SOX-2 and EZH-2 Expression in Primary Epithelial Malignant Salivary Gland Tumors - research article

Q: What was the study’s main objective regarding SOX-2 and EZH-2?

To assess the association between SOX-2 and EZH-2 expression and survival and pathological characteristics in patients with primary epithelial malignant salivary gland tumors, and to evaluate their value as diagnostic and prognostic markers.

Q: How many patients were included, and over what time frame?

The study group comprised 104 patients diagnosed with primary epithelial malignant salivary gland tumors at “Sf. Spiridon” County Hospital, Iasi, over fifteen years.

Q: Which clinical or pathological factors were associated with high SOX-2 and high EZH-2 expression?

High SOX-2 was associated with lymphatic invasion, pT stage, histological tumor type, and tumor grading. High EZH-2 was associated with perineural invasion, vascular invasion, lymphatic invasion, tumor grading, and pathological extranodal extension.

Sep 23, 2026

Uploaded by Jordan Avery

Malignant salivary gland tumors are a diverse group of neoplasms whose heterogeneity likely reflects variable tissue origins. Evidence indicates that SOX-2 and EZH-2 contribute to salivary gland carcinogenesis by influencing tumor-cell stemness, promoting accelerated progression, and worsening clinical outcomes. This study evaluates the association between SOX-2/EZH-2 expression, survival, and pathological characteristics in 104 patients with primary epithelial malignant salivary gland tumors, and tests their diagnostic and prognostic potential.

LanguageEnglish

CategoryHealthcare

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Pages24

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Abstract

Keywords

1. Introduction

Article SOX-2 and EZH-2 Expression in Primary Epithelial Malignant Salivary Gland Tumors Constantin Aleodor Costin 1, Adriana Grigoras, 1,2, * and Cornelia Amalinei 1,2 Academic Editor: KonstantinosDimas Received: 11 March 2026 Revised: 2 April 2026 Accepted: 7 April 2026 Published: 9 April 2026 Copyright: © 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. 1 Department of Morphofunctional Sciences I, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Ias, i, Romania; aleodor.costin@umfiasi.ro (C.A.C.); cornelia.amalinei@umfiasi.ro (C.A.) 2 Institute of Legal Medicine Iasi, 700455 Ias, i, Romania * [Correspondence: a_grigoras6600@yahoo.com or adriana.grigoras@umfiasi.ro](Correspondence: a_grigoras6600@yahoo.com or adriana.grigoras@umfiasi.ro) Abstract Background: Malignant salivary gland tumors represent a highly diverse group of neoplasms, their heterogeneity likely arising due to variable origin in different tissue components. Emerging evidence suggests that SOX-2 and EZH-2 play critical roles in salivary gland carcinogenesis, being related to tumor cell stemness potential, along with accelerated tumor progression and unfavorable clinical outcomes. The aim of this study was to assess the association between SOX-2 and EZH-2 expression, survival parameters, and tumors’pathological characteristics in a group of patients with primary epithelial malignant salivary gland tumors (MSGTs) and to evaluate their value as diagnostic and prognostic markers. Methods: Our study group comprised 104 patients with primary epithelial MSGTs diagnosed in “Sf. Spiridon” County Hospital, Iasi, over a period of fifteen years. Pathological parameters and survival evaluation, along with SOX-2 and EZH-2 immunohistochemistry assessment and scoring, were conducted, and the associations between different parameters were analyzed. Results: High SOX-2 immunoexpression was significantly associated with lymphatic invasion (LY) (p = 0.003), pT stage (p = 0.010), histological tumor type (p = 0.003), and tumor grading (p = 0.037), while high EZH-2 immunoexpression was significantly associated with perineural invasion (PnI) (p < 0.001), vascular invasion (p = 0.038), LY (p = 0.001), tumor grading (p = 0.002), and pathological extranodal extension (pENE)(p = 0.018) . The tumors with high SOX-2 and EZH-2 expressions were associated with a reduced overall survival (OS) (p = 0.013 and p = 0.011) . Cox regression analysis revealed that pT (HR = 1.826, p = 0.019), LY (HR = 0.318, p = 0.007), and tumor grade (HR = 0.505, p = 0.021) added to high SOX-2 and EZH-2 immunoexpression independently predicted a poor survival outcome (HR = 2.373, p = 0.016 and HR = 2.746, p = 0.015) . Conclusions: Our findings suggest that SOX-2 and EZH-2 may serve as biomarkers of aggressive behavior and a poor prognosis in primary epithelial MSGTs, providing potential opportunities for precision-targeted therapies. Keywords: SOX-2; EZH-2; primary epithelial malignant salivary glands tumors; therapy; prognosis; survival 1. Introduction Malignant salivary gland tumors (MSGTs) account for only 5–8.5% of all head and neck tumors, being considered rare neoplasms in the general population [1] . Their global incidence ranges between 0.57 and 0.69 cases per 100,000 people per year, with an estimated 53,583 new cases registered in 2020 [2,3] . The reported incidence of MSGTs is around 1.1 cases per 100,000 individuals in the United States [4] . Similarly, the crude incidence rate of these tumors is 1.3 per 100,000 people per year, and the age-adjusted rate is 0.67 per 100,000 people per year, with 9917 new registered cases in Europe in 2020 [2] . MSGTs exhibit a male predominance and primarily involve the major salivary glands, mainly the parotid gland [3] . In support of this consideration, 32.6% of malignant lesio

FAQs

What was the study’s main objective regarding SOX-2 and EZH-2?

To assess the association between SOX-2 and EZH-2 expression and survival and pathological characteristics in patients with primary epithelial malignant salivary gland tumors, and to evaluate their value as diagnostic and prognostic markers.

How many patients were included, and over what time frame?

The study group comprised 104 patients diagnosed with primary epithelial malignant salivary gland tumors at “Sf. Spiridon” County Hospital, Iasi, over fifteen years.

Which clinical or pathological factors were associated with high SOX-2 and high EZH-2 expression?

High SOX-2 was associated with lymphatic invasion, pT stage, histological tumor type, and tumor grading. High EZH-2 was associated with perineural invasion, vascular invasion, lymphatic invasion, tumor grading, and pathological extranodal extension.

Sep 23, 2026

Uploaded by Jordan Avery