Baş Boyun Adenoid Kistik Karsinom Hastalarında GLUT-1'in Histopatolojik Korelasyonu ve Prognoza Etkisi

Abstract

. Adenoid cystic carcinoma is a rare salivary gland tumor of the head and neck. Long-term follow-up is important because it has a slow clinical course and systemic metastases and local recurrences are seen after 15-20 years. Solid subtype, lymph node metastasis and perineural invasion are generally accepted poor prognostic factors in the literature for adenoid cystic carcinoma. However, clearer prognostic markers are needed. In our study, the prognostic value of GLUT-1 in adenoid cystic carcinomas and its correlation with its subtypes were examined. Our study included 42 patients who were diagnosed with adenoid cystic carcinoma in our clinic, whose clinical information was accessed, followed-up, and preparations that could be evaluated in the pathology department. The mean age at the time of diagnosis was 52.6, the rate of patients over 60 years old was 71.4%, the rate of female patients was 59.5%, 52.4% of the patients were minor salivary gland localized, PNI positivity 81%, surgical margin positivity 71.4% , the rate of solid subtype was 52.4%, the rate of those in T4 stage was 43.9%, the rate of patients with positive lymph node metastasis was 21.4%, the rate of patients with distant metastasis was 35.7%, the rate of patients with recurrence was 26.2%, the rate of patients who died in the follow-up was found to be 35.7%. When the treatments of our patients are evaluated; The rate of patients treated with surgical treatment was 100%, RT 59.5%, CT 23.8%, CRT 28.6%, neck dissection (ND) 14.3%. The mean follow-up period was 57.76±50.01 months (min-max. 8-204). There was no significant relationship between histological type and age, PNI, surgical margin, T stage, lymph node metastasis, distant metastasis, and recurrence (p>0.05). There is a significant relationship between histological type and ex status (p<0.05). 86.7% of patients with ex were solid subtype and 66.7% of surviving patients were nonsolid subtype. In terms of GLUT-1 evaluation, the patients were divided into sub-evaluation groups as GLUT-1 prevalence, GLUT-1 intensity and GLUT-1 score. In the statistical analysis results: GLUT-1 density; there is no significant difference according to age, localization, PNI, surgical margin, histological type, T stage, lymph node metastasis, distant metastasis, recurrence and ex status (p>0.05). GLUT-1 score; there is no significant difference according to age, localization, PNI, surgical margin, histological type, T stage, lymph node metastasis, distant metastasis, recurrence and ex status (p>0.05). GLUT-1 prevalence; It differs significantly according to lymph node metastasis (p<0.05). The mean of the negative ones is 2.15±0.83, while the mean of the positive ones is 1.33±0.87. Accordingly, the mean GLUT-1 prevalence is higher in those with negative lymph node metastasis. GLUT-1 prevalence; It differs significantly according to ex status (p<0.05). Accordingly, the GLUT-1 prevalence average of survivors is higher. According to the Ex status, GLUT-1 gives the best discrimination value of 1.50 for prevalence. There was no significant relationship between GLUT-1 prevalence grouping and age, gender, localization, PNI, histological type, T stage, distant metastasis, and recurrence (p>0.05). There was a significant correlation between GLUT-1 prevalence grouping and surgical margin (p<0.05). 83.3% of the positive ones; While 62.5% of the negative ones are above 1.5, 75.0% of the unevaluated ones are 1.5 below. There is a significant correlation between GLUT-1 prevalence grouping and lymph node metastasis (p<0.05). While 84.8% of the negative ones are above 1.5, 66.7% of the positive ones are 1.5 below. Longer-term studies with larger numbers of patients are needed to determine the prognosis of adenoid cystic carcinoma with GLUT-1.