and study MYB-NFIB fusion and MYB protein expression in a large retrospective cohort of 135 patients with a median follow-up of 6.3 years. The 5- and 10-year local recurrence-free survival (RFS) rate of 94% and 78%, 5- and 10-year distant metastasis survival rate of 77% and 58%, and 5- and 10-year RFS of 66% and 44%. The following features were identified as adverse prognostic factors of RFS on univariate analysis: large tumor size, solid growth pattern, increased mitoses, positive margin, American Joint Committee on Cancer clinical staging, high-grade transformation, vascular invasion, nuclear atypia, open chromatin, prominent nucleoli, and tumor necrosis. However, on multivariate analysis, only increased mitoses (≥5/10 high-power fields), any solid growth pattern, and advanced American Joint Committee on Cancer TNM staging were independent adverse predictors for RFS. MYB immunoexpression and MYB-NFIB translocation were common findings in ACC, occurring in 72% and 59% of the tested ACCs, respectively. The sensitivity and specificity of MYB immunohistochemistry in detecting MYB-NFIB fusion was relatively low at 78% sensitivity and 50% specificity. The high prevalence of alterations leading to high expression of the MYB transcription factor family suggests that targeted approaches developed to suppress the expression of these oncogenic transcription factors and/or the transcriptional activity of these proteins would be a rational therapeutic approach to investigate in ACC.

Clinical Outcomes and Prognostic Factors of Adenoid Cystic Carcinoma of the Head and Neck.

Adenoid cystic carcinoma (ACC) is a salivary gland malignancy with unpredictable growth and poorly understood prognostic factors. A database search of patients treated at a single Institution was used to identify patients with histologically-confirmed ACC. Patient, tumor, and treatment characteristics were examined via review of medical records. Overall survival of 70 patients identified at 5, 10, and 15 years was 80.4%, 61.3%, and 29.4%, respectively. Disease recurrence was seen in 31.9%; of these, 72.7% developed distant metastasis. Older age, higher stage, skull base involvement, positive margins, and metastatic disease, but not local recurrence, predicted a worse overall survival. Higher stage and skull base disease were also associated with shorter disease-free survival. While lung metastasis was the most common, vertebral metastasis was associated with poorer survival. Disease stage, positive margins, skull base involvement, perineural invasion, time to recurrence, and location of metastasis, but not nodal involvement, could serve as poor prognostic factors in ACC.

Prognostic factors of adenoid cystic carcinoma of the head and neck in carbon-ion radiotherapy: The impact of histological subtypes

The aim of this study was to evaluate the effect of histological subtypes of head and neck adenoid cystic carcinoma (ACC) on the results of carbon-ion radiotherapy (CIRT). Of the 113 patients with ACC who were treated with CIRT between December 2006 and July 2013, 100 patients with identified histological subtypes were enrolled in this study. CIRT at a total dose of 57.6 or 64.0Gy (RBE) was administered in 16 fractions. Histological grading was defined as the presence or absence of a solid growth pattern. Median follow-up was 60 months. 5-Year local control (LC), overall survival (OS) and distant metastasis free survival (DMFS) of all patients were 68.6%, 74.8% and 65.7%, respectively. On multivariate analysis, the prescribed dose (p=0.001) and gross tumor volume (p=0.002) were significant independent risk factors for LC. No significant difference for local control of solid/non-solid growth patterns was found (p=0.093). Solid growth pattern was an independent risk factor for both OS (p=0.033) and DMFS (p=0.024). CIRT appears able to locally control solid growth pattern ACC in the head and neck. Improved intervention is needed to extend DMFS and OS.

Clinicopathologic and prognostic factors in adenoid cystic carcinoma of head and neck minor salivary glands: A clinical analysis of 130 cases

This study was to investigate clinicopathologic characteristics and prognostic factors in adenoid cystic carcinoma of head and neck minor salivary glands. We conducted a retrospective review of 130 patients with adenoid cystic carcinoma of head and neck minor salivary glands that were evaluated between 2000 and 2013 in Beijng Tongren Hospital. Five-year overall survival and disease-free survival rates were 80.8% and 55.6%. Local recurrence rate was 40%, regional recurrence 3.8%, and distant metastasis was 28.5%. On univariate analysis, solid histological subtype, perineural invasion, positive surgical margins and advanced stages were found to be poor prognostic indicators. On multivariate analysis, solid histological subtype and positive surgical margins were significant prognostic factors of worse overall survival. Solid histological subtype and positive surgical margins were the most important predictors of poor outcome in adenoid cystic carcinoma of minor salivary glands. Surgery with postoperative radiation were recommended treatment and offered durable local control.

Adenoid cystic carcinoma of the head and neck: Clinicopathologic analysis of 218 cases in a Chinese population

The aim of this study was to analyze the clinicopathologic characteristics and prognostic factors of adenoid cystic carcinoma of the head and neck (ACCHN). This was a retrospective study of 218 patients with ACCHN. The cohort included 110 men and 108 women; the parotid and the palate were the most common site of involvement. Of 203 patients with follow-up information (range 2-132 months), 57 had died of the tumor. Distant metastasis (DM) and local recurrence (LR) were documented in 83 (40.9%) and 34 (16.7%) patients, respectively. Cox regression analysis indicated that a solid pattern was a marker for LR and that positive margins and older age were risk factors for DM. Histologic pattern, T stage, N stage, LR, DM, and patient age contributed to the prediction of disease-specific survival. A solid pattern, metastasis, LR, and older age are the most important factors for predicting poor prognosis in Chinese patients with ACCHN.

Clinical Characteristics and Prognostic Factors of Adenoid Cystic Carcinoma of the Head and Neck

This study was intended to evaluate prognostic factors and the role of postoperative radiotherapy (RT) in patients with adenoid cystic carcinoma (ACC) of the head and neck (ACCHN). Retrospective study. Eighty-eight patients with ACCHN who underwent curative intent surgery with or without RT between 1991 and 2009 at a single institute were retrospectively analyzed. Patients with ACC of the sinonasal area (P=.005) and those with diabetes mellitus (DM; P=.027) showed a significantly higher risk of local recurrence. Age (<40 or >60 years, P=.028) and tumor stage III or IV (P=.022) were significant adverse factors predicting distant metastasis. High-grade histology (P=.014) and DM (P=.027) were independently associated with shorter disease-free survival (DFS). In addition, postoperative RT (≥59 Gy) significantly enhanced local control (P=.025) and DFS (P=.001) in both univariate and multivariate analyses. Age, DM, tumor site, histologic grade, and stage were independently significant prognostic factors for ACCHN. In addition, an adequate dose of postoperative radiotherapy can improve local control and DFS of patients with ACCHN.

Lymphatic vessels and related factors in adenoid cystic carcinoma of the salivary gland

Adenoid cystic carcinoma of the salivary gland preferentially metastasizes to distant organs. It rarely metastasizes to lymph nodes. Recently, lymphangiogenesis has been associated with lymph node metastasis. Therefore, lymphangiogenesis in adenoid cystic carcinoma was evaluated from the number of lymphatic vessels and the expression of lymphangiogenic factors. Immunohistochemistry and molecular analysis were performed on clinical materials (29 cases for immunohistochemistry and 9 cases for molecular analysis). Normal submandibular gland was used as a negative control of lymphangiogenesis (10 cases for immunohistochemistry and 5 cases for molecular analysis). In adenoid cystic carcinoma, podoplanin-positive lymphatic vessels were small and often constricted, and localized to the tumor periphery. They did not have Ki67-positive endothelial cells. The lymphatic vessel density of the tumor did not exceed that of the salivary gland. By reverse transcriptase-polymerase chain reaction, adenoid cystic carcinoma and the salivary gland expressed vascular endothelial growth factor receptor-3 (VEGFR-3) similarly but VEGF-C and VEGF-D differently. Adenoid cystic carcinoma expressed VEGF-C, whereas the salivary gland expressed both VEGF-C and VEGF-D. VEGF-C was weak in adenoid cystic carcinoma and strong in the salivary gland. Real-time reverse transcriptase-polymerase chain reaction of VEGF-C showed that the ratio of the tumor to the salivary gland was 1 to 30 (P<0.01). Immunohistochemistry barely detected VEGF-C in adenoid cystic carcinoma. VEGF-C was expressed faintly by the tumor cells. VEGF-C and VEGF-D were detected in the serous acinar and duct cells and in the duct contents in the salivary gland. VEGFR-3 appeared to be expressed by lymphatic vessels in both adenoid cystic carcinoma and the salivary gland. These results indicate that lymphangiogenesis does not occur in adenoid cystic carcinoma. This condition would lead to the uncommon lymphatic metastasis.

Prognostic factors of adenoid cystic carcinoma of head and neck.

5584 Background: Adenoid cystic carcinoma is a rare malignancy, accounting for about 1% of head and neck cancer. We assessed clinical characteristics and prognostic factors affecting clinical outco...

Treatment results and prognostic analysis of 54 patients with adenoid cystic carcinoma originated from the major salivary glands

Objective Adenoid cystic carcinoma (ACC), a rare malignancy in head and neck region, is predominately found in the salivary glands. Our study is to retrospectively analyze the treatment outcomes and prognostic factors of ACC originated from the major salivary glands. Methods A total of 54 patients diagnosed as ACC were treated in our institution, including 24 cases originated from the parotid gland and 30 from the submandibular or sublingual gland. According to the records, 26 patients received surgery alone and 28 were treated with surgery followed by radiotherapy with a median dose of 58 Gy (range, 50 -65 Gy). Results The Follow-up rate was 94%, and 15 patients from postoperative radiotherapy group and 20 from surgery alone group were followed up more then 5 years. The 5-year overall survival rate, local-regional control rate, distant metastasis rate, and disease-free survival rate were 97%, 71%, 13% and 69%, respectively. Lung metastasis, occurred in 7 patients, was the most common distant failure. Fifteen recurrences were observed, including 13 in surgery alone group and 2 in postoperative radiotherapy group. The 5-year local-regional control and disease-free survival rates were 90% and 85% for patients treated with postoperative radiotherapy, 54% and 55% for those treated with surgery alone. Univariate and multivariate analyses showed that postoperative radiotherapy was the only prognostic factor of local-regional control and survival rates. Other parameters such as nerve involvement did not significantly influence the treatment results. Conclusions Postoperative radiotherapy can improve the prognosis of ACC originate from the major salivary glands compared with surgery alone. Distant metastasis is an obstacle in curing the disease, which indicates the value of systemic treatment. Key words: Salivary glands neoplasms / surgery ; Salivary glands neoplasms / radiotherapy ; Prognosis

Immunotherapy for adenoid cystic carcinoma of salivary glands: Cancer/testis antigens and 5-aza-2′-deoxycytidine

Adenoid cystic carcinoma of salivary glands is the epithelial tumor. There are amount of malignant occurrences of adenoid cystic carcinoma of salivary glands in the head and neck area. Cancer/testis antigens can be found in various malignant tumors, normal adult testis and occasionally placenta, but not in the other normal adult tissues. This characteristic makes Cancer/testis antigens as potential markers to be applied in immunotherapeutic strategies against cancer. It has been shown that in different tumors, the expression of certain Cancer/testis antigens is activated treated with 5-aza-CdR via the demethylation of their promoter CpG islands. It is logical that multiple Cancer/testis antigens may correlate with the clinicopathologic factors of adenoid cystic carcinoma of salivary glands and be the potential markers of prognosis treated with 5-aza-CdR. So the hypothesis will provide the new direction that we can use Cancer/testis antigens as candidate antigens for adenoid cystic carcinoma of salivary glands immunotherapy due to the high expression rate activated with 5-aza-CdR.

Prognostic factors for adenoid cystic carcinoma of the head and neck: a retrospective evaluation of 96 cases

Cases of adenoid cystic carcinomas of the salivary (n = 90) and lacrimal glands (n = 6) from the years 1965-1980 were evaluated retrospectively with regard to clinical, epidemiologic and histomorphologic parameters, and in 52 cases, nuclear DNA content was assessed using a single cell scanning cytophotometry procedure in order to determine prognostic factors. Clinical courses were poor with a high incidence of recurrences, hematogenous metastases and deaths from tumor. Histology was related to prognosis, glandular tumors showing a better prognosis than solid ones. Tumor size greater than 4 cm was correlated with an unfavorable clinical course in all cases. Cytophotometry yielded various types of histograms (7 diploid, 10 proliferative, 14 triploid, 19 atypical, 2 tetraploid). Significant correlations were found as to the time of survival, tumors with diploid histograms showing the longest intervals and those with atypical ones the shortest. Although the prognosis of adenoid cystic carcinoma remains poor, cytophotometry can offer additional prognostic information in the individual case.