Hoyek-Gebeily J, Nehmé E, Aftimos G, Sader-Ghorra C, Sargi Z, Haddad A
Service de diagnostic et de pathologie orale, faculté de médecine dentaire, université Saint-Joseph, Beyrouth, Liban.
Rev Stomatol Chir Maxillofac. 2007 Dec;108(6):482-8. doi: 10.1016/j.stomax.2007.01.008. Epub 2007 Aug 29.
Mucoepidermoid carcinoma is one of the most frequent malignant lesions of salivary glands. The treatment is based on clinical, paraclinical and histological data. Several studies on the prognostic value of molecular markers for these cancers were made with contradictory results. The aim of this retrospective study was to analyze the prognostic value of molecular markers of salivary gland mucoepidermoid carcinoma.
Sixteen patients were treated for mucoepidermoid carcinoma of principal and/or accessory salivary glands between 1994 and 2003. An immunohistochemical study of archive specimen was performed. Nine markers were specifically studied: 4 proteins/oncoproteins (p53, bcl2, c-erb-B2 and cd117), 2 markers of proliferation (PCNA and Ki67), 1 growing factor receptor (EGFR), 1 epithelial adhesion molecule (E-cadherin), and 1 angiogenic cytokine (PDGF).
Nine men and 7 women were included, with a mean age of 43.7 years (14-80). The mean diameter of tumors was 3.1 mm (1-14), and the parotid gland was the most frequent location. The mean global survival rate was 57.3 months with a median of 55 months. The 2 to 5 years survival expectation rate were 82.5% and 46.4% respectively. The mean survival rate for women was superior to that of men (P=0.043). The expression of p53 and the high expression rate of EFGR were bad prognostic factors (respectively P=0.049 and P=0.012). The expression of PCNA was linked to the location (mainly the salivary gland) and to the diameter of the tumor (respectively P=0.037 and P=0.029). The degree of EFGR positivity and the histological grade were linked (P=0.027).
The strong expression of EGFR was statistically linked to the histological tumor grade. The degree of PCNA positivity seemed to be associated to the preferential location in the main salivary glands and to the diameter of the tumor. The strong expression of p53 and EGFR were bad prognostic factors. These retrospective results need to be confirmed by prospective randomized and larger studies. EGFR and p53 were significant negative prognostic factors. EGFR was highly correlated to the histological grade, making it an interesting target for further investigation.
黏液表皮样癌是唾液腺最常见的恶性病变之一。治疗基于临床、副临床和组织学数据。针对这些癌症的分子标志物预后价值进行了多项研究，但结果相互矛盾。本回顾性研究的目的是分析唾液腺黏液表皮样癌分子标志物的预后价值。
1994年至2003年间，16例患者接受了主要和/或副唾液腺黏液表皮样癌的治疗。对存档标本进行了免疫组织化学研究。专门研究了9种标志物：4种蛋白质/癌蛋白（p53、bcl2、c-erb-B2和cd117）、2种增殖标志物（PCNA和Ki67）、1种生长因子受体（EGFR）、1种上皮粘附分子（E-钙粘蛋白）和1种血管生成细胞因子（PDGF）。
纳入9名男性和7名女性，平均年龄43.7岁（14 - 80岁）。肿瘤平均直径为3.1毫米（1 - 14毫米），腮腺是最常见的发病部位。总体平均生存率为57.3个月，中位数为55个月。2至5年的生存预期率分别为82.5%和46.4%。女性的平均生存率高于男性（P = 0.043）。p53的表达和EFGR的高表达率是不良预后因素（分别为P = 0.049和P = 0.012）。PCNA的表达与发病部位（主要是唾液腺）和肿瘤直径有关（分别为P = 0.037和P = 0.029）。EFGR阳性程度与组织学分级有关（P = 0.027）。
EGFR的强表达在统计学上与肿瘤组织学分级有关。PCNA阳性程度似乎与主要唾液腺的好发部位和肿瘤直径有关。p53和EGFR的强表达是不良预后因素。这些回顾性结果需要通过前瞻性随机和更大规模的研究来证实。EGFR和p53是显著的阴性预后因素。EGFR与组织学分级高度相关，使其成为进一步研究的一个有趣靶点。
