• Hasan Mujtaba Institute of Cancer Research Xi'an Jiaotong University, Xi'an China
  • Muhammad Atique Department of Pathology, Combined Military Hospital (CMH), Lahore
  • Iffat Batool Consultant Pediatrician BARWTH Phase 8 Baharia Town Islamabad
  • Muhammad Farooq Umer Epidemiology, School of Public Health Xi'an Jiaotong University, Xi'an China


Background: Oestrogen has a physiological role throughout the body including oral cavity. The effects are mediated by binding to two receptors in nucleus alpha and beta, which are ligand-activated transcription factors. The alpha receptors have a prognostic significance in cancer of breast while in Adenoid cystic carcinoma of salivary glands the results are inconsistent. This study was conducted to determine the oestrogen receptor Alpha staining in adenoid cystic carcinoma of salivary gland. Methods: Paraffin blocks of thirty cases of adenoid cystic carcinoma of salivary gland were retrieved and evaluated through immunohistochemistry by anti-oestrogen antibody clone 1D5.The intensity and proportion of nuclear staining was scored using Allred scoring system. Results: From total of thirty cases, 5 cases expressed as mild staining of oestrogen receptors using Allred scoring system. Three cases of cribriform and two cases from tubular pattern expressed positivity. In the case series selection of our study cohort there was no association seen in age, gender, site and histological type of tumour with the expression of oestrogen receptor. Conclusion: Role of oestrogen is well established in breast cancers, some of salivary gland adenoid cystic carcinoma also express these receptors and could be involved in the pathogenesis. Further studies are recommended to seek possible explanation of variable staining pattern observed in many other studies, and also to determine the possible therapeutic use of tamoxifen in such tumours.Keywords: Adenoid cystic carcinoma of Salivary Gland; Oestrogen receptor; Immunohistochemistry

Author Biography

Hasan Mujtaba, Institute of Cancer Research Xi'an Jiaotong University, Xi'an China

PhD researcherXi'an Jiaotong UniversityXi'anChina


Ettl T, Schwarz-Furlan S, Gosau M, Reichert TE. Salivary gland carcinomas. Oral Maxillofac Surg 2012;16(3):267–83.

Coca-Pelaz A, Rodrigo JP, Bradley PJ, Vander Poorten V, Triantafyllou A, Hunt JL, et al. Adenoid cystic carcinoma of the head and neck - An update. Oral Oncol 2015;51(7)652–61.

Dodd RL, Slevin NJ. Salivary gland adenoid cystic carcinoma: A review of chemotherapy and molecular therapies. Oral Oncol 2006;42(8):759–69.

Bradley PJ. Adenoid cystic carcinoma of the head and neck: a review. Curr Opin Otolaryngol Head Neck Surg 2004;12(2):127–32.

Luna-Ortiz K, Carmona-Luna T, Cano-Valdez AM, Mosqueda-Taylor A, Herrera-Gómez A, Villavicencio-Valencia V. Adenoid cystic carcinoma of the tongue – clinicopathological study and survival analysis. Head Neck Oncol 2009;1:15.

Luo SD, Su CY, Chuang HC, Huang CC, Chen CM, Chien CY. Estrogen receptor overexpression in malignant minor salivary gland tumors of the sinonasal tract. Otolaryngol Head Neck Surg 2009;141(1):108–13.

Reyes C, Jorda M, Gomez-Fernández C. Salivary gland-like tumors of the breast express basal-type immunohistochemical markers. Appl Immunohistochem Mol Morphol 2013;21(4):283–6.

Actis AB. A hypothesis to relate salivary tumors with mammary and prostate neoplasias. Bioinformation 2005;1(1):12–3.

Deroo BJ, Korach KS. Estrogen receptors and human disease. J Clin Invest 2006;116(3):561–70.

Herynk MH, Fuqua SAW. Estrogen receptor mutations in human disease. Endocr Rev 2004;25(6):869–98.

Bai Z, Gust R. Breast cancer, estrogen receptor and ligands. Arch Pharm (Weinheim) 2009;342(3):133–49.

Ascenzi P, Bocedi A, Marino M. Structure-function relationship of estrogen receptor alpha and beta: impact on human health. Mol Aspects Med 2006;27(4):299–402.

Chang M. Tamoxifen resistance in breast cancer. Biomol Ther (Seoul) 2012;20(3):256–67.

Cole MP, Jones CT, Todd ID. A new anti-oestrogenic agent in late breast cancer. An early clinical appraisal of ICI46474. Br J Cancer 1971;25(2):270–5.

Shadaba A, Gaze MN, Grant HR. The response of adenoid cystic carcinoma to tamoxifen. J Laryngol Otol 1997;111(12):1186–9.

Elkin AD, Jacobs CD. Tamoxifen for salivary gland adenoid cystic carcinoma: Report of two cases. J Cancer Res Clin Oncol 2008;134(10):1151–3.

Szanto PA, Luna MA, Tortoledo ME, White RA. Histologic grading of adenoid cystic carcinoma of the salivary glands. Cancer 1984;54(6):1062–9.

Allred DC, Bustamante MA, Daniel CO, Gaskill HV, Cruz AB Jr. Immunocytochemical analysis of estrogen receptors in human breast carcinomas: Evaluation of 130 cases and review of the literature regarding concordance with biochemical assay and clinical relevance. Arch Surg 1990;125(1):107–13.

Dimery IW, Jones LA, Verjan RP, Raymond AK, Goepfert H, Hong WK. Estrogen receptors in normal salivary gland and salivary gland carcinoma. Arch Otolaryngol Head Neck Surg 1987;113(10):1082–5.

Ozono S, Onozuka M, Sato K, Ito Y. Immunohistochemical localization of estradiol, progesterone, and progesterone receptor in human salivary glands and salivary adenoid cystic carcinomas. Cell Struct Funct 1992;17(3):169–75.

Düe W, Herbst WD, Loy V, Stein H. Characterisation of adenoid cystic carcinoma of the breast by immunohistology. J Clin Pathol 1989;42(5):470–6.

Miller AS, Hartman GG, Chen SY, Edmonds PR, Brightman SA, Harwick RD. Estrogen receptor assay in polymorphous low-grade adenocarcinoma and adenoid cystic carcinoma of salivary gland origin. An immunohistochemical study. Oral Surg Oral Med Oral Pathol 1994;77(1):36–40.

Shick PC, Riordan GP, Foss RD. Estrogen and progesterone receptors in salivary gland adenoid cystic carcinoma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995;80(4):440–4.

Gaffney EV, Pinkston JA, Eidson JJ. Estrogen receptors in parotid tumors. Endocr Res 1995;21(3):635–43.

Jeannon JP, Soames JV, Bell H, Wilson JA. Immunohistochemical detection of oestrogen and progesterone receptors in salivary tumours. Clin Otolaryngol Allied Sci 1999;24(1):52–4.

Dori S, Trougouboff P, David R, Buchner A. Immunohistochemical evaluation of estrogen and progesterone receptors in adenoid cystic carcinoma of salivary gland origin. Oral Oncol 2000;36(5):450–3.

Nasser SM, Faquin WC, Dayal Y. Expression of androgen, estrogen, and progesterone receptors in salivary gland tumors: Frequent expression of androgen receptor in a subset of malignant salivary gland tumors. Am J Clin Pathol 2003;119(6):801–6.

Pires FR, da Cruz Perez DE, de Almeida OP, Kowalski LP. Estrogen receptor expression in salivary gland mucoepidermoid carcinoma and adenoid cystic carcinoma. Pathol Oncol Res 2004;10(3):166–8.

Barrera JE, Shroyer KR, Said S, Hoernig G, Melrose R, Freedman PD, et al. Estrogen and progesterone receptor and p53 gene expression in adenoid cystic cancer. Head Neck Pathol 2008;2(1):13–8.

Ito FA, Ito K, Coletta RD, Vargas PA, Lopes MA. Immunohistochemical study of androgen, estrogen and progesterone receptors in salivary gland tumors. Braz Oral Res 2009;23(4):393–8.

Kolude B, Adisa A, Adeyemi B, Lawal A. Immunohistochemical expression of oestrogen receptor-α and progesterone receptor in salivary gland tumours. J Oral Pathol Med 2013;42(9):716–9.

Tabatabaei SH, Jafri N, Tafti MA, Hosseini AT. Immunohistochemical Study of Estrogen Receptor Expression in Adenoid Cystic Carcinoma and Mucoepidermoid Carcinoma of the Salivary Gland. Avicenna J Dent Res 2015;8(2):e26715.

Qureshi A, Pervez S. Allred scoring for ER reporting and it’s impact in clearly distinguishing ER negative from ER positive breast cancers. J Pak Med Assoc 2010;60(5):350–3.

Tozlu-Kara S, Roux V, Andrieu C, Vendrell J, Vacher S, Lazar V, et al. Oligonucleotide microarray analysis of estrogen receptor α-positive postmenopausal breast carcinomas: Identification of HRPAP20 and TIMELESS as outstanding candidate markers to predict the response to tamoxifen. J Mol Endocrinol 2007;39(3–4):305–18.

Yaziji H, Taylor CR, Goldstein NS, Dabbs DJ, Hammond EH, Hewlett B, et al. Consensus recommendations on estrogen receptor testing in breast cancer by immunohistochemistry. Appl Immunohistochem Mol Morphol 2008;16(6):513–20.

Walker RA. Immunohistochemical markers as predictive tools for breast cancer. J Clin Pathol 2008;61(6):689–96.

Hammond MEH, Hayes DF, Dowsett M, Allred DC, Hagerty KL, Badve S, et al. American Society of Clinical Oncology/College of American Pathologists Guideline Recommendations for Immunohistochemical Testing of Estrogen and Progesterone Receptors in Breast Cancer. Arch Pathol Lab Med 2010;134(6):907–22.

Goldstein NS, Hewitt SM, Taylor CR, Yaziji H, Hicks DG. Recommendations for improved standardization of immunohistochemistry. Appl Immunohistochem Mol Morphol 2007;15(2):124–33.