Differential expression of hormonal and growth factor receptors in salivary duct carcinomas: biologic significance and potential role in therapeutic stratification of patients

Am J Surg Pathol. 2007 Nov;31(11):1645-52. doi: 10.1097/PAS.0b013e3180caa099.

Abstract

Salivary duct carcinoma (SDC), a rare malignancy, manifests remarkable morphologic and biologic resemblance to high-grade mammary ductal carcinoma. We contend that, similar to mammary ductal carcinoma, hormones and growth factors may play a role in SDCs. Our aim was to determine the incidence and clinical significance of the expression of several hormone and growth factor receptors and evaluate their potential in therapeutic stratification of SDC patients in the largest cohort studied to date. Eighty-four archived tumor tissue blocks were analyzed immunohistochemically for expression of estrogen receptor-beta (ERbeta), androgen receptor (AR), and proline, glutamic acid, and leucine-rich protein-1 and growth factor receptors HER-2 and epidermal growth factor receptor. The results were correlated with available pathologic, demographic, and clinical data from 59 of 84 cases. Proline, glutamic acid, and leucine-rich protein-1, ERbeta, and AR were expressed individually in 94% (71/76), 73% (57/80), and 67% (56/84) of SDCs, respectively, and coexpressed in 45% (34/75). AR was expressed significantly more often in SDCs of men than in SDCs of women [79% (35/57) vs. 33% (9/27), P<0.001]. Epidermal growth factor receptor and HER-2 were overexpressed individually in 48% (40/83) and 25% (21/84), respectively, and co-overexpressed in 12% (10/83). Survival decreased significantly in patients with lymph node metastasis (P=0.002) and positive surgical margins (P=0.006). Lack of ERbeta expression correlated with increased local and regional recurrence (P=0.05 and P=0.002, respectively). Together, these results indicate that (a) ERbeta down-regulation is associated with adverse clinical features, (b) lymph node and surgical margin status are significant survival factors, and (c) the differential expression of these hormones and growth factor receptors may assist in triaging patients with SDC for novel therapies.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / analysis*
  • Carcinoma / chemistry*
  • Carcinoma / mortality
  • Carcinoma / pathology
  • Carcinoma / therapy
  • Co-Repressor Proteins
  • Cohort Studies
  • Down-Regulation
  • ErbB Receptors / analysis
  • Estrogen Receptor beta / analysis
  • Female
  • Humans
  • Immunohistochemistry
  • Kaplan-Meier Estimate
  • Lymph Nodes / pathology
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Patient Selection*
  • Phenotype
  • Prognosis
  • Receptor, ErbB-2 / analysis
  • Receptors, Androgen / analysis
  • Salivary Ducts / chemistry*
  • Salivary Ducts / pathology
  • Salivary Gland Neoplasms / chemistry*
  • Salivary Gland Neoplasms / mortality
  • Salivary Gland Neoplasms / pathology
  • Salivary Gland Neoplasms / therapy
  • Trans-Activators / analysis
  • Transcription Factors

Substances

  • AR protein, human
  • Biomarkers, Tumor
  • Co-Repressor Proteins
  • Estrogen Receptor beta
  • PELP1 protein, human
  • Receptors, Androgen
  • Trans-Activators
  • Transcription Factors
  • ERBB2 protein, human
  • ErbB Receptors
  • Receptor, ErbB-2