The Expression And Meaning Of P_2Y2 Purinoceptor In Human Salivary Adenoid Cystic Carcinoma

Part one Clinical analysis of salivary adenoid cystic carcinoma in 40 casesSalivavy adenoid cystic carcinoma(SACC)is a kind of strong invasive malignant tumor spreading widely into the surrounding structure, following the nerves and vessels. Although excision of tumor extensively, the local recurrence and distant metastasis rates are still high, therefore, prognosis is poor even after treatment. The aim was analyzed the clinical manifestation of SACC in 40 cases, and the important factors influencing the prognosis were comprehensively studied.Method:Pathologically diagnosed 108 cases of salivary gland malignant neoplasm were collected with 40 cases of SACC among them. The clinical stage was carried out by the TNM classification of UICC in 2002, and the pathologic type according to the new method of WHO in 1991 (salivary gland tumor).Result:1. In salivary gland malignant tumors, the most commonly original sites were parotid glands, followed by submandibular glands and minor salivary glands in palate. The average of patients was 49.97 years with the ratio of male to female being 1.20:1. Adenoid cystic carcinoma is most common in salivary gland malignant tumors which accounts for 98.15%; parotid gland and submandibular gland are also the most commonly original sites; the age of patients is 51.83 in average with the ratio of male to female being 1:1.2. The main cause of death in SACC is local recurrence and distant metastasis. The rates of recurrence and metastasis are higher in submandibular gland and minor salivary gland in palate,Ⅲ-Ⅳstage, solid type and nerve invaded than that in other sites,Ⅰ-Ⅱstage, sieve-tubular and non-nerve invaded.Conclusion:1. Among the salivary gland malignant tumors, original tumors were most likely to develop in parotid and submandibular glands in sequence, and the middle and the aged are the most likely attacked groups. Salivary adenoid cystic carcinoma is the most common salivary gland malignant tumor with high morbidity.2. The recurrence and metastasis rates in SACC are higher after treatment, which depend upon sites of tumor, clinical stage, histological type and nerve involvement.Part two The expression of P2Y2 purinoceptor in human salivary gland and adenoid cystic carcinomaSalivary adenoid cystic carcinoma(SACC)is one of the most common salivary malignant tumors . The conspicuous feature of SACC is the strong invasion and early hematogenous metastasis, and the main reason of death is local recurrence and distant metastasis. But till now, very few things were known about the signal mechanism which mediates the malignant progress. Some researches have demonstrated that some kinds of purine receptors which mediate different physiology reaction are in the acinus and ductus cells of salivary gland. As one of ATP receptors, purinoceptor P2Y can extensively induce pathologic and physiological functions on the growth and differentiation of cells.Recently, researches on ATP of anti-cancer function have already been subjected to the concern of many scholars home and abroad. According to the relevant literature, P2Y activated or inactivated may lead to the proliferation and apoptosis of epidermal cancer cells. But at present, researches on the relationshipbetween P2Y activated and diversion or infestation of salivary malignant tumor have not been reported.The objective of this research was to study through histogenesis and morphogenesis, the expression and distribution of P2Y2 in normal human salivary gland and salivary adenoid cystic carcinoma by immunohistochemistry, and investigated the significance of P2Y2 in SACC. This experiment has established the basis for further research, which is related with signal mechanism of differentiation, apoptosis and proliferation mediated by ecto-nucleotide as well as the effect of P2Y2 in SACC. This topic has also provided a new strategy on the treatment of salivary gland tumors.Method:49 specimens of human salivary adenoid cystic carcinoma were collected, and each paraffin sample has normal salivary gland organization in the edge of tumor. According to three methods (pathologic type, clinical stage and nerve invaded), the specimens were divided as follows: Group A1(sieve-tubular type)and A2(solid type), GroupB1(Ⅰ～Ⅱstage)and B2(Ⅲ～Ⅳstage), GroupC1(nerve invaded) and C2(non-nerve invaded). Through immunohistochemical assay ,expression and distribution of P2Y2 in normal salivary gland and SACC were examined. The gray-scale degree of P2Y2 was measured by microscopic analyzing technique, and the data through statistics.Results:1. P2Y2 was observed on nuclear membrane of duct and gland alveolus cells in the normal human salivary gland, and less P2Y2 was located in the cytoplasm; little was expressed on the myoepithelium cells. The value of grey scale is 3.76±1.82 in average.2. In SACC, the P2Y2 was located mainly in caryon and caryotheca of the ductal and basel epithelial tumor cells whose nucleus are pooly differentiated with obvious heteromorphism, little is expressed on the fusiform myoepithelium tumor cells. The average gradation numerous of P2Y2 in the 49 SACC specimens is 3.76±1.82. According to the pathologic type, clinical stage and nerve invaded, the average grey scale of P2Y2 was measured: the value in the solid type is more than that in the sieve-tubular type, the value in theⅢ～Ⅳstage is more than that in theⅠ～Ⅱstage, and the value in nerve invaded is more than that in non-nerve invaded. There is statistical significance in terms of difference in each group.3. The expression of P2Y2 in normal salivary gland is less than that inSACC, and the difference of grey scale has highly statistical significance.Conclusions:1. Purinoceptor P2Y2 which are mainly located on the nuclear membrane of duct and gland alveolus cells can be observed in normal human salivary gland. Expression of P2Y2 in the salivary gland may be related to the mechanism of tumorigenesis.2. The expression of P2Y2 in SACC is correlated with pathologic type, clinical stage and neurotropism; the expressing level may be a marker for malignancy in SACC. The differentiation of SACC cells can be regulated by ATP reaction on the purinoceptor P2Y2.