Immunohistochemical Expression Of Human Epidermal Growth Factor Receptor-2 (Her-2) In Common Salivary Gland Carcinomas.

BACKGROUND: Carcinomas of the salivary gland are known to be aggressive in nature, making them difficult to manage. The therapeutic options offered include excision of the gland (maxillectomy in cases of palatal tumours), with or without lymph node dissection, proceeded with radiotherapy. Chemotherapy has not produced promising outcomes and has a minimal impact as a therapeutic alternative. Targeted therapy against human epidermal growth factor receptor 2 (HER-2), which is a commonly used treatment modality for their mammary analogues, is not being offered to these patients since scant literature is available showing its usefulness and no promising evidence is present regarding their efficacy and efficiency in such cases. The study aimed to evaluate and quantify the immunohistochemical expression of HER-2 in cases of adenoid cystic carcinoma (AdCC), mucoepidermoid carcinoma (MEC) and salivary duct carcinoma (SDC), which are analogues of similar tumours arising in breast tissue. METHODS: A retrospective, cross-sectional study was carried out in the department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, duration of which was six months. A total of 45 cases (15 of each tumour) were taken, and sampled using non-probability convenience technique. The immunohistochemical marker, monoclonal HER-2 antibody (Leica microsystem Germany) was applied on appropriate blocks of all included cases. The staining pattern and intensity were recorded after visualizing the slides under a light microscope. RESULTS: Seven cases of salivary duct carcinoma and a single case of mucoepidermoid carcinoma expressed positivity for HER-2, while no expression could be seen in the case of adenoid cystic carcinoma. A statistically significant difference was seen when HER-2 expression was compared among the aforementioned tumours. CONCLUSIONS: The use of targeted therapy against HER-2 is limited to patients of salivary duct carcinoma and a fraction of patients suffering from mucoepidermoid carcinoma.

Role Of Cd8+ Tumour-Infiltrating Lymphocytes In Predicting Regional Lymph Node Metastasis In Lip And Oral Cavity Squamous Cell Carcinoma.

BACKGROUND: Lip and oral squamous cell carcinoma maintains a significant disease burden in Pakistan. The latest research on cancer focuses more on the role of body's immune response in tumour progression and spread rather than on the nature of neoplastic cells. Tumour-infiltrating lymphocytes constitute a major part of the tumour microenvironment and infiltration of tumour stroma by cytotoxic T-cells are known to limit the tumour progression in various malignancies, such as colorectal and stomach cancers. In our study, we aim to establish the prognostic role of CD8+ tumour-infiltrating lymphocytes in lip and oral squamous cell carcinoma. METHODS: Clinico-pathological data and paraffin-embedded blocks were obtained for 100 cases of lip and oral squamous cell carcinoma. These cases were selected through non-probability, convenience sampling at the Histopathology department of A.F.I.P., Rawalpindi. Fresh sections from the tumour proper were taken and CD8 immuno-marker was applied. Data was recorded, entered and analysed with S.P.S.S. version 27.0 and Microsoft Excel. Qualitative variables were represented as frequency/percentages and quantitative variables were represented as mean and standard deviation. Chi-squared test was applied to test association between categorical data. A p-value of <0.05 was taken as significant. RESULTS: Increased CD8 T.I.L. density was significantly associated with pN stage (p-value= .000) and early clinical stage (p-value= .014). No significant association with other clinico-pathological parameters was established. CONCLUSIONS: CD8 T.I.L. density is a reliable marker for predicting absence or presence of cervical nodal metastasis in lip and oral S.C.C. Its predictive role in determining overall survival rate should be evaluated in future studies.