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. 2021 Jul;278(7):2517-2528.
doi: 10.1007/s00405-020-06389-7. Epub 2020 Oct 3.

Cancer stem cell markers in adenocarcinoma of the salivary glands - reliable prognostic markers?

Jennifer L Spiegel  1 , Mark Jakob  2 , Marie Kruizenga  3 , Saskia Freytag  4 , Mattis Bertlich  2 , Martin Canis  2 , Friedrich Ihler  2   5 , Frank Haubner  2 , Julia Kitz  6 , Bernhard G Weiss  2
Affiliations

Cancer stem cell markers in adenocarcinoma of the salivary glands - reliable prognostic markers?

Jennifer L Spiegel et al. Eur Arch Otorhinolaryngol. 2021 Jul.

Abstract

Purpose: Adenocarcinoma of the salivary glands is of low incidence and a broad range of histopathological subtypes. Cancer stem cell markers (CSC) might serve as novel prognostic parameters. To date, only a few studies examined the expression of CSC in adenocarcinoma of the salivary glands with diverging results. To further investigate the reliability in terms of prognostic value, a histopathological analysis of CSCs on a cohort of patients with adenocarcinomas of the major salivary glands was performed.

Methods: Tumor samples of 40 consecutive patients with adenocarcinoma of the major salivary gland treated with curative intend at one tertiary center were stained with the CSCs ALDH1, BMI-1, CD44, Nanog, and SOX2. Expression of these markers was correlated with clinicopathological parameters and survival estimates.

Results: Correlation of high expression of ALDH1 with higher grading (p < 0.001) and high expression of CD44 with the localization of the neoplasm (p = 0.05), larger tumor size (p = 0.006), positive pN-category (p = 0.023), and advanced UICC stage (p = 0.002) was found. Furthermore, high expression of SOX2 correlated with a negative perineural invasion (p = 0.02). No significant correlation of any investigated marker with survival estimates was observed.

Conclusion: In conclusion, our study did not find a significant correlation of the investigated CSCs with survival estimates in adenocarcinoma of the major salivary glands. Recapitulating the results of our study in conjunction with data in the literature, the CSCs ALDH1, BMI-1, CD44, Nanog, and SOX2 do not seem to serve as reliable prognostic parameters in the treatment of adenocarcinoma of the salivary glands.

Keywords: Adenocarcinoma; CSC; Cancer stem cell markers; Prognostic marker; Salivary gland malignoma; Salivary glands.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Inclusion criteria and subtypes of adenocarcinomas. a 40 patients with adenocarcinoma of the major salivary glands, who received surgical treatment at one tertiary centre were included in the study. b 9 different entities of adenocarcinoma were summarized as adenocarcinoma of the major salivary glands, listed in a descending order regarding their share of patients (%). AC, adenocarcinoma; SCC, squamous cell cancer
Fig. 2
Fig. 2
Immunohistochemical staining with low and high expression of the cancer stem cell markers ALDH1, BMI-1, CD44, Nanog, and SOX2. (a) Immunostaining with ALDH1: low expression (left; × 10) in a ductal adenocarcinoma, high expression (right; × 10) in an adenoidcystic carcinoma. (b) Immunostaining with BMI-1: low expression (left; × 20) in an adenocarcinoma, high expression (right; × 20) in a salivary duct carcinoma. (c) Immunostaining with CD44: low expression (left; × 40) in a salivary duct carcinoma, high expression (right; × 20) in an adenocarcinoma. (d) Immunostaining with Nanog: low expression (left; × 20) in a mucoepidermoid carcinoma, high expression (right; × 20) in a mucoepidermoid carcinoma. (e) Immunostaining with SOX2: low expression (left; × 20) in a mucoepidermoid carcinoma, high expression (right; × 20) in a polymorphous low-grade adenocarcinoma
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