The Relationship Between The Clinical Manifestation About Head And Neck Adenoid Cystic Carcinoma And The Expression Of E-cad、 Ep-CAM、NCAM And Integrin αvβ6

Objective: Invasion and metastasis of tumor is a complexprocess, it is involved by many factors and regulated by a lot of genes. Celladhesion molecule(CAM) is a important molecular basis for invasion andmetastasis. Research about the pathogenesis of adenoid cystic carcinoma(ACC)showed that there has a specifical adhesion between ACC cell and extracellularmatrix. This study aimed to investigate the expression of E-cad, Ep-CAM,NCAM, integrin αvβ6in head and neck ACC and normal gland tissue, toanalyse the relationship between those CAMs and clinical manifestation ofACC, to clarify those roles of CAMs in the malignant progress, invasion andmetastasis of ACC. Methods:1. A retrospective analysis has been made on theclinical data of60patients with ACC from January2004to January2009hospitalized at the Affiliated Hospital of Luzhou Medical College. Thesurvival state was obtained in the follow-up periods.2. The expression ofE-cad、Ep-CAM、NCAM and integrin αvβ6in60cases of head and neck ACCspecimens and30cases of normal gland tissues were detected byimmunohistochemistry EnVision method. The Image-Pro Plus6.0imageanalysis system was utilized to evaluate the staining level of E-cad、Ep-CAM、NCAM and integrin αvβ6in mean optical density (MOD). Results:1. In the group of ACC, patients’age ranged from23to73years (median55years).There are32cases in I and II stages,28cases in III and IV stages. Twenty-sixpatients (43%) underwent diagnostic errors. The follow-up period was fromfive years to ten years. Twenty patients died during follow-up.2. Theexpression of E-cad in head and neck ACC is statistically significant lowerthan that in normal gland tissue(t=6.652, P=0.000). The expression ofEp-CAM、NCAM and integrin αvβ6in head and neck ACC are all statisticallysignificant higher than that in normal gland tissue(t’=9.898, P=0.000; t’=8.456,P=0.000; t’=9.552, P=0.000).3. The decreasing expression of E-cad in headand neck ACC is closely related to the different pathologicalpatterns(F=23.119, P=0.000), clinical stages(t=2.239, P=0.029), neurologicalsymptom(t=3.454,P=0.001)and local recurrences or distant metastases(t=2.433,P=0.018).4. The high expression of Ep-CAM in head and neck ACC is closelyrelated to the different pathological patterns(F=6.240, P=0.004), clinicalstages(t=3.489, P=0.001), neurological symptoms(t=3.222, P=0.002)and localrecurrences or distant metastases(t=2.830, P=0.006).5. The expression ofNCAM in different pathological patterns of head and neck ACC was nostatistic significant(F=0.525, P=0.594). The same result was also found indifferent clinical stages(t=1.540, P=0.129). The expression of NCAM in headand neck ACC are statistically significant higher in patients with neurologicalsymptoms(t’=6.304, P=0.000) and in patients with local recurrences or distantmetastases(t=2.514, P=0.015).6. The high expression of integrin αvβ6in head and neck ACC is closely related to the different pathological patterns(F=5.898,P=0.005), clinical stages(t=3.977, P=0.000), neurological symptoms(t=3.298,P=0.002) and local recurrences or distant metastases(t=2.850, P=0.006).7.There was a negative correlation about the expression between E-cad andEp-CAM, NCAM, integrin αvβ6in head and neck ACC, respectively(r=-0.890,P=0.000; r=-0.354, P=0.006; r=-0.803, P=0.000). The expression of Ep-CAMin head and neck ACC has positive correlations with NCAM, integrin αvβ6,respectively(r=0.381, P=0.003; r=0.867, P=0.000). The expression of NCAMhas a positive correlation with integrin αvβ6in head and neck ACC(r=0.370,P=0.004).8. The prognosis of head and neck ACC patients is correlation withage（χ2=4.987, P=0.026），pathological patterns(χ2=22.307, P=0.000), clinicalstages(χ2=7.452, P=0.006), neurological symptoms(χ2=3.961, P=0.047), localrecurrences or distant metastases(χ2=8.220, P=0.004) and the expression levelof E-cad(χ2=8.230, P=0.004), Ep-CAM(χ2=15.771, P=0.000), integrinαvβ6(χ2=16.490, P=0.000), respectively. But it is not correlation with theexpression of NCAM(χ2=2.935, P=0.087). Pathological patterns, age, localrecurrences or distant metastases and the expression level of integrin αvβ6areindependent prognostic factors in head and neck ACC patients. Conclusions:1.The expression of E-cad in head and neck ACC is lower than that in normalgland tissue. The expression of E-cad has negative correlations with high grademalignancy, quick rate of progress and poor prognosis. E-cad may act as ainhibitor in the occurrence and development of ACC. It can be used as an prognostic prediction factor of ACC.2. The higher expression of Ep-CAM inhead and neck showed that ACC has a more higher malignant, more quickerprogress and more poorer prognosis.3. Multivariable analysis of Cox showedthat the expression level of integrin αvβ6is an independent prognostic factorof ACC. It can be used as a target to evaluate prognosis.4. The perineuralinvasion of ACC may be related to the high expression level of NCAM.5.There was a correlation about the expression of E-cad, Ep-CAM, NCAM andintegrin αvβ6in head and neck ACC. It is suggested CAMs influence witheach other and have a synergic impact in the malignant process of ACC. Butthe ways and methods of work need to be further study.