Role of Inflammation in Benign Salivary Gland Tumor Etiopathogenesis: An Evaluation through the Blood Inflammatory Biomarkers
Objectives: To investigate the immune inflammatory profile in patients affected by benign salivary gland tumors (SGTs) by evaluating the blood inflammatory biomarkers.
Methods: A retrospective chart review was performed between January 2015 and April 2020, collecting the data of all patients admitted for benign SGTs in our maxillofacial surgery unit. A total of 191 patients were divided into two groups: 94 with Warthin’s tumor (WT group) and 97 with pleomorphic adenoma (PA group) at histological diagnosis. The third group consisted of 90 patients randomly selected as the control group (C group).
Results: The most relevant correlations were found by analyzing the values of some inflammatory biomarkers among the three groups. The neutrophil-to-lymphocyte ratio was found significantly higher in patients in the PA (p<0.005) and WT (p<0.001) groups than in patients in the C group. Similarly, the systemic immune-inflammation index was found significantly higher in patients in the PA and WT (p<0.005) groups than in patients in the C group. The platelet-tolymphocyte ratio was significantly higher in patients in the PA group than in patients in the WT (p<0.05) and C groups (p<0.05).
Conclusion: In both WT and PA groups, the inflammatory status of the patients was found altered. Thus, inflammation and the immune system seem to have a role in the genesis of these benign salivary neoplasms whose etiopathogenesis is still debated.
1. Brenner DR, Scherer D, Muir K, Schildkraut J, Boffetta P, Spitz MR, et al. A review of the application of inflammatory biomarkers in epidemiologic cancer research. Cancer Epidemiol Biomarkers Prev 2014;23:1729–51. [CrossRef]
2. Lima SS, Soares AF, Amorim RF, Freitas RDA. Perfil epidemiológico das neoplasias de glândulas salivares: análise de 245 casos. Rev Bras Otorrinolaringol 2005;71:335–40. [CrossRef]
3. Orabona GDA, Abbate V, Piombino P, Romano A, Schonauer F, Iaconetta G, et al. Warthin's tumour: Aetiopathogenesis dilemma, ten years of our experience. Journal of Cranio-Maxillofacial Surgery 2015;43:427–31. [CrossRef]
4. Cope W, Naugler C, Taylor SM, Trites J, Hart RD, Bullock MJ. The association of warthin tumor with salivary ductal inclusions in intra and periparotid lymph nodes. Head Neck Pathol 2014;8:73–6. [CrossRef]
5. Clark K. Etiology and familial inheritance of pleomorphic adenomas. Dentistry 3000 2017;5:54–8. [CrossRef]
6. Choi JS, Cho BH, Kim HJ, Kim YM, Jang JH. Identification of new genes of pleomorphic adenoma. Medicine (Baltimore) 2019;98:e18468.
7. El-Naggar AK, Chan JKC, Grandis JR, Slootweg PJ. Tumours of salivary glands. WHO Classification of head and neck tumours. 4th ed. Lyon, France: IARC Press; 2017. p. 159.
8. Hu B, Yang XR, Xu Y, Sun YF, Sun C, Guo W, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res 2014;20:6212–22. [CrossRef]
9. Geng Y, Shao Y, Zhu D, Zheng X, Zhou Q, Zhou W, et al. Systemic immune-inflammation index predicts prognosis of pa-tients with esophageal squamous cell carcinoma: a propensity score-matched analysis. Sci Rep 2016;6:39482.
10. Hong X, Cui B, Wang M, Yang Z, Wang L, Xu Q. Systemic Immune-inflammation Index, based on platelet counts and neutrophil-lymphocyte ratio, is useful for predicting prognosis in small cell lung cancer. Tohoku J Exp Med 2015;236:297–304.
11. Damar M, Dinç AE, Erdem D, Aydil U, Kizil Y, Eravcı FC, et al. Pretreatment neutrophil-lymphocyte ratio in salivary gland tumors is associated with malignancy. Otolaryngol Head Neck Surg 2016;155:988–96. [CrossRef]
12. Kuzucu İ, Güler İ, Kum RO, Baklacı D, Özcan M. Increased neutrophil lymphocyte ratio and platelet lymphocyte ratio in malignant parotid tumors. Braz J Otorhinolaryngol 2020;86:105– 10. [CrossRef]
13. Kuzenko YV, Romanuk AM, Dyachenko OO, Hudymenko O. Pathogenesis of Warthin's tumors. Interv Med Appl Sci 2016;8:41–8. [CrossRef]
14. Allegra SR. Warthin's tumor: a hypersensitivity disease? Ultrastructural, light, and immunofluorescent study. Hum Pathol 1971;2:403–20. [CrossRef]
15. Foulsham CK 2nd, Johnson GS, Snyder GG 3rd, Carpenter RJ 3rd, Shafi NQ. Immunohistopathology of papillary cystadenoma lymphomatosum (Warthin's tumor). Ann Clin Lab Sci 1984;14:47–63.
16. Aga M, Kondo S, Yamada K, Wakisaka N, Yagi-Nakanishi S, Tsuji A, et al. Immunoglobulin class switching to IgG4 in Warthin tumor and analysis of serum IgG4 levels and IgG4-positive plasma cells in the tumor. Hum Pathol 2014;45:793–801.
17. Savera AT, Zarbo RJ. Defining the role of myoepithelium in salivary gland neoplasia. Adv Anat Pathol 2004;11:69–85.