Novel Discovery of the Somatostatin Receptor (SSTR2) in Pleomorphic Adenomas via Immunohistochemical Analysis of Tumors of the Salivary Glands

Simple Summary Currently, the diagnosis of salivary gland tumors using current imaging techniques is unreliable. In this study we examined salivary gland tumors and discovered that the pleomorphic adenoma, a tumor which should be surgically removed because it has a tendency to become malign, has a strong concentration of the somatostatin receptor 2. This characteristic may allow physicians to identify and potentially treat the tumor in a non-invasive manner. Reliable preoperative diagnosis between salivary gland tumor entities is difficult. In this monocentric retrospective study, we examined the somatostatin receptor 2 (SSTR2) status of salivary gland tumors after salivary gland tumor resection via immunohistochemistry (IHC), and stains were compared in analogy to the HER2 mamma scale. A total of 42.3% of all pleomorphic adenoma (PA) tumors (42 of 99, 95% confidence interval 32.5-52.8%) demonstrated & GE;20% of cells displaying the SSTR2 as compared to just 1% of all other tumors (1/160, 95% CI 0.02-3.4%). The other tumor was a neuroendocrine carcinoma. PA had a higher intensity of SSTR2 staining, with 90.9% staining & GE; an intensity of 2 (moderate). Tumors with an intensity of SSTR2 expression equal to or greater than 2 had an 89.9% likelihood of being a PA (95% CI: 82.2-95.0%, AUC: 0.928). Only one Warthin tumor demonstrated a 'strong' SSTR2 staining intensity. No Warthin tumor showed a percentage of cells staining for SSTR2 above & GE;20%. This result demonstrates consistent and strong expression of SSTR2 in PAs as compared to Warthin tumors, which may allow physicians to utilize radioligand-somatostatin analog PET CT/MR imaging to diagnose the PA. SSTR2 positivity, if shown to be clinically relevant, may allow peptide receptor radionuclide therapy in the future.

Automated summary

In this study, it was found that pleomorphic adenoma in salivary glands has a high concentration of the somatostatin receptor 2 (SSTR2), which may allow for non-invasive diagnosis and treatment of this tumor. Reliable preoperative diagnosis of salivary gland tumors is difficult. Immunohistochemistry testing showed that 42.3% of pleomorphic adenoma tumors demonstrated positive expression of SSTR2.