Analysis Of Recurrence, Invasion & Metastasis Of Adenoid Cystic Carcinoma

Objective(1)To study factors of influencing prognosis of adenoid cystic carcinoma(ACC).(2)Observe the expression of NGF,VEGF, Ki-67 and count MVD in ACC tissue,analyse their relationships with recurrence,invasion,metastasis of ACC.(3)To study the inhibiting effect of ACC cells with suramin.Methods(1)63 cases were studied to investigate factors influencing prognosis of patients.The data was statistically treated for survival curves according to the Kaplan-Meier method and differences between survival curves were compared by Log-Rank test.Cox regression model was used for multivariate prognostic analysis.(2) 63 ACC tissue samples were divided according to the presence of clinical,rNMstage,pathological type.NGF,VEGF,Ki-67 were examined by immunohistochemistry staining,MVD of ACC tissue was counted.(3)MTT assay was performed for chemosensitivity testing of ACC-2 and ACC-M cells.The expression of NGF and VEGF protein of ACC-2 and ACC-M cells in different dose of Suramin was tested by Western-Blot.Gel Doc2000 medical color image measure system of Bio-Rad company of America was used for the expression of NGF and VEGF protein,which results were described by gray scale,T test was used for statistics analysis. Results(1)The tumor-free survival rates of 63 cases for 3,5 and 10 years were 77.64%,68.31%,39.26%and the over-all survival rates were 65.73%,57.17%,38.92%respectively.Multivariate analysis of Cox proportional hazard model showed that TNMstage,pathological type,nerve invasion,surgical method,Radiotherapy/Chemotherapy, local recurrence and distant metastasis were important factors to the long-term surviving of patients.(2)NGF was present in ductule cells of normal parotid glands,and cancer cells far from nerves presented weaker positive than those in perinural space.VEGF was present in normal salivary glands and ACC,but the degree of staining was different.The expression of Ki-67 in deceased group were higher than those in survival group.Overexpression of Ki-67 could be found in recurrent group than those in non-recurrent group.MVD of ACC tissue in different pathological type is different.(3)The result which was detected by MTT assay showed that Suramin can prevent the growth of ACC cells,and the preventing effect was indicated dose-dependent manner.The result of Western-Blot showed that the expression of NGF and VEGF in ACC cells were declined after Suramin' s affection,and the declining effect was indicated dose-dependent.NGF and VEGF expression in groups with Suramin was significantly less than control group.Conclusion(1)TNMstage,pathological type,nerve invasion,local recurrence and distant metastasis are risk factors to the long-term surviving of patients,which can reduce the survival time after operation.Surgical operation plus RT/CT are protective factors of ACC.Combination therapy for ACC plays an important role in influencing the long-term surviving of patients.(2)Enhanced expression of NGF,VEGF and Ki-67 may contribute to the prognosis of ACC,perhaps they played an important role in recurrence,invasion and metastasis of ACC.(3)The expression of NGF and VEGF in ACC was inhibited by suramin,it indicated that suramin was very well in preventing the growth of ACC cells.