Prognosis Of Adenoid Cystic Carcinoma Research Articles

The clinical features and prognosis analysis of adenoid cystic carcinoma in nasal cavity and paranasal sinus

Objective:To investigate the clinical features and prognosis of adenoid cystic carcinoma (ACC) in nasal cavity and sinus. Method:67 patients with ACC were recruited interview in our department from 2007 to 2017. The association between clinical parameters and survival were evaluated by statistical analysis. Result:The 1-, 5- and 10- overall survival were 95%, 79%, 67%, and the 1-, 3- and 5-year recurrence rate were 5%, 7%, 9%, respectively. Simple factor analysis displays that age, the location of the tumour, clinical stages, sex, the interval time between starting symptoms to diagnosis time, the expression quantity of Ki-67 were related to the prognosis, and the latter three and surgical margin were also influential factors of distant metastasis after treatment. Multi-factors analysis revealed that sex, the interval time between starting symptoms to diagnosis time, the expression quantity of Ki-67 were significant factors for prognosis, and the latter two and surgical margin were influential factors of distant metastasis after treatment. Conclusion:The sex and the interval time between starting symptoms to diagnosis time and Ki-67 may be independent prognostic factors for ACC. The interval time between starting symptoms to diagnosis time and Ki-67 level may be independent factors of distant metastasis after treatment. Patients with long interval time between starting symptoms to diagnosis time and high expression of Ki-67 may have a higher risk of recurrence and mortality, which need reexamination of cycle-time reduction. The surgical margin is influential factor of distant metastasis, but not for the patients' prognosis.

MicroRNA Profiling and Target Genes Related to Metastasis of Salivary Adenoid Cystic Carcinoma.

Perineural invasion and distant metastasis lead to a poor prognosis of adenoid cystic carcinoma and there is no effective therapy available. MicroRNAs (miRNAs) are small non-coding RNAs that regulate target gene expression, which can be biomarkers or therapeutic targets for certain cancer types. We aimed to identify miRNAs and their target genes possibly involved in metastasis of salivary gland adenoid cystic carcinoma (SACC). Using Nanostring nCounter analysis, we examined miRNA expression in two SACC cell lines: SACC-83 and SACC-LM, with low and high lung metastasis rates, respectively. We then verified the differentially expressed miRNAs with real-time polymerase chain reaction in the cell lines and in tumor samples from patients with SACC. miRNA target-gene expression was also analyzed. SACC-83 showed higher gene expression of miR-130a, miR-342, and miR-205; SACC-LM showed higher gene expression of miR-99a and miR-155. In human tissue, miR-205 was highly expressed in the primary SACC, while miR-155 and miR-342 were highly expressed in recurrent SACC. Six predicted target genes of miRNA-155 and miR-99a linked to tumorigenesis were further analyzed and RNA expression of ubiquitin-like modifier activating enzyme 2 (UBA2) was higher in SACC than normal salivary gland tissue, and higher in primary compared to recurrent SACC (p<0.05). RNA expression of retinoic acid receptors (RARS) was higher in tissue from primary than recurrent SACC and normal salivary gland (p<0.05), but that in recurrent SACC was not significantly higher than normal salivary gland tissue. RNA expression of minichromosome maintenance 8 homologous recombination repair factor (MCM8) and 24-dehydrocholesterol reductase (DHCR24) was higher in primary SACC than normal salivary gland tissue (p<0.05). miR-99a, miR-155, miR-130a, miR-342, and miR-205 may play a role in metastasis of SACC. MiR-155 may be involved in SACC metastasis through UBA2 pathways, and UBA2 may function as a biomarker/mediator of SACC metastasis.

Prognostic significance of p53 immunohistochemical expression in adenoid cystic carcinoma of the salivary glands: a meta-analysis.

Adenoid cystic carcinoma of salivary glands is a rare adenocarcinoma and has been placed in “high-risk” category as poor long-term prognosis. The purpose of this study was to investigate p53 protein expression in adenoid cystic carcinoma of salivary glands and its correlation with clinicopathological parameters and prognosis. Literatures were searched from PubMed, Embase, Cochrane Library and Web of Science, which investigated the relationships between p53 expression and pathological type, clinical stage, local recurrence, metastasis, nerve infiltration and overall survival. A total of 1,608 patients from 36 studies were included in the analysis. The results showed that p53-postive expression rate was 49% in adenoid cystic carcinoma of salivary glands (OR=10.34, 95%CI: 4.93-21.71, P < 0.0001). The p53-postive expression was closely related to tumor types (OR=0.30, 95%CI: 0.14-0.65, P < 0.0001). The tumor with solid histological subtype had a strong positive correlation with p53 expression. The combined analysis revealed that the p53-positive expression rate among patients in T1and T2 stage was 41.4%, compared to 53.2% among those in T3 and T4 stage. However, there was no significant correlation between tumor stage and p53 expression (OR=0.47, 95% CI: 0.17-1.29, P = 0.14). Besides, compared to patients with p53-negative expression, those with p53-positive expression had a greater chance of developing metastasis, local recurrence and nerve infiltration as well as poorer 5-year overall survival (P < 0.01). In conclusion, the p53 expression is related to the survival of adenoid cystic carcinoma of salivary glands. It can be considered as the auxiliary detection index in treatment and prognosis of adenoid cystic carcinoma of salivary glands.

Identification of methylated genes in salivary gland adenoid cystic carcinoma xenografts using global demethylation and methylation microarray screening.

Salivary gland adenoid cystic carcinoma (ACC) is a rare head and neck malignancy without molecular biomarkers that can be used to predict the chemotherapeutic response or prognosis of ACC. The regulation of gene expression of oncogenes and tumor suppressor genes (TSGs) through DNA promoter methylation may play a role in the carcinogenesis of ACC. To identify differentially methylated genes in ACC, a global demethylating agent, 5-aza-2′-deoxycytidine (5-AZA) was utilized to unmask putative TSG silencing in ACC xenograft models in mice. Fresh xenografts were passaged, implanted in triplicate in mice that were treated with 5-AZA daily for 28 days. These xenografts were then evaluated for genome-wide DNA methylation patterns using the Illumina Infinium HumanMethylation27 BeadChip array. Validation of the 32 candidate genes was performed by bisulfite sequencing (BS-seq) in a separate cohort of 6 ACC primary tumors and 6 normal control salivary gland tissues. Hypermethylation was identified in the HCN2 gene promoter in all 6 control tissues, but hypomethylation was found in all 6 ACC tumor tissues. Quantitative validation of HCN2 promoter methylation level in the region detected by BS-seq was performed in a larger cohort of primary tumors (n=32) confirming significant HCN2 hypomethylation in ACCs compared with normal samples (n=10; P=0.04). HCN2 immunohistochemical staining was performed on an ACC tissue microarray. HCN2 staining intensity and H-score, but not percentage of the positively stained cells, were significantly stronger in normal tissues than those of ACC tissues. With our novel screening and sequencing methods, we identified several gene candidates that were methylated. The most significant of these genes, HCN2, was actually hypomethylated in tumors. However, promoter methylation status does not appear to be a major determinant of HCN2 expression in normal and ACC tissues. HCN2 hypomethylation is a biomarker of ACC and may play an important role in the carcinogenesis of ACC.

Obatoclax induces Beclin 1- and ATG5-dependent apoptosis and autophagy in adenoid cystic carcinoma cells.

Adenoid cystic carcinoma (ACC) is one of the most common salivary gland cancers. The prognosis of adenoid cystic carcinoma is poor for its high frequency of distant metastases and insensitivity to chemotherapy or molecular therapies. This study investigated the effect of Obatoclax on adenoid cystic carcinoma cells and its cytotoxic mechanism. Western blot, transmission electron microscopy, and pEGFP-LC3 plasmids transfection were carried out to detect autophagy in ACC cells treated with Obatoclax. 3-MA and RNA interference against Beclin 1 and ATG5 were used to inhibit autophagy. Then we used Western blot and Hochest 33342 staining for apoptosis assessment. Finally, cell viability was assessed by MTT assay. We found that Obatoclax induced cytoprotective autophagy which depended on ATG5 and partly on Beclin 1 in adenoid cystic carcinoma cells. Furthermore, pharmacologically inhibiting Obatoclax-induced autophagy promoted apoptosis. Downregulation of Beclin 1 or ATG5 attenuated the cytotoxicity of Obatoclax by suppressing both autophagy and apoptosis. Finally, when apoptosis was pharmacologically inhibited, autophagic cell death was initiated in adenoid cystic carcinoma cells treated with Obatoclax. In summary, Beclin 1 and ATG5 play important roles in regulating both Obatoclax-induced autophagy and apoptosis in adenoid cystic carcinoma.

Histopathological grading of adenoid cystic carcinoma of the head and neck: Analysis of currently used grading systems and proposal for a simplified grading scheme

Histopathological grading of adenoid cystic carcinoma (ACC) is a controversial issue. It is generally agreed that solid type ACC has a relatively poor prognosis. However, the amount of solid regions within this often mixed type tumor that predicts a poor prognosis is not firmly established. Some authors stipulate that the presence of a solid component regardless of the amount is a poor prognosticator where others argue that the amount should be taken into consideration. Two grading systems most commonly used are those described by Perzin et al./Szanto et al. and Spiro et al., respectively. They report that prognosis of ACC is poor if >30% and >50% of the tumor volume has a solid growth pattern, respectively. The described grading systems are applied to a series of 81 surgically treated cases of ACC at the VU University Medical Center, Amsterdam, The Netherlands. Moreover, we introduced an alternative grading system, in which the presence of a solid component, irrespective of its amount, is considered. All three systems of grading were tested for inter-observer concordance and prediction of prognosis. Inter-observer concordance for grading ACC according to Perzin et al./Szanto et al. and Spiro et al., proved to be moderate with Kappa Scores of 0.393 and 0.433, respectively. Our alternative grading system yielded inter-observer concordance with a Cohen's kappa result of 0.990. All systems were comparable in discriminating patients with poor clinical outcome. Histopathological grade proved to be an independent prognosticator. The presence of any solid component in ACC is a negative prognosticator, and can histopathologically be diagnosed with a high reliability. These results suggest to merely register the presence or absence of a solid tumor component since its inter-observer variability is very low, its reproducibility is high and its predictive value is comparable to the traditional grading systems used.

Adenoid cystic carcinoma of the nasal cavity and paranasal sinuses: a meta-analysis.

Objectives To identify independent predictors of outcome in patients with adenoid cystic carcinoma (ACC) of the paranasal sinuses and skull base. Design Meta-analysis of the literature and data from the International ACC Study Group. Setting University-affiliated medical center. Participants The study group consisted of 520 patients, 99 of them from the international cohort. The median follow-up period was 60 months (range, 32 to 100 months). Main Outcome Measures Overall survival (OS) and disease-specific survival (DSS). Results The 5-year OS and DSS of the entire cohort were 62% and 67%, respectively. The local recurrence rate was 36.6%, and the regional recurrence rate was 7%. Distant metastasis, most commonly present in the lung, was recorded in 106 patients (29.1%). In the international cohort, positive margins and ACC of the sphenoid or ethmoidal sinuses were significant predictors of outcome (p < 0.001). Perineural invasion and adjuvant treatment (radiotherapy or chemoradiation) were not associated with prognosis. Conclusion Tumor margin status and tumor site are associated with prognosis in ACC of the paranasal sinuses, whereas perineural invasion is not. Adjuvant treatment apparently has no impact on outcome.

Adenoid Cystic Carcinoma of the Breast: A Rare Histopathology- Good Prognosis

Background: Adenoid cystic carcinoma (ACC), one of the rarest neoplasia of the breast, constitutes 0.1% of all breast carcinomas. The prognosis of ACC is very good compared to other histological subtypes of breast carcinoma. Lymph node involvement and distant metastasis are very infrequent. Estrogen receptor (ER), progesterone receptor (PR) and c-erbB2 (also known as HER-2/neu) are typically negative.CaseA fourty eight year-old premenauposal women was admitted to hospital with a mass on the upper outer quadrant of her left breast. Since the result of through-cut biopsy of this suspicious lesion was consistent with adenoid cystic carcinoma, modified radical mastectomy with axillary lymph node excision was applied. Pathological examination revealed a moderately differantiated adenoid cystic carcinoma of the breast. The size of invasive tumor component was 4.8 cm in its greatest dimension. Immunohistochemical analysis was consistent with triple negative phenotype ( ER,PR and c-erbB2 negative).Conclusion: ACC is a rare type of human breast carcinoma with ER, PR and c-erbB2 negative phenotype. They usually show an excellent prognosis however there is no well defined treatment options for ACC since the rarity of clinical studies in such kind of unusual histological subtypes of breast carcinomas.

頭頸部腺様嚢胞癌72症例の臨床的検討

We reviewed 72 cases treated in our hospital for adenoid cystic carcinoma of the head and neck during the 37 years between 1972 and 2009. The disease-specific survival rate at 3, 5, 10, 15, and 20 years was 76%, 70%, 46%, 33%, and 33%, respectively so survival rate had decreased gradually to 15 years. There was no significant difference in the survival rate of primary site, but T3 & T4 disease indicated a worse prognosis, and patients with lymph node positive findings tended to have a worse prognosis. The loco-regional control rate was 65% at 5 years, but after that, it continued to decrease, and the loco-regional control rate at 15 years was 31%. In addition, the median of the period for loco-regional recurrence was 93 months, with the longest time being 168 months. The relatively long lapse was traced to recurrence. The rate of absence of distant metastasis was 54% at 5 years, but after that, it continued to decrease, with the rate at 20 years was being 22%. The median time of survival after patients tested positive for distant metastasis was 25 months, with longest recognized period being 216 months. The long-term prognosis of adenoid cystic carcinoma is generally poor, so a long-term follow-up is necessary.

Clinical analysis of 52 cases of adenoid cystic carcinoma in minor salivary gland

To investigate the prognosis of adenoid cystic carcinoma (ACC) in minor salivary glands and its influencing factors. Clinical data of 52 patients with ACC in minor salivary glands were reviewed. The distribution of stage was as follows: stage I (6%), stage II (21%), stage III (27%) and stage IV (46%). Counting data was analyzed by χ(2) test or Fisher's exact. Survival rates were calculated by Kaplan-Merier method. Statistical significance of differences in the cumulative survival curves was evaluated using the Log-rank test. Multivariate analysis was performed by Cox proportional hazard model. All patients underwent primary tumor radical resection, 39 patients (75%) received postoperative radiation. The regional recurrence rate was 37% and distant metastasis rate was 21%. The 5-, 10-year cumulative local control rate were 68% and 63% respectively. The 5-, 10-year cumulative distant control rate were 86%, 68% respectively. The 5-, 10-year tumor specific survival rates were 70% and 54% respectively. Multivariate analysis showed that T stage, lymph node metastasis and perineural invasion were relevant to the tumor specific survival of ACC in minor salivary glands. Recurrence and metastasis were the main cause of treatment failure of ACC in minor salivary glands. T stage, lymph node metastasis and perineural invasion were the independent prognostic factors of ACC in minor salivary glands. Radical surgery and reasonably postoperative radiotherapy were the main treatment strategy.

Clinicopathological features of salivary and non-salivary adenoid cystic carcinomas

Adenoid cystic carcinoma (ACC), commonly from salivary glands, is known for its insidious local growth and usually protracted clinical course. ACC developing from non-salivary glands (i.e., non-salivary ACC) is heterogeneous, and its clinicopathological features remain poorly defined. Patients treated for ACC in a single institution between 1995 and 2007 were included in this study. Immunohistochemical evaluation of Ki-67, E-cadherin, p16, and cyclinD1 was performed. The prognostic significance of clinical and immunophenotypic markers was evaluated. 83 cases of salivary ACC and 24 cases of non-salivary ACC were included. The expression levels of Ki-67 (54.8%), E-cadherin (90.4%), p16 (32.9%), and cyclinD1 (19.2%) between ACCs present at various sites were not different. Sinonasal, lacrimal, and tracheobronchial ACCs had significantly worse outcomes than those of ACC of the major salivary glands. Postoperative radiotherapy reduced the recurrence rate of patients with a negative resection margin (P=0.028). Older age (age >60 years), advanced stage, positive resection margin, high histological grade, and high expression of Ki-67 were significantly correlated with poor prognosis. In conclusion, the site of origin plays a role in the prognosis of ACC, in which positive resection margin and advanced stage are possible factors underlying the differences in outcomes.

Treatment outcomes and prognostic features in adenoid cystic carcinoma originated from the head and neck

Surgery is the main treatment modality for adenoid cystic carcinoma (ACC) originated from the head and neck. However, the extensive local infiltrative and perineural spread related to this malignancy often cause difficulty to achieve high tumor control. The aim of this study is to evaluate the efficacy of postoperative radiotherapy (RT) in ACC, and to identify prognostic variables associated with treatment outcomes. A retrospective review of 101 patients diagnosed with ACC in the head and neck region was performed. T stage distribution was T1, 25; T2, 35; T3, 18; and T4, 23 patients. All patients were grouped into two arms: surgery alone or combined with postoperative radiotherapy. The 5-year local-regional control (LRC), overall survival (OS) and disease-free survival (DFS) rates for all the patients were 70.5%, 91.7% and 63.2%, respectively. On univariant analysis, postoperative radiotherapy did improve the 5-year LRC and DFS compared to surgery alone (81.0% vs. 53.4%, p=0.0003 and 71.3% vs. 50.0%, p=0.0052, respectively). And patients with T1-T2 lesions achieved better treatment outcomes, whereas stage T3-T4 was associated with high local failure and poor disease-free survival. Furthermore, multivariate analysis revealed that the addition of radiotherapy and early lesions were both favorite predictors for local control and survival rates. The prognosis for ACC of the head and neck was excellent. Surgery combined with postoperative radiotherapy significantly reduced the local failure, and further improved disease-free survival. Nevertheless, the relatively high distant metastasis was an obstacle of curing the ACC patients.

Correlation between transcription factor Snail1 expression and prognosis in adenoid cystic carcinoma of salivary gland

Transcription factor Snail1 has a central role in induction of epithelial-mesenchymal transition (EMT). The aim of the present study was to study the association of Snail1 expression with clinicopathologic factors and prognosis in adenoid cystic carcinoma (ACC) of salivary gland. Demographic variables and primary tumor site, dates of diagnoses, perineural invasion, local regional recurrence, and distant metastasis of 121 cases of salivary ACC were retrieved. The Snail1 expression of all these cases was examined by immunohistochemical methods. The association between Snail1 expression and clinicopathologic variables was analyzed using chi-square test, and the prognostic factors were examined by univariate and multivariate analyses. Our data demonstrated that the positive expression of Snail1 was observed in 58.68% (71/121) of cases. Snail1 expression was significantly associated with histologic pattern, perineural invasion, local regional recurrence, and distant metastasis of patients with ACC (P < .05). And Snail1 expression, local regional recurrence, and distant metastasis were independent and significant prognostic factors in all patients. Snail1 may play an important role in the invasion and metastasis of ACC, and Snail1 has the potential for being a strong prognosis indicator at presentation of ACC patients.

Surgery Alone or Combined with Postoperative Radiotherapy for Adenoid Cystic Carcinoma of the Head and Neck

Surgery Alone or Combined with Postoperative Radiotherapy for Adenoid Cystic Carcinoma of the Head and Neck

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

Reg IV expression is associated with cell growth and prognosis of adenoid cystic carcinoma in the salivary gland

Regenerating islet-derived family, member 4 (Reg IV) is associated with the progression of various cancers. The aim was to examine Reg IV expression in adenoid cystic carcinomas (ACCs) in salivary glands. Reg IV expression was detected by immunohistochemistry and compared with clinicopathological parameters. Expression of phosphorylated epidermal growth factor receptor (pEGFR), phosphorylated AKT (pAKT) and MUC2 was examined by immunohistochemistry. Reg IV function was assessed with Reg IV antisense S-oligodeoxynucleotides (AS) in ACC3 human ACC cells. Reg IV was expressed by salivary duct epithelia and acinus myoepithelia, but not in squamous epithelia. Reg IV expression was found in 41% (17/41) of ACCs, but in none of 40 oral squamous cell carcinomas (OSCCs) and was associated with nodal metastasis (P = 0.047) and poor prognosis (P = 0.012) in ACCs. Reg IV expression was associated with pEGFR (14/17, 82%) in Reg IV+ ACCs, but had no relationship with pAKT or MUC2 expression in ACCs. Cell growth was inhibited by AS treatment in Reg IV+ ACC3 cells, but not in HSC-4 OSCC cells, whereas in vitro invasion of neither cell types was affected by AS treatment. These results suggest that Reg IV might accelerate cell growth and disease progression of ACCs.

Expression patterns and prognostic significance of inhibitor of apoptosis proteins in adenoid cystic carcinoma and pleomorphic adenoma of lachrymal gland

It has been widely reported that IAPs family are overexpressed in various malignancies, and their expression patterns are associated with clinical outcome of these diseases. Adenoid cystic carcinoma (ACC) of lachrymal gland is a malignant tumor with a poor prognosis, while, pleomorphic adenoma (PA) is the benign tumor of lachrymal gland epithelia. It was the first time that we investigated the expression profile of IAPs in tissues from ACC and PA, and evaluated the prognostic significance of IAPs. Paraffin-embedded tissues with 27 cases of ACC and 33 cases of PA were enrolled, and another 17 fresh frozen tissues were also collected. Expression of cIAP1, cIAP2, XIAP, Survivin and Livin in embedded tissues was analyzed by immunohistochemistry, and expression of five IAPs in fresh tissues was evaluated by semiquantitive RT-PCR and Western blot. Prognostic significance of IAPs with clinicopathological variables and outcome was then investigated with univariate and multivariate analysis. Survivin and cIAP2 expression in ACC were significantly higher than that of in PA ( p < 0.05). cIAP1 and XIAP tended to show stronger expression in ACC than in PA, although the differences were not statistically significant. Livin expression was almost undetectable in both malignancy and benign lesion of lachrymal gland. Survivin expression in lachrymal tumors was localized in cytoplasm exclusively, and its expression was related to T staging and proliferative index in ACC, multivariate analysis demonstrated that Survivin was the only factor that could independently predict poor prognosis of ACC (RR = 3.681, 95%CI: 1.068–12.688, p = 0.039). Furthermore, Survivin expression was associated with progression of PA. Expression of cIAP1, cIAP2, XIAP and Survivin was higher in ACC than in PA tissues, however, only differential expression of Survivin and cIAP2 between ACC and PA was significant. Different prognosis between ACC and PA might be attributable to the different expression profiles of IAPs. Overexpression of Survivin in ACC was associated with poorer survival, which may have clinical impact on diagnosis and therapeutic considerations of this malignancy.

High expression of Polycomb group protein EZH2 predicts poor survival in salivary gland adenoid cystic carcinoma

Background:The prognosis of adenoid cystic carcinoma (ACC), a malignant salivary gland tumour, depends on clinicopathological parameters. To decipher the biological behaviour of ACC, and to identify patients at risk of...

Recurrence of Adenoid Cystic Carcinoma in the Breast After Lumpectomy and Adjuvant Therapy

Adenoid cystic carcinoma (ACC) of the breast is very rare, accounting for only 0.1% of all breast carcinomas. 1-4 This unusual neoplasm of the breast has certain histopathologic and biological characteristics that distinguish it from more common histologic types. For example, the prognosis of ACC appears to be very favorable. The incidence of axillary lymph node involvement is lower, and distant metastases are uncommon, although they can occur without previous lymph node involvement. Clinical experience has shown that this entity has a low propensity for local recurrence after excision. 4,5 We present a case of local recurrence of ACC in the breast detected by ultrasonography after successful treatment by lumpectomy followed by adjuvant chemotherapy and radiotherapy.

Cyclin D1 expression does not effect cell proliferation in adenoid cystic carcinoma of the salivary gland.

Adenoid cystic carcinoma is a malignant tumor of salivary gland origin. It tends to grow slowly, but shows frequent recurrence and metastasis. Cyclin D1, a cell-cycle regulation protein, has been reported to be overexpressed in various types of cancer and to correlate with poor survival of the patients. However, the prognostic significance of cyclin D1 expression in ACC of the salivary glands has not yet been determined. To evaluate the role of cyclin D1 in the biological regulation of ACC, we constitutively expressed an antisense cyclin D1 complementary DNA (cDNA) in an established ACC cell line that exhibits high endogenous expression of cyclin D1. The effect of cyclin D1 expression on in vitro cell growth and cell cycle were examined. In addition, we also examined the immunohistochemical expression of cyclin D1 protein in 31 cases of ACC of the salivary gland and correlated its expression with proliferative activity or prognosis. There were no significant differences of the in vitro growth and in the percentage of the total cell population in the G1 phase and S phase between antisense cyclin D1 clones and control clones. Thirty-two percent of tumors derived from surgical specimens examined were immunohistochemically positive for cyclin D1 protein. No association was found between cyclin D1 expression and cell proliferation or the clinical outcome of the patients. It is concluded that cyclin D1 overexpression alone does not induce a marked increase in the proliferative activity of ACC cells and that expression of this protein is not linked to poor prognosis in adenoid cystic carcinoma of the salivary gland.