Analysis of clinicopathological characteristics, rearrangement and prognostic factors in salivary adenoid cystic carcinoma.

Recent studies have indicated that a recurrent t(6;9)(q22-23;p23-24) chromosomal translocation in salivary adenoid cystic carcinoma (ACC) results in a MYB proto-oncogene transcription factor-nuclear factor I/B gene fusion, which has not previously been detected in any non-ACC carcinomas of the head and neck. In the present study, data on clinical factors affecting the survival rate of patients with salivary ACC from a single institution was retrospectively analyzed, and the frequency of gene rearrangement determined. A total of 97 patient cases were analyzed, and young adults presenting with ACC (<40 years old) accounted for 19.6% of all patients (n=19). A total of 70.1% (n=68) displayed neurological symptoms, including pain, paraesthesia, tongue deviation, and facial paralysis. A marked majority of the analyzed tumors (85.6%) displayed evidence of rearrangement. rearrangement was significantly higher in patients with late Tumor-Node-Metastasis (TNM) stage cancer compared with that in patients with early TNM stage (P=0.033), as detected by a dual color break-apart fluorescence hybridization probe. Kaplan-Meier analysis revealed significant differences in patient overall survival (OS) time with regard to age, gender, TNM stage, neurological symptoms, margin status and rearrangement. Specifically, young age was significantly associated with a shorter OS time. In summary, the present study suggested that young patients with salivary ACC presented with a worse prognosis, in contrast to the majority of patients with salivary ACC. Moreover, alterations exhibited a high positive rate in salivary ACC, and therefore, the absence of rearrangements may be associated with a better prognosis.