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Category: Volume 12 Issue 01 Janaury 2024
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Title: A Clinicopathological Study of Salivary Gland Lesions and Immunohistochemical Expression of Bcl2 in Benign and Malignant Salivary Gland Neoplasms

Authors: Yashika Sharma, Nidhi Verma, Kavita Tiwari, Vijay Kumar, Anamika Thakur

 DOI: https://dx.doi.org/10.18535/jmscr/v12i01.12

Abstract

Introduction

Salivary glands neoplasms (SGNs) are rare tumors and comprise approximately 3-10% of the neoplasms of the head and neck region and 1% of the neoplasms of the whole body(1). Annual global incidence of SGNs is between 0.4 to 13.5 cases per 1, 00,000 individuals(2). Among these, malignant salivary gland neoplasms (MSGNs) are 0.40 to 0.65 per 1, 00,000 cases(3). MSGNs are 0.3% of all malignancies(4). Early diagnosis of MSGNs play an important role in better management of these tumors(5). Fine-needle aspiration cytology (FNAC) is used as a screening and early diagnostic tool in SGNs however its role is limited(6).

Accurate diagnosis depends upon the histological evaluation of SGNs.

Although haematoxylin-eosin (H&E) staining is still the gold standard for diagnosing the SGNs yet its role is limited in certain cases. Immunohistochemistry (IHC) can enhance the accuracy and may be a helpful tool when there is a need to investigate cell type and differentiation status, cell proliferation, and tumor protein expression that cannot be assessed by routine histological examination alone. There is also a need to investigate new biomarkers that can be useful in the diagnosis and grading of malignant salivary gland neoplasm(7). Bcl-2 (B-cell lymphoma) oncoprotein is a useful marker for investigation in SGNs. Bcl-2 gene family consists of different regulators involved in apoptosis. It is considered as anti-apoptotic protein and plays a key role in preventing programmed cell death by favouring prolonged survival in normal and neoplastic cells. Increased expression has been seen in a number of tumors and is related to resistance to conventional cancer management(8). It’s expression has been studied in oral epithelial dysplasia, oral sub mucous fibrosis and oral squamous cell carcinoma and its expression showed increasing with the severity of dysplasia and decreased expression in differentiation of oral carcinoma. The present study was planned to determine the expression of Bcl-2 proteins in benign and malignant salivary gland neoplasms and to determine association of Bcl-2 expression with different grades of malignant salivary gland neoplasms.

References

  1. Araya J, Martinez R, Niklander S, Marshall M, Esguep A. Incidence and prevalence of salivary gland tumours in Valparaiso, Chile. Med Oral Patol Oral Cir Bucal. 2015; 20(5): 532-9. Doi: 10.4317/medoral.20337.
  2. Sando Z, Fokouo JV, Mebada AO, Djomou F, NDjolo A, Oyono JLE. Epidemiological and histopathological patterns of salivary gland tumors in Cameroon. Pan Afr Med J. 2016; 23(1): 1-66. Doi: 10.11604/pamj.2016.23.66.5105.
  3. Carlson ER, Schlieve T. Salivary gland malignancies. Oral and Maxillofacial Surgery Clinics. 2019; 31(1): 125-44. Doi: 10.1016/j.coms.2018.08.007.
  4. Faur, AC, Sas I, Motoc AGM, Cornianu M, Zamfir CL, Lazar DC, et al. Ki-67 and p53 immunostaining assessment of proliferativeactivity in salivary tumors. Rom J Morphol Embryol. 2015; 56(4): 1429–39. PMID: 26743291.
  5. Stenner M, Klussmann JP. Current update on established and novel biomarkers in salivary gland carcinoma pathology and the molecular pathways involved. Eur Arch Otorhinolaryngol. 2009; 266(3): 333–41. Doi: 10.1007/s00405-008-0882-7.
  6. Gupta A, Koochakzadeh S, Neskey DM, Nguyen SA, Lentsch EJ. Salivary Carcinosarcoma: An Extremely Rare and Highly Aggressive Malignancy. The Laryngoscope. 2020; 130(5): E335-9. Doi: 10.1002/lary.28183.
  7. Ibrahim TR, Ahmed MM, Hegazy AA. Diagnostic Utility of Immunohistochemical Expressions of IMP3 Versus DOG1 and p63 in Salivary Gland Tumors. Turk Patoloji Derg. 2020; 36(3). 227-236. doi: 10.5146/tjpath.2020.01496.
  8. Abdulhussain MM, Mohsen AS. Immunohistochemical Evaluation of Bcl-2 in Mucoepidermoid Carcinoma and Adenoid Cystic Carcinoma of Salivary Glands. Journal of International Dental and Medical Research. 2020; 13(1): 180-7.
  9. Soini Y, Törmänen U, Pääkkö P. Apoptosis is inversely related to bcl-2 but not to bax expression in salivary gland tumours. Histopathology. 1998;32:28-34.
  10. Kala C, Kala S, Khan L. Milan System for Reporting Salivary Gland Cytopathology: An Experience with the Implication for Risk of Malignancy. J Cytol. 2019 Jul-Sep;36(3):160-164. doi: 10.4103/JOC.JOC_165_18. PMID: 31359916; PMCID: PMC6592120.
  11. Manjunatha BS, Kumar GS, Raghunath V. Immunohistochemical expression of Bcl-2 in benign and malignant salivary gland tumors. Med Oral Patol Oral Cir Bucal. 2011 Jul 1;16(4):e503-7. doi: 10.4317/medoral.16.e503. PMID: 21196881
  12. Gordón-Núñez MA, Godoy GP, Soares RC, De Souza LB, de Almeida Freitas R, Queiroz L, et al. Immunohistochemical expression of PCNA, p53 and bcl-2 in pleomorphic adenomas. Int J Morphol. 2008;26:567–72.
  13. Al-Rawi NH, Omer H, Al Kawas S. Immunohistochemical analysis of P(53) and bcl-2 in benign and malignant salivary glands tumors. J Oral Pathol Med. 2010;39:48–55.

Corresponding Author

Yashika Sharma