Aims: We investigated the extent of apoptosis in 55 benign and malignant salivary gland tumours and its association with the immunohistochemical expression of bcl-2 and bax.
Methods and results: Apoptosis was detected in histological sections by the 3'-end DNA labelling method. bcl-2 and bax protein expression was determined by immunohistochemistry. The frequency of apoptosis was clearly higher in malignant than in benign tumours. In pleomorphic adenomas and Warthin's tumours the average apoptotic index was 0.01% (range 0.00-0.07%) while in the malignant salivary gland tumours it was 0.42% (range 0.00-1.75%). Immunohistochemical bcl-2 expression was observed in all pleomorphic adenomas and Warthin's tumours and in most cases the expression was strong. In malignant tumours, 9/25 cases showed no expression and in the rest of the cases, apart from adenoid cystic carcinomas, the bcl-2 expression was often weak. There were significantly more cases with no or weak bcl-2 positivity in malignant than in benign salivary gland tumours (P = 0.001). There was a statistically significant association between a weak bcl-2 expression and a high frequency of apoptosis (P = 0.02). In contrast to bcl-2, strong bax expression was found in both benign and malignant tumours and was not associated with the frequency of apoptosis.
Conclusions: The low bcl-2 expression in malignant tumours suggests that down-regulation of its expression might contribute to their higher frequency of apoptosis.