title: Adenoid cystic carcinoma of the trachea and bronchus--a clinicopathologic study with DNA flow cytometric analysis and oncogene expression.
abstract: OBJECTIVE
  Adenoid cystic carcinoma (ACC) of the tracheobronchial tree is quite uncommon. The clinicopathologic analysis and the therapeutic outcomes of tracheobronchial ACC have been reported earlier. However, their biological behavior should differ from other tracheal neoplasms. Thus, DNA flow cytometric analysis and biomarkers of p53, HER-2/neu and COX-2 for tracheobronchial ACC were investigated in order to evaluate their clinicopathological significance.
  
  
  METHODS
  Between 1985 and 1999, nine patients with tracheobronchial ACC were included for the study. All the patients had pathologically confirmed ACC. Five were male and four were female. Eight patients underwent surgical resections. Seven paraffin embedded tumors from six patients were available for DNA flow cytomeric analysis and immunohistochemical staining of p53, HER-2/neu and COX-2.
  
  
  RESULTS
  Histologically, nine pathologic specimens from eight surgical patients (including one patient received operation twice) showed one grade I, five grade II and three grade III. The mitotic activity, lymphatic invasion and vascular invasion were more frequent in advanced grading tumor. The higher grade tumors seemed to be associated with a higher synthetic phase fraction (SPF). Immunohistochemically, except for one grade II tumor showing positive expression of HER-2/neu, all the seven tumorous samples revealed negative expressions of p53, COX-2 and HER-2/neu. The patient with positive HER-2/neu tumor had distant metastases 4 years after surgery.
  
  
  CONCLUSIONS
  Complete surgical resection may provide best survival for tracheobronchial ACC. The DNA ploidy and SPF may correlate with tumor grading or metastasis. The overexpressions of HER-2/neu, p53 and COX-2 may impact the prognosis in patients with stage I non-small cell lung cancer, but did not express difference in our patients.
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang Ming University, Taipei, Taiwan, ROC.
authors.forename: Chih-Ming
authors.initials: CM
authors.lastname: Lin
authors.forename: Anna Fen-Yau
authors.initials: AF
authors.lastname: Li
authors.forename: Li-Hwa
authors.initials: LH
authors.lastname: Wu
authors.forename: Yu-Chung
authors.initials: YC
authors.lastname: Wu
authors.forename: Frank Cheau-Feng
authors.initials: FC
authors.lastname: Lin
authors.forename: Liang-Shun
authors.initials: LS
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D001984:Bronchial Neoplasms / Q000737:chemistry* / Q000473:pathology / Q000601:surgery; D003528:Carcinoma, Adenoid Cystic / Q000737:chemistry* / Q000473:pathology / Q000601:surgery; D051546:Cyclooxygenase 2; D004273:DNA, Neoplasm / Q000096:biosynthesis; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D007527:Isoenzymes / Q000032:analysis; D008207:Lymphatic Metastasis; D008297:Male; D008565:Membrane Proteins; D008875:Middle Aged; D008940:Mitotic Index; D009361:Neoplasm Invasiveness; D011003:Ploidies; D011379:Prognosis; D011451:Prostaglandin-Endoperoxide Synthases / Q000032:analysis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D012189:Retrospective Studies; D014134:Tracheal Neoplasms / Q000737:chemistry* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; D051546:Cyclooxygenase 2; D004273:DNA, Neoplasm; D007527:Isoenzymes; D008565:Membrane Proteins; D011451:Prostaglandin-Endoperoxide Synthases; D018719:Erb-b2 Receptor Tyrosine Kinases; D016159:Tumor Suppressor Protein p53; C496540:PTGS2 protein, human