title: Radiation-induced sarcoma in the head and neck region: a clinicopathologic and immunohistochemical study of 13 cases.
abstract: OBJECTIVE
  To study the clinical and histological features of radiation-induced sarcoma in the head and neck (RISHN).
  
  
  METHODS
  Medical records of 13 patients with RISHN treated at our institution between 1990 and 2011 were studied, and paraffin-embedded samples were analyzed by haematoxylin and eosin staining and immunohistochemistry to determine mitosis counts and assess expression of Ki-67, bcl-2, and survivin.
  
  
  RESULTS
  Positive bcl-2 was observed in 12 (100%) and survivin in 10 (76.9%) patients. The Ki-67 labeling index ranged from 1% to 90%, and it showed significant positive correlation with mitosis count in RISHN tissues, based on Spearman analysis. Percentage of distal metastasis with T2b was significantly higher than T1b stage (P=0.035).
  
  
  CONCLUSIONS
  Stage T2b may be a useful indicator for predicting distant metastasis of RISHN. The MIB-1 score may be used as a histological grading system for RISHN. In addition, bcl-2 and survivin protein may play an important role in pathogenesis and progression of RISHN.
authors.affiliation: Department of Head and Neck Tumor Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China. wzhbo1973@yahoo.com.cn
authors.forename: Zhengbo
authors.initials: Z
authors.lastname: Wei
authors.forename: Jian
authors.initials: J
authors.lastname: Xu
authors.forename: Xianjie
authors.initials: X
authors.lastname: Zeng
authors.forename: Yuan
authors.initials: Y
authors.lastname: Luo
authors.forename: Falong
authors.initials: F
authors.lastname: Chen
authors.forename: Yunli
authors.initials: Y
authors.lastname: Yang
authors.forename: Qifang
authors.initials: Q
authors.lastname: Huang
authors.forename: Ying
authors.initials: Y
authors.lastname: Xie
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis*; D005260:Female; D006258:Head and Neck Neoplasms / Q000737:chemistry / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D051034:Inhibitor of Apoptosis Proteins / Q000378:metabolism; D019394:Ki-67 Antigen / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009381:Neoplasms, Radiation-Induced / Q000737:chemistry / Q000473:pathology*; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism; D012509:Sarcoma / Q000737:chemistry / Q000473:pathology; D000077022:Survivin
chemical_list: C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D051034:Inhibitor of Apoptosis Proteins; D019394:Ki-67 Antigen; D019253:Proto-Oncogene Proteins c-bcl-2; D000077022:Survivin