High Expression of SOX2 Is Associated with Poor Prognosis in Patients with Salivary Gland Adenoid Cystic Carcinoma

Abstract

Sex determining region Y-BOX2 (SOX2), one of the key members of the SOX family, is a transcription factor that is involved in the maintenance of embryonic stem cell pluripotency and in multiple developmental processes. Recent studies have shown that SOX2 is aberrantly expressed in several types of tumors. The present study aimed to investigate the clinicopathological and prognostic significance of SOX2 in adenoid cystic carcinoma (ACC) of salivary gland. In this study, the expression of SOX2 in ACC tissues and matched adjacent non-cancerous tissues was measured by immunohistochemistry, western blot, and quantitative polymerase chain reaction. High SOX2 expression occurred in approximately 62.6% of primary ACC. In addition, high expression of SOX2 was significantly associated with T classification (p = 0.003) and distant metastasis (p = 0.002). The 5-year overall survival (OS) and disease-free survival (DFS) in patients with high SOX2 expression is poorer than those with low SOX2 expression. When adjusted by multivariate analysis, high SOX2 expression, together with distant metastasis, was an independent prognostic factor. The findings of the present study provide evidence that SOX2 represents a potential novel prognostic biomarker for ACC patients.

Epithelial-to-Mesenchymal Transition in the Pathogenesis and Therapy of Head and Neck Cancer

“…Although the accuracy of this statement must be questioned given the small number of MMHN cohorts, the protective role of KLK6 has been described before in other tumor entities such as breast cancer, and therefore seems to be highly dependent on the microenvironment and the tumor entity. In contrast to previous results in HNSCC, SOX2 seems to promote invasion and tumor progression by creating a more mesenchymal phenotype in ACCs [ 56 ]. These controversial findings of well-described mesenchymal and epithelial markers as well as new mediators of EMT in three tumor entities with different progressive behavior underlines that the exact molecular mechanisms underlying the cross-linking between various EMT pathways in different HNCs remains to be fully elucidated.…”

The Role of CD44 AND SOX-2 Cancer Stem cell Markers in The Development and Progression of Mucoepidermoid Carcinoma and Primary Squamous Cell Carcinoma of Salivary Glands

“…In the study of Dai et al 56 SOX2 expression was associated with ACC development. They found a significant correlation between advanced T stage, distant metastasis and SOX2 expression advocating a clinical relevance of SOX2 expression to the progression of ACC.…”

Salivary gland stem cells: A review of development, regeneration and cancer

“…In spite of this, high expression of many of these markers is linked to metastasis and poor patient survival. An example of this is SOX2, which is often aberrantly expressed in HNCs (Dong et al , 2014; Ge et al , 2010; Lee et al , 2014; Li et al , 2014; Schrock et al , 2014) with high SOX2 expression being linked to distant metastasis in adenoid cystic carcinoma (ACC) of the salivary gland (Dai et al , 2014) and high tumour grade in salivary cancer (Sedassari et al , 2017) as well as head and neck cancers in general (Dong et al , 2014). Elevated SOX2 expression is also associated with increased resistance to chemotherapy agents, although whether this is a direct effect is uncertain (Schrock et al , 2014).…”