Prognostic Factors of Head and Neck Adenoid Cystic Carcinoma: Quantitative Morphological Analysis of 19 Cases

Abstract

This quantitative study was prompted by concerns regarding the clinical and histopathologic correlation of adenoid cystic carcinoma (ACC). We reviewed the clinical and histopathologic data of 19 cases of ACC in the head and neck region treated during the last 25 years. An image analyzing system was employed for quantitative analysis. Each specimen was observed microscopically at 100½ magnification, by two of the authors, the area of pure cellular component in five randomly selected fields was measured and the averaged cellular ratio per field was calculated as a percentage and then correlated with the behavior of the tumor. The cellular ratio was 66% for the 8 patients who died of disease and 47% (at 3-year follow-up; n ¾ 9) and 58% (at 10-year follow-up; n ¾ 4) for the 11 patients who survived without evidence of disease. For all of the patients who developed distant metastasis the cellular ratio was >60%. The results of this quantitative study did correlate, to some extent, with the patients' clinical behavior. Although non-quantitative clinical and histological criteria of ACC have been reported to correlate with clinical behavior, it is important to thoroughly understand these criteria and also to combine multiple criteria in order to manage head and neck ACC.

• Adenoid
• Cystic
• Carcinoma
• Prognosis
• Quantitative
• Study