Objective: The aim of this study was to investigate the relationship between membrane cytoskeleton linker protein Ezrin and CD44v6, iNOS, Ki-67, and clinicopathologic characteristics, and the prognostic significance of Ezrin expression in salivary gland adenoid cystic carcinoma (SACC).
Study design: Immunohistochemistry and reverse-transcription polymerase chain reaction were used to quantify the expression of Ezrin, CD44v6, inducible nitric oxide synthase (iNOS), and Ki-67 in 75 primary SACCs, 25 tumor-free salivary tissues, and 2 SACC cell lines (ACC-M and ACC-2). Survival analysis was performed to find the prognostic significance of Ezrin expression.
Results: Expressions of Ezrin, CD44v6, iNOS, and Ki-67 in SACC tissues, especially with distant metastasis, were significantly higher than in tumor-free tissues. Ezrin mRNA and protein levels in ACC-M cells were significantly higher than in ACC-2 cells. Ezrin, CD44v6, iNOS, and Ki-67 expressions were significantly higher in solid pattern than in cribriform and tubular patterns. Ezrin and its partners, CD44v6, iNOS, and Ki-67, were significantly related to tumor size, clinical stage, perineural and vascular invasion, and recurrence. Furthermore, Ezrin had an independent prognostic effect on overall survival.
Conclusions: The increased expression of Ezrin and its partners, CD44v6, iNOS, and Ki-67, in SACC correlated with histologic patterns, may play a role in distant metastasis, and might indicate poor clinical outcome.
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