Abstract. Pim-1 proto-oncogene, serine/threonine kinase (PIM-1) phosphorylates a series of substrates to exert its oncogenic function in numerous malignancies. The present study investigated the clinical significance of the PIM-1 protein, apoptosis status and apoptosis-associated proteins, including forkhead box O3a (FOXO3a), B cell lymphoma-2 (BCL-2) and BCL-2-associted agonist of cell death (BAD), were investigated in salivary gland adenoid cystic carcinoma (ACC) tissues. PIM-1 expression levels in 4 pairs of ACC tissues and corresponding normal salivary gland tissues were determined by western blot analysis. PIM-1, FOXO3a, BAD and BCL-2 expression levels in 60 ACC tissues were evaluated by immunohistochemistry (IHC). A terminal deoxynucleotidyl-transferase-mediated dUTP nick end labeling assay was performed to detect the apoptosis status of ACC tissues. PIM-1 was revealed to be highly expressed in ACC tissues compared with adjacent normal tissues. IHC staining results demonstrated high expression ratios of PIM-1, FOXO3a, BCL-2 and BAD [33.33% (20/60), 51.67% (31/60), 51.67% (31/60) and 55% (33/60)], respectively, and significant correlations between the expression of PIM-1 and FOXO3a and BCL-2 (P<0.05). Apoptotic rates were significantly associated with PIM-1, FOXO3a, BCL-2 and BAD expression levels (P<0.05). PIM-1 expression levels were significantly associated with tumor size, lymph node involvement, nerve invasion, distant metastasis and weakly associated with tumor node metastasis stage. Kaplan-Meier survival curves revealed that PIM-1 expression level was significantly associated with disease-free survival of patients with ACC (P=0.009). Cox regression multivariate analysis results revealed that histotype, distant metastasis and apoptotic rate were independent prognosis factors for ACC. Assessment of PIM-1 may be useful in investigating the malignant behaviors of ACC and predicting the outcome of patients with ACC.
IntroductionSalivary gland adenoid cystic carcinoma (ACC) accounts for ~10% of cases of epithelial salivary tumors and has a low 5-year survival rate (<20% in patients with highly metastatic tumors) (1,2). The development of ACC involves the interaction of oncogenes and tumor suppressor genes, similar to most other types of tumor (3). However, the precise mechanisms underlying ACC carcinogenesis remain to be elucidated (4,5).PIM kinases are oncogenic and are known to phosphorylate numerous substrates to exert their functions and have important roles in numerous malignancies. PIM-1, Pim-1 proto-oncogene, serine/threonine kinase (PIM-1) is upregulated in a number of cancer subtypes and the overexpression of PIM-1 is thought to be involved in cancer-specific apoptosis signaling pathways (6-12). Apoptosis is modulated by complex pathways that involve a series of apoptosis-associated proteins. As a substrate of PIM-1 kinase, Forkhead box O3a (FOXO3a) is a proapototic transcription factor and regulates the expression of numerous apoptosis-associated genes to induce apoptosis (13). It has previously ...