Prognostic significance of PDCD4 expression in human salivary adenoid cystic carcinoma.

Programmed cell death 4 (PDCD4) has been recognized as a tumor suppressor gene that may inhibit neoplastic transformation and tumor promotion/progression. It was demonstrated that PDCD4 expression was associated with prognosis of multiple types of tumors and cancers. However, PDCD4 expression in salivary adenoid cystic carcinoma (ACC) has not been studied. We analyzed PDCD4 protein level by immunohistochemistry in 96 cases of ACC and found that PDCD4 expression was downregulated in 64.6 % (62/96) of tumor samples compared with adjacent nontumor salivary gland tissues. Moreover, decreased PDCD4 expression was significantly associated with clinical stage of the disease (P < 0.01). Analyses of overall survival and disease-specific survival by Kaplan-Meier method revealed that poor prognosis of ACC patients was associated with decreased PDCD4 expression (χ (2) = 5.971, P = 0.013; χ (2) = 4.274, P = 0.029). Furthermore, multivariate Cox model analysis demonstrated that PDCD4 expression was an independent risk factor for ACC (P < 0.05). Thus, our study suggested, for the first time, that PDCD4 expression might have an essential role in the progression of ACC.