Hans Gustafsson

Recurrent rearrangements of 11q14–22 in mucoepidermoid carcinoma

We describe the cytogenetic findings in five mucoepidermoid carcinomas (MEC) of the major and minor salivary glands. Three of the five tumors analyzed showed an apparently identical t(11;19)(q14-21;p12). In one case, the t(11;19) was the only common clonal abnormality, while in the other two cases the translocation was found together with +16, +20, and inv(1)(p32-33q42), t(6;15)(p12;q25), respectively. The latter case also showed an interstitial short arm deletion of the der(11) chromosome. Of the two remaining cases, one had a del(3)(p13p23) as the sole karyotypic abnormality, while the other had a hyperdiploid stemline characterized by the following numerical deviations: +2, +5, +6, +7, +8, +17, +18, and +19. These findings, together with previously published data from seven from seven MEC, indicate that at least two different, partially overlapping cytogenetic subgroups exist: 1) cases with structural rearrangements of 11q14-22; the finding of three tumors with an apparently identical t(11;19)(q14-21;p12) demonstrates that this is a non-random, and possibly primary abnormality in MEC, and 2) single or multiple trisomies, either observed as the sole anomalies or in combination with structural rearrangements.

p53 Expression and cell proliferation in squamous cell carcinomas of the head and neck

Background. In squamous cell carcinoma of the head and neck (SCCHN), overexpression of the p53 protein has been found in 34‐80% of the tumors studied. No data are available regarding p53 expression versus tumor cell proliferation and prognosis for this tumor type.

Expression of cytokeratins and vimentin in salivary gland carcinomas as revealed with monoclonal antibodies

The expression and distribution of cytokeratins and vimentin in fifteen malignant salivary neoplasms were examined by immunocytochemical techniques using, five monoclonal antibodies (mAbs) against different epitopes of Cytokeratins (CKs) (mAbs PKK1, PKK2, and PKK3, identifying CKs 8, 18 and 19, CKs 7, 17 and 19, and CK 18, respectively) and Vimentin (mAbs V9 and V24). Antibody PKK1 gave strong reactions in all neoplasms showing the similarity of these tumours to other digestive system adenocarcinomas. Three general staining patterns of the neoplasms were recognized with respect to the reactivity of mAbs PKK2, PKK3, and V9. Mucoepidermoid cancer, salivary duct carcinoma and a clear cell carcinoma had a higher relative content of CKs 7, 17 and 19 than of CK 18. Adenoid cystic carcinoma showed the same CK pattern but in the periphery of the tumour cords vimentin was readily detected. In two acinic cell carcinomas, the relative content of CK 18 was higher than that of CKs 7, 17 and 19. Furthermore vimentin was expressed in the tumour cells. However, one mucoepidermoid carcinoma showed vimentin expression and two acinic cell carcinomas were vimentin negative and more reative for PKK2 than PKK3. Pecularities in CK expression were seen: squamous areas of mucoepidermoid carcinomas were stained by mAb PKK3 although CK 18 is not present in normal squamous epithelia or in squamous cell carcinomas of tongue and skin. In conclusion, the different salivary neoplasms can be distinguished on basis of IFP content. Such a differentiation fits with current theories of histogenesis, i.e. vimentin is seen in tumours presumed to arise from intercalated duct reserve cells, whilst the vimentin negative neoplasms would be expected to arise in excretory duct reserve cells.

Predictive value of potential doubling time in head and neck cancer patients treated by conventional radiotherapy

Purpose: The goal of this study was to investigate the clinical utility of pretreatment measurements of tumor cell kineticsto predict the outcome of patients with squamous cell carcinoma of the head and neck receiving conventional radiotherapy. Methods and Materials: All patients received between 64 and 70 Gy as 2 Gy fractions, five fractions per week. Cell kinetics were assayed rapidly and quantitatively using flow cytometric evaluation of iododeoxyurldine ( IdUrd) incorporation, in viva, from a biopsy removed several hours after the administration of the DNA precursor to the patient prior to the start of treatment. Results: The measured proliferation parameters were not related to the clinicopathological features of the tumors, emphasizing the independent nature of these parameters. In univariate analysis, nodal involvement was the most important clinical feature of the tumors related to local control followed by T,, DNA aneuploidy, and attainment of complete regression at 6 weeks. Of these only Tpot and nodal status maintained significance in multivarlate analysis, with respect to loco-regional control. In subgroup analysis, T, was able to stratify patients into high or low rate of loco-regional control in node negative patients, in aneuploid tumors and in patients who did achieve complete regression at 6 weeks. For cause specific survival, N-stage was the only parameter that significantly discriminated the prognosis in these patients. Conclusions: The conclusion of this study is that T,, provides clinically important information that can predict patients with a low probability of achieving long-term local control with conventional fractionation. Further improvements to the methodology to address the shortcomings of analyzing diploid tumors may increase the predictive power of the measurement. 0 1997 Elsevler Science Inc.

Distribution of intermediate filament proteins in developing and adult salivary glands in man.

SummaryAdult and developing salivary glands were investigated using five monoclonal antibodies against cytokeratins (CKs) and vimentin. Acinar cells displayed mainly CK 18 whereas CKs 7, 17 and 19 were only detected in duct and myoepithelial cells. All epithelial and myoepithelial cells were unreactive for one vimentin antibody (Vim 9) whereas with the other (Vim 24), myoepithelial cells and basal cells of excretory ducts were stained. Fetal cells showed the CK pattern of duct cells. At gestational week 18, a reaction for both vimentin antibodies could be found in basal cells of terminal tubules. Although vim 9 reactivity has been shown for a number of salivary neoplasms, it has not been detected in any adult epithelial salivary tissue. The finding of this reactivity in the fetal gland indicates that the expression of this intermediate filament protein in certain salivary neoplasms may be a sign of dedifferentiation resulting in the expression of a filament pattern found in an earlier stage of gland development.

Bilateral irradiation of head and neck induces an enhanced expression of substance P in the parasympathetic innervation of the submandibular gland.

Substance P and calcitonin gene-related peptide (CGRP) are present in nerve fibers innervating the submandibular gland. Radiotherapy of tumors in the head and neck region usually embraces the salivary glands in the irradiated field and consequently a dramatic decrease in salivary function is seen. In this study, the submandibular glands and ganglia of rats subjected to fractionated irradiation were examined by use of immunohistochemical techniques for demonstration of substance P and CGRP. Irradiation was given on five consecutive days (daily doses of 6-9 Gray) with unilateral or bilateral irradiation techniques. Specimens of control and experimental animals were processed in parallel. A marked increase in the expression of substance P in the ganglionic cells--presumably parasympathetic--and in the number of fibers showing substance P-like immunoreactivity in association with acini and small ducts was seen in response to bilateral irradiation. (Surprisingly, unilateral irradiation of the parotid area had no effect on peptide distribution in the irradiated gland and ganglion). No changes in the pattern of CGRP immunoreactivity occurred. In the trigeminal ganglion, which supplies the submandibular gland with the majority of the sensory substance P- and CGRP-containing nerve fibers, no changes in the expression of substance P or CGRP immunoreactivity were seen. The results suggest that bilateral irradiation leads to an increase in the synthesis of substance P-like substance in the parasympathetic ganglionic cells supplying the submandibular gland with secretory nerves, and can thus be an additional factor in explaining the altered secretory capacity of salivary glands.

Glial fibrillary acidic protein and desmin in salivary neoplasms. Expression of four different types of intermediate filament proteins within the same cell type.

SummaryThe presence of intermediate filament proteins (IFP) in normal salivary gland tissue and in a number of salivary gland neoplasms has been investigated by immunohistochemical techniques on frozen sections. Cytokeratins (CKs) were seen in almost all normal epithelial cells. In the parotid gland and in palatal gland tissue, a co-expression of cytokeratin and glial fibrillary acidic protein (GFAP) was seen in some myoepithelial cells, but this was not apparent in the submandibular gland. In some pleomorphic adenomas, carcinomas in pleomorphic adenomas, one mucoepidermoid carcinoma, one mucus-producing adenopapillary carcinoma and one adenoid cystic carcinoma, cells expressing three different IFP classes were found (CKs, vimentin, GFAP). These cells were most often situated peripherally in the tumour cords or ducts. The cytokeratin pattern in these cells, as revealed by mAbs PKK1-3, was similar to that in normal myoepithelial cells. Furthermore, reactivity for a fourth class of IFP, desmin, could be seen in this cell type in two carcinomas in pleomorphic adenomas, and also in a few cells in a pleomorphic adenoma and an adenoid cystic carcinoma. Thus the pattern of IFP expression in salivary gland neoplasms, is very complex, and cannot always be related to the normal tissue.

Time- and dose-related changes in the expression of substance P in salivary glands in response to fractionated irradiation

PURPOSE The expression of different neuropeptides in the innervation of submandibular and parotid glands of the rats was examined 2 and 5 days after initiation of radiation treatment as well as 10 and 180 days following the termination of irradiation. METHODS AND MATERIALS The irradiation was given on 2 or 5 consecutive days with daily doses of 4-8 Gy up to a total dose of 20-40 Gy. Immunohistochemical methods were used for the demonstration of substance P (SP), calcitonin gene-related peptide (CGRP), neuropeptide Y (NPY) and, the rate-limiting enzyme in the catecholamine synthetic pathway, tyrosine hydroxylase (TH). The content of SP was also analyzed by the use of radioimmunoassay (RIA). RESULTS In the parenchyma of both the submandibular and the parotid glands of control animals as well as after 2 days of irradiation treatment, a few nerve fibers showing SP-like immunoreactivity (LI) were observed. A marked increase in the expression of SP in the innervation of the parenchyma in both glands was observed 10 days after cessation of radiation treatment. The number of stained nerve fibers and the intensity of fluorescence in the fibers seemed to be dose dependent because the group subjected to a total dose of 40 Gy displayed a more pronounced staining intensity than that treated with 30 Gy. These results were supported by the RIA analysis. One hundred eighty days after treatment no obvious differences in SP-expression were seen between control and irradiated animals. No acute and long-term alterations were seen with regard to the other peptides and TH. CONCLUSIONS These results suggest that specific dose- and time-dependent changes in the expression of SP in the parenchyma of both submandibular and parotid glands occur in response to fractionated irradiation. The observations add further aspects to the tissue differences in physiological response and sensitivity to irradiation.

Mucoepidermoid carcinoma in a minor salivary gland in childhood

Salivary gland neoplasms in childhood and adolescence are rare, especially in the minor salivary glands. Vasoformative tumours and pleomorphic adenomas appear to be the most common benign neoplastic salivary gland lesions in the pediatric age group. The distribution of various malignant histological types is not always consistent with that in the adult population, and they appear more often in girls than in boys. Only 17 cases have previously been documented. The clinical and histological picture of a case of palatal mucoepidermoid carcinoma in a 13-year-old girl is presented as well as a review of the literature on malignant salivary gland tumours in childhood.

Cell kinetics of head and neck squamous cell carcinomas. Prognostic implications.

Forty-three squamous cell carcinomas of the head and neck region were in vivo labelled with the thymidine analogue iododeoxyuridine. Combined flow cytometric (FCM) and immunohistochemical (IHC) analysis was performed, and the following parameters calculated: labelling index (LI), S-phase time (TS) and potential tumor doubling time (Tpot). Complete FCM and IHC analyses could successfully be performed in 31 cases, showing a median LI of 13.6% with FCM and 9.1% with IHC. A correlation achieved between LI/FCM and LI/IHC was due to the aneuploid cases, whereas the diploid cases showed no such correlation. Data indicated that Tpot calculated with LI from IHC (Tpot/IHC) might be a prognostic factor, in contrast to Tpot determined using LI/FCM.