| Objective: To detect the expression of CD44v6,ESM-1, CNTF, LIF in adenoid cystic carcinoma（ACC） and normaltissues near the ACC, and then investigate their relevance withoncogenesis and development of the ACC and with its clinicalpathological features such as perineural invasion(PNI) and metastasis,thus to provide effective evidence for diagnosing and treating ACC.Methods:Sixty patients with ACC who were diagnosed inOtolaryngology and the stomatology department at the Affiliated Hospitalof Luzhou Medical College from January2004to January2009wereretrospectively covered in this study. Twenty normal tissues werecollected from part of the patients above as the control group. Theneurologic symptoms, recurrence, metastasis and state of survival werecollected through follow-up. The expression of CD44v6, ESM-1, CNTFand LIF in all specimens was detected by immunohistochemistryEnvision method. The Image-Pro Plus6.0image analysis system wasused to evaluate their expression level in MOD (MOD=Sum IOD/SumArea). In accordance with the expression of CD44v6, ESM-1, CNTF, LIFin ACC and normal tissues and combined with patients’ clinicalinformation, the relationship between the message molecules’ expressionand clinicopathological parameter was analyzed. Results:(1) In the cases of our group,56cases occurred in salivary glands. Among our groupthere were23men and37women, aged from23to73, and their medianage was55years old. There were13solid subtype ones and47cribriform-tubular subtype ones while34cases in the stage of T1-2and26cases in T3-4. At first26patients were misdiagnosed, the misdiagnosisrate was43%, and12cases of them were misdiagnosed as pleomorphicadenoma. All patients were followed up for about5-10years except the7lost to follow-up. Among the follow up fellow,26cases of recurrence,13cases of distant metastasis and20cases of died. The PNI occurrenceprobability of the ACC in T3-4stage, with metastasis, with recurrence orin solid subtype was much higher than that in T1-2stage, withoutmetastasis, without recurrence or the cribriform-tubular subtype, thedifference was statistically significant (χ2=5.195,5.195,6.590,7.127,P=0.023,0.01,0.023,0.008). However the PNI occurrence probabilitywas not correlated with age, gender and the primary site.(all P>0.05)（2）The expression of CD44v6was strong in cytoplasm and cell membraneof ACC (MOD=0.2135±0.065), while in normal tissue especially theductal epithelial the expression is weak (MOD=0.0554±0.0142), thedifference was statistically significant (t’=17.424, P=0.000), and itsexpression is correlated with pathological classification, T stage, andpresence of PNI, recurrence and metastasis (t=3.525,3.525,3.387,2.124,2.064, P=0.011,0.010,0.044,0.038,0.044respectively).(3) ESM-1is strongly expressed in ACC (MOD=0.1176±0.0476), the positive partswere mainly located in cytoplasm, cell membrane and the vascularendothelial cells, while weakly expressed in normaltissue(MOD=0.0274±0.0130), the difference was statistically significant(t=8.333, P=8.333). The tissues with later T stage, recurrence, metastasisor with PNI showed stronger expression than the earlier T stage, withoutrecurrence or metastasis or PNI tissues, the difference was statisticallysignificant (t=2.292,2.292,3.535,2.646, P=0.026,0.001,0.024,0.010respectively).(3) CNTF was weakly expressed in normaltissues(MOD=0.0139±0.0064), while strongly expressed in cytoplasmand cell membrane of ACC (MOD=0.0740±0.0398), the difference wasstatistically significance (t=6.700, P=6.700), there was significantdifference in different pathological classification, T stage, or with PNI,recurrence and metastasis (t=3.482,3.482,2.687,2.150,2.231, P=0.001,0.009,0.01,0.036,0.030respectively).(4)LIF was strongly expressed incytoplasm and cell membrane of ACC(MOD=0.0415±0.0202), and onlyweakly or negatively expressed in normal tissue(MOD=0.0102±0.0053),the difference was statistically significant (t=10.935, P=0.000). And thereshowed significantly difference with the presence of PNI, recurrence andmetastasis(t=2.654,3.689,2.350, P=0.010,0.000,0.022), while there wasno statistically significance in pathological classification (t=0.323,P=0.748) and T stage (t=0.684, P=0.497).(5) The expression of CNTF and LIF in the tissues of ACC was positive correlation significantly(r=0.703, P=0.703), while there was no obvious correlation among otherindicators (all P>0.05). Conclusion:(1)CD44v6, ESM-1, CNTF, LIFwere strongly expressed in ACC tissues, and with the pace of themalignant progression, T stage, presence of PNI, recurrence or metastasis,there came a positive correlation, the four information molecules ofabnormally high expression in ACC may indicate that they may be relatedto ACC oncogenesis, development and deterioration.(2)There was anobvious positive correlation between CNTF and LIF expression in ACC,it may point out that the two may interact with each other in thedevelopment of ACC process and promote the oncogenesis and malignantprogression of ACC.(3)The expression of CD44v6, ESM-1, CNTF andLIF in ACC may become a biological indicators to evaluate the prognosisof ACC, but the way the four works and how the signal transductionpathways play their roles still need further study. |
