Immunohistochemical expression of estrogens and progesterone receptors in carcinoma ex pleomorphic adenoma-undifferentiated and adenocarcinoma types.

Head of Department of Oral Pathology, Faculty of Dentistry, Aleppo University, Aleppo, Syria.
Medicina oral, patologia oral y cirugia bucal (Impact Factor: 1.1). 05/2010; 15(3):e432-6. DOI: 10.4317/medoral.15.e432
Source: PubMed

ABSTRACT Cancer of the salivary gland is one of the common cancers in the head and the neck regions. This type of cancer develops in the minor and the major salivary glands, and it sometimes metastasizes to other organs, particularly the lung. Morphologic mimicry and similarity in the expression of steroid hormone receptors between salivary gland tumours and breast tumours are well-known phenomena and are occasionally debated in the field of surgical pathology. The expression of sex hormone receptors in some tumours suggests a role for these receptors in tumor pathogenesis and therapy. Previous studies of the expression of estrogens and progesterone receptors in salivary gland tumours have reported conflicting results.
Our study aimed to characterize alteration in the immunohistochemical expression of oestrogens receptor and progesterone receptor in the tumour cells of carcinoma arising in pleomorphic adenoma.
27 cases of carcinoma arising in pleomorphic adenoma (undifferentiated and adenocarcinoma types) were examined.
The results showed that 27 (100 %) of 27 cases had negative nuclear staining for either oestrogens or progesterone receptors.
Our data suggest that carcinomas arising in pleomorphic adenoma were not dependent on endocrine function.

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    ABSTRACT: This study aimed to characterize alteration in the immunohistochemical expression of pRb in normal tissue of the salivary gland surrounding pleomorphic adenoma, the tumor cells of pleomorphic adenomas, and carcinoma arising in pleomorphic adenoma. A selected series of 29 cases of pleomorphic adenomas, and 27 cases of carcinoma ex-pleomorphic adenoma (undifferentiated and adenocarcinoma types) were examined. The results showed that pRb expression was negative in the components of normal tissue of the salivary gland surrounding pleomorphic adenoma. PRb expression in pleomorphic adenomas shows that 2 cases out of 29 (6.9%) strongly expressed in the duct cells, 7/29 (24.1%) cases showed moderate staining. pRb nuclear staining in myxochondroid was identified in 10/29 (34.5%) cases of pleomorphic adenomas with weak staining, 6/29 (20.7%) with moderate staining. pRb was strongly expressed in carcinoma cells in 19 out of 27 cases (70.4%). This study suggests the alteration of pRb expression would increase from pleomorphic adenoma to carcinoma arising in pleomorphic adenomas (6.9% versus 70.4%).
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    ABSTRACT: Carcinoma ex pleomorphic adenoma (Ca ex PA) is a carcinoma arising from a primary or recurrent benign pleomorphic adenoma. It often poses a diagnostic challenge to clinicians and pathologists. This study intends to review the literature and highlight the current clinical and molecular perspectives about this entity. The most common clinical presentation of CA ex PA is of a firm mass in the parotid gland. The proportion of adenoma and carcinoma components determines the macroscopic features of this neoplasm. The entity is difficult to diagnose pre-operatively. Pathologic assessment is the gold standard for making the diagnosis. Treatment for Ca ex PA often involves an ablative surgical procedure which may be followed by radiotherapy. Overall, patients with Ca ex PA have a poor prognosis. Accurate diagnosis and aggressive surgical management of patients presenting with Ca ex PA can increase their survival rates. Molecular studies have revealed that the development of Ca ex PA follows a multi-step model of carcinogenesis, with the progressive loss of heterozygosity at chromosomal arms 8q, then 12q and finally 17p. There are specific candidate genes in these regions that are associated with particular stages in the progression of Ca ex PA. In addition, many genes which regulate tumour suppression, cell cycle control, growth factors and cell-cell adhesion play a role in the development and progression of Ca ex PA. It is hopeful that these molecular data can give clues for the diagnosis and management of the disease.
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    ABSTRACT: Hormone therapy is highly recommended on patients with breast cancer who show positive nuclear staining of the cancer cells. It is not known however whether salivary gland tumours can respond to hormone therapy. Twenty eight studies undertaken between 1980 to 2009 involving different types of salivary gland cancers were evaluated and taken into consideration the type of used antibody and the criteria to assess the intensity staining. This review has shown that estrogen progesterone and androgen receptors were detected in few cases of salivary gland tumours. Different types of used antibodies were identified, and the criteria of assessment of the staining intensity were different as well. The outcome of this review indicated that the growth of those tumours was not dependent on hormone function. It is recommended that sensitive and specific biochemical methods can be used to determine if estrogen and progesterone receptors can be detected in salivary gland cancers. It is necessary to use one criterion such as positive or negative nuclear staining to determine the existence of estrogen and progesterone receptors and to avoid any bias. The discrepancy in the results reflects a clear need for consensus on a protocol for scoring of immunohistochemical staining. Key words: oestrogen, progesterone, androgen receptors, salivary gland tumours.
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