Stroma-and Tumor-Associated Predictive Features in Salivary Gland Adenoid Cystic Carcinoma of the Head and Neck

Aleksi Rytkönen, Hanna K. Laine, Antti Mäkitie, Caj Haglund, Jaana Hagström, Alhadi Almangush, Ilmo Leivo

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background: There is lack of knowledge on the utility of prognostic histopathologic characteristics in adenoid cystic carcinoma (ACC) of the head and neck. We evaluated the prognostic value of tumor and stroma-related histopathologic features in ACC. Materials and Methods: A total of 65 cases of ACC from minor and major salivary glands were included in this study. We evaluated tumor budding, tumor-infiltrating lymphocytes (TILs), and tumor-stroma ratio (TSR) in hematoxylin and eosin (HE) stained sections. Results: Stroma-rich ACCs recurred more frequently (p = 0.029) during follow-up and associated with distant metastasis (p = 0.038). In multivariable analysis, stroma-rich tumors associated with poorer disease-specific survival with a hazard ratio of 3.76 (95% CI 1.10–12.83, p = 0.034). ACCs commonly showed a low infiltration of TILs as 89% of the tumors was characterized by an immune desert pattern. Low infiltration of TILs associated significantly with increased tumor budding (p = 0.039). Conclusion: Adverse features of TSR and tumor budding are widely expressed in ACC, and stroma-rich tumors are associated with poor prognosis. Low number of TILs in ACC tissue indicates a weak immune response by the host and illustrates the nature of ACC as a relentless malignancy.

Original languageEnglish
JournalJournal of Oral Pathology and Medicine
Volume54
Issue number1
Pages (from-to)22-30
Number of pages9
ISSN0904-2512
DOIs
Publication statusPublished - Jan 2025
MoE publication typeA1 Journal article-refereed

Bibliographical note

Publisher Copyright:
© 2024 The Author(s). Journal of Oral Pathology & Medicine published by John Wiley & Sons Ltd.

Fields of Science

  • adenoid cystic carcinoma
  • survival
  • tumor budding
  • tumor-infiltrating lymphocytes
  • tumor-stroma ratio
  • 3125 Otorhinolaryngology, ophthalmology

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