title: Periocular sebaceous gland carcinoma: do androgen receptor (NR3C4) and nuclear survivin (BIRC5) have a prognostic significance?
abstract: OBJECTIVE
  The study aimed at evaluating the expression of androgen receptor (AR) and nuclear survivin (NS) in periocular sebaceous gland carcinoma (SGC) and to determine whether this expression is associated with histopathological features, markers of apoptosis and proliferation and with clinical outcomes.
  
  
  METHODS
  This was a retrospective, comparative case series which included 56 patients with a biopsy-proven periocular SGC. Immunohistochemical staining for AR, survivin, p53 and Ki-67 was analysed in all cases.
  
  
  RESULTS
  All patients expressed AR, p53 and Ki-67 in the nucleus of tumour cells. Twenty-four patients (42.8%) had a high AR score, and 32 patients (57.2%) had a low AR score. Twenty-four (42.8%) patients expressed survivin in the nucleus of tumour cells. Nine (37.5%) had a high NS score, and 15 (62.5%) had a low NS score. Patients with a high AR score had a greater recurrence (p < 0.005), higher expression of Ki-67 (p < 0.0001) and a lower p53 expression (p < 0.005). Nuclear expression of survivin correlated with a high Ki-67 labelling index (0.0001) and low p53 expression (<0.005). Neither nuclear expression of survivin nor the NS score correlated with any clinicopathological features.
  
  
  CONCLUSIONS
  Expression of AR significantly impacts prognosis and is thus promising prognostic marker in periocular SGC.
authors.affiliation: National Reporting Centre for Ophthalmic Pathology, Centre for Sight, Hyderabad, India; Ocular Pathology Service, L.V.Prasad Eye Institute, Hyderabad, India.
authors.forename: Kaustubh
authors.initials: K
authors.lastname: Mulay
authors.forename: Sneha J
authors.initials: SJ
authors.lastname: Shah
authors.forename: Ekta
authors.initials: E
authors.lastname: Aggarwal
authors.forename: Valerie A
authors.initials: VA
authors.lastname: White
authors.forename: Santosh G
authors.initials: SG
authors.lastname: Honavar
mesh_terms: D018266:Adenocarcinoma, Sebaceous / Q000175:diagnosis / Q000378:metabolism*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D005142:Eyelid Neoplasms / Q000175:diagnosis / Q000378:metabolism*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D051034:Inhibitor of Apoptosis Proteins / Q000378:metabolism*; D019394:Ki-67 Antigen / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011944:Receptors, Androgen / Q000378:metabolism*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012626:Sebaceous Gland Neoplasms / Q000175:diagnosis / Q000378:metabolism*; D000077022:Survivin; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
chemical_list: C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D051034:Inhibitor of Apoptosis Proteins; D019394:Ki-67 Antigen; D011944:Receptors, Androgen; D000077022:Survivin; D016159:Tumor Suppressor Protein p53
keywords: Ki-67; androgen receptor; p53; periocular; sebaceous carcinoma; survivin