Expression of apoptosis-related markers in malignant epithelial tumours of the lacrimal gland and their relation to clinical outcome.

OBJECTIVE

To investigate the correlation between the expression of apoptosis-related markers and prognosis in malignant epithelial tumours of the lacrimal gland.

MATERIALS AND METHODS

Series of cases.

PARTICIPANTS

Twenty one cases with malignant epithelial tumours of the lacrimal gland. Histological diagnosis was re-examined and blocks selected were evaluated for the following parameters: incidence of apoptosis with TUNEL assay, expression of p53 and Bcl-2 using monoclonal antibody. Predictors factors for survival, local recurrence and cumulative probability of death were statistically evaluated.

RESULTS

Re-eximination of the 21 specimens was as follow: 11 adenoid cystic carcinomas, 4 mucoepidermoid carcinomas, 3 squamous cell carcinomas and 3 adenocarcinomas. Eleven of the 21 patients (53%) died during the follow-up period (4-192 months; mean 71). Bcl-2 staining >6% was significantly correlated with the death of patients. A statistically significant positive relationship for TUNEL and p53, and an inverse correlation for Bcl-2 staining, was demonstrated with overall survival.

CONCLUSION

The correlation with survival of apoptotic index, p53 and Bcl-2 expression suggest the more tumour cells go in apoptosis, upregulating p53 and down-regulating Bcl-2, the better the survival of patients. This study establishes a role of apoptosis-regulatory proteins in the pathogenesis of malignant epithelial lacrimal gland tumours, and supports the hypothesis that evaluation of the expression of apoptosis-related markers in these tumours may provide a prognostic tool.