Clinical and immunohistologic typing of salivary duct carcinoma

Abstract

BACKGROUNDDue to the low incidence of salivary duct carcinoma (SDC), only limited data in regard to the biologic behavior of this tumor and its immunohistochemical characteristics are available. The authors analyzed the clinical, molecular, and genetic profile of SDC and identified prognostic factors.METHODSThe follow‐up of 50 patients with SDC was obtained and paraffin‐embedded tumor samples were examined immunohistochemically. In all samples, the expression of Ki‐67, HER‐2, and the oncoproteins p16 and p53 was examined immunohistochemically, followed by a mutation analysis of p16 and p53. The survival rate was calculated by the Kaplan–Meier method and prognostic variables were analyzed with the log‐rank test.RESULTSSDC predominantly effected male patients (66%) in their 7th decade of life. SDC mainly occurred in the parotid gland (78%; submandibular gland, 12%; minor salivary glands, 10%). Approximately two‐thirds of the patients (33 of 50) presented with a T3/T4 tumor. In 28 patients (56%), cervical lymph node metastasis was present at the time of diagnosis. Local disease recurrence was observed in 48% of patients an average of 17.4 months after initial treatment. Distant disease metastasis developed in 48% of patients an average of 29 months after initial treatment. The average overall survival period was 56.2 months. In the current study, 20.6% of the probes with positive HER‐2/neu expression were (+++) positive. p53 was expressed in 83.9% of the tumor samples. In 11.8% of the tumor samples, there was a lack of p16 expression.CONCLUSIONSMutations of the p53 gene were more frequent in tumor samples with (++) and (+++) immunoreactivity and mainly affected exons 7 and 8. A mutation of the p16 gene was only found in 1 tumor sample. Expression of HER‐2/neu and p53 was statistically linked (P < 0.05) to early local disease recurrence, distant disease metastasis, and survival rates. Cancer 2005. © 2005 American Cancer Society.

Salivary duct carcinoma: A clinopathological report of 11 cases

“…Notably, the present analysis determined a good short-term outcome for the patients with primary SDC, which was in disagreement with the findings reported in previous studies (2,3,6,7,(10)(11)(12)(13). Mortality in late-stage patients was 22.2% compared with 0% in early-stage patients with similar prognoses; however, N status did not appear to have a significant impact on the patient prognosis.…”

“…A number of previous studies demonstrated that HER-2/neu and p53 expression are statistically associated with SDC survival rates (3,(15)(16)(17)(18)(19)(20). However, in the present study, the protein expression levels of HER-2/neu, AR, Ki-67, p16 and p53 did not correlate with prognosis, although HER-2/neu, AR and p16 demonstrated a positive expression rate of >50%, which may contribute to the diagnosis for SDC.…”

“…Salivary duct carcinoma (SDC) is a rare type of salivary malignancy which accounts for <10% of all salivary malignancies, and the majority of its histological characteristics are similar to those of mammary duct carcinoma (1)(2)(3). SDC exhibits characteristic ductal lesions and tumor cells are often arranged in a 'Roman bridge' formation and cribriform architecture, with comedo necrosis (2).…”

Hormone Therapy for the Treatment of Patients with Malignant Salivary Gland Tumor (MSGT)

“…Various studies of HER-2 in SDC have shown variable results, with amplification occurring in 25-100% of tumors (Jaspers et al, 2011). Nonetheless, the proportion is much higher than that observed in the other histological subtypes, such as the ACCs and MECs described above (Etges et al, 2003;Giannoni et al, 1995;Gibbons et al, 2001;Glisson et al, 2004;Hellquist et al, 1994;Jaehne et al, 2005;Locati et al, 2009;Milanoet al, 2007;Nguyen et al, 2003;Press et al, 1994;Skalova et al, 2001;Williams et al, 2007). HER-2 expression is considered to correlate with histological grade in both salivary gland neoplasms as well as breast cancer, and represents a potential attractive therapeutic approach for SDCs.…”

Factores pronósticos en neoplasias malignas primarias de glándulas salivares: Estudio retrospectivo de 20 años

“…3 Estudios inmuno-histoquímicos para detectar la expresión de proteínas reguladoras del ciclo celular demuestran que la pRB2/p130 tiene una influencia estadísticamente significativa en la presencia de metás-tasis y en la patogénesis y progresión de algunas neoplasias de glán-dulas salivares. 4 El factor de crecimiento endotelial vascular muestra una asociación con la expresión del p53 y tiene valor pronósti-co en los carcinomas de glándulas salivares.…”