Tissue factor expression in salivary gland carcinoma: a potential novel therapeutic target for advanced disease

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Background: Salivary gland carcinomas (SGC) are rare head and neck malignancies with diverse molecular profiles and treatment challenges. Tissue factor (TF), a transmembrane glycoprotein involved in cancer pathophysiology, has emerged as a potential therapeutic target. Objectives: The objective of this study was to investigate TF expression in SGC and its correlation with clinicopathological data. Design: A cohort of 109 SGC patients who underwent curative surgery between 1990 and 2023 was analyzed. Methods: TF expression in primaries and lymph node (LN) metastases was assessed using immunohistochemistry on tissue microarrays. Histo-scores were calculated for cytoplasmic and membranous staining and correlated with clinicopathological data. Results: TF was expressed in 80.7% of samples with a mean combined H -score of 29.6. Moderate and high expression was found in 22.9% of all cases. Mucoepidermoid carcinoma (MEC), secretory carcinoma, and salivary duct carcinoma (SDC) showed the highest expression. A significantly higher membranous TF expression was observed in SDC LN metastases compared to primaries (71.1 vs 31.7, p = 0.012). Survival analysis revealed a trend toward worse outcomes for tumors with higher TF expression. Conclusion: This study provides the first analysis of TF expression in SGC revealing its presence across various subtypes. The findings suggest potential for TF-targeted therapies in SGC treatment, particularly for metastatic SDC and MEC. The trend toward worse survival outcomes in high TF-expressing tumors warrants further investigation.

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