Adenoid Cystic Carcinoma (ACC) is a rare malignant neoplasm that has its greatest propensity to occur in salivary glands, although it has a remarkable similarity to ACC of the Breast. No standard histologic parameters have proven to be markers of local recurrence or distant metastases of ACC. Breast carcinomas express estrogen (ER) and progesterone receptors (PR) that impart prognostic significance. This suggests a possible role for sex steroid hormones in the development and progression of salivary gland ACC. The presence of p53 mutation or allelic loss has been shown to be an adverse predictor of disease activity in many diverse forms of human cancer including ACC. Objectives: The current study examined the role of ER, PR and p53 mutations in ACC to determine if positive results might influence the development and natural course of the disease process. Methods: Fifteen samples of formalin-fixed, paraffin-imbedded salivary gland ACC's and 15 samples of normal salivary gland tissue were immunohistochemically evaluated for ER and PR, and for the presence of p53. Immunoreactivity was scored using a 0 to +3 scale in which staining was either negative (0), spotty (+1), weakly positive (+2), or strongly positive (+3). Results: We were able to demonstrate ER in formalin-fixed, paraffin-imbedded sections in 2 of 15 tumors, PR in 3 of 15 tumors and p53 expression in 6 of 15 tumors. The tumors showed varying degrees of immunopositivity ranging from 0 to +3. Conclusions: These studies suggest that p53 alterations may be involved in some ACC tumor progression and that ER and PR may play a role in ACC development. These findings may be of possible prognostic and therapeutic value in some cases of ACC.

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