| Chronic sclerosing sialadenitis of the submandibular gland (CSSS)(also known as Kuttner tumor) is a fibrosing chronic inflammatory lesion of the submandibular gland that mimics a true neoplasm clinically because of presentation as a hard submandibular mass. It was first described by Kiittner in 1896. Pathological examination of the excised specimens reveals a fibrosclerosing lesion in the submandibular glands. This disease was classified as a tumor-like lesion by WHO in 1991. Recently, a series of studies have demonstrated that the cytokines play an important role in the development of organ fibrosis, in which transforming growth factor (TGF) was mostly studied, especially in close association with extracellular matrix (ECM). TGF participates in the development of the organ fibrosis and has become a target of treating orgen fibrosis. Connective tissue growth fortor (CTGF),as a downstream factor of TGF, is also a cytokine contributing to fibrosis and closely associate with TGF. While TGF specifically induces the expression of CTGF and CTGF partly mediates negative biological effect of TGF which stimulates cellular proliferation and ECM synthesis and accelerate organ fibrosis. The aim of our study was to apply the image analysis system to investigate quantitively the immunohistochemical expression of TGF CTGF collagen I (COL-I ) collagen (COL) fibronectin(FN)in the chronic sclerosing sialadenitis of the submandibular gland.For this purpose, biopsy specimens from submandibular glands of 44 patientswith the histological diagnosis of chronic sclerosing sialadenitis and 6 patients with oralcarcinoma who underwent radical neck dissection were divided into the case group and the control group. Subsequently, the specimen slices were stained respectively with immunohistochemical staining technique, to mark TGF CTGF COL-I COL-which followed by quantitive analysis with the image analysis system. Consequently, the obtained data were analyzed detailedly with the SPSS10.0 statistic analysis software package.The results of the statistic analysis showed: 1. The expression levels of COL-I FN TGF and CTGF in the case group were statistically significantly higher than those of the control group (P<0.05), and gradually increased with the degree of submandibular gland fibrosis. But COL had no expression in both case group and control group; 2. The stepwise lineal regression analyses showed that there were statistically significantly positive lineal correlations between the COL and TGF CTGF respectively (F=l 6.726, P=0.000) . TGF may be more influence on COL-I than CTGF; 3. The stepwise lineal regression analyses showed that there were statistically significantly positive lineal correlations between FN and TGF CTGF(F=l5.565, P=0.000 ), CTGF may be more influence on FN than TGF; 4. The stepwise lineal regression analyses of the F-test showed that there were statistically significantly positive lineal correlations between TGF and CTGF (F=38.334, P=0.000) .In conclusion, the results of this study suggest: 1. COL-1 and FN are two main components of ECM excessive depositing in the submandibular gland with chronic sclerosing sialadenitis; 2.The increased expression of TGF and CTGF may play important role in the developing and progressing of the fibrosis in patients with chronic sclerosing sialadenitis of submandibular gland; 3. TGF may increase the synthesis and accumulation of ECM, mainly COL-1, which would contribute to the development of chronic sclerosing sialadenitis of submandibular gland; 4. CTGF maybe ,as well, increase the synthesis and accumulation of ECM, principally FN, which would resultedly cause the development of the disease.Thus, the chronic sclerosing sialadenitis of the submandibular gland may be the result of a fibrosis process triggered by some cytokines, such as TGF and CTGF.
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