Estudo imunohistoquimico e analise multivariada de fatores prognosticos de carcinomas mucoepidermoides de glandulas salivares

AUTOR(ES)
DATA DE PUBLICAÇÃO

2002

RESUMO

Clinical staging and histological grade have been reported as the main prognostic factors in mucoepidermoid carcinoma (MEC). The aim of this study was to report clinical, pathological and immunohistochemical features as prognostic factors in head and neck MEC. From 1953 to 1997, 173 cases of head and neck MEC were retrieved from the files of the A. C. Camargo Cancer Hospital, São Paulo, Brazil. Clinical and histopathological data were obtained from the patients records and from the histological review. Immunohistochemical reactions against PCNA, ki-67, p53, c-erbB-2, CEA, bcl-2 and Mel-CAM, and univariate and multivariate survival analysis were performed. Parotids were affected in 61 cases (35.2%), TNM revealed 50.3% stages I or II and histological grading revealed 45.2% and 36.3% low and high-grade MEC, respectively. Local recurrence, regional and distant metastasis were found in 12.7%, 9.8% and 9.2% of the patients, respectively, and five-year overall survival rate was 70%. Univariate survival analysis revealed that age of the patients (>40 years) (p<0.001), male gender (p=0.005), fixation of the tumors (p=0.002), invasion of the adjacent structures (p=0.004), T (p<0.001), N (p<0.001), clinical stage (p<0.001) and histological grade (p<0.001) were correlated to a worst prognosis. Submandibular cases had the worst survival rates. PCNA (p<0.001), ki-67 (p<0.001) and p53 (p<0.001) expression were also correlated to a worst prognosis and, on the contrary, expression of CEA (p=0.012) and bcl-2 (p<0.001) were correlated to a better prognosis. Multivariate survival analysis revealed that age of the patients (>40 years), fixation of the tumors, T, N and histological grade were independent significant prognostic factors. Mel-CAM expression demonstrated a inversely correlation to local recurrence, regional and distant metastasis. Several clinical and immunohistochemical features were correlated to prognosis in MEC and should be also considered when establishing patient management

ASSUNTO(S)

cabeça imunohistoquimica pescoço

ACESSO AO ARTIGO

Documentos Relacionados