Prognostic significance of GLUT-1 in adenoid cystic carcinoma

Adenoid cystic carcinoma (ACC) is a common malignant tumor of the salivary glands. However, it lacks established prognostic markers. This study investigates the prognostic relevance of glucose transporter-1 (GLUT-1) in ACC.

Seventy patients diagnosed with ACC were included in the study. Immunohistochemical analysis was performed to evaluate GLUT-1 expression levels by intensity, distribution, and scoring. These scores were correlated with clinicopathological parameters, overall survival (OS), and disease-free survival (DFS). The prognostic performance of GLUT-1 was assessed using ROC curve analysis and independent prognostic factors were identified through univariate and multivariate Cox regression models.

The GLUT-1 expression rate was 98.5%. Higher GLUT-1 scores were linked to solid histological subtype (p < 0.001), advanced T-stage (p < 0.001), perineural invasion (p < 0.001), lymph node metastasis (p = 0.009), and distant metastasis (p < 0.001). A GLUT-1 score > 5 accurately predicted mortality (AUC 0.921, 81.5% sensitivity, 95.3% specificity; p < 0.001), according to ROC analysis. Univariate analysis identified several risk factors for OS. In the multivariable Cox regression model, only a GLUT-1 score > 5 remained independently associated with a 14.7-fold increase in mortality risk (HR: 14.795; p = 0.003).

Our findings demonstrate that GLUT-1 expression is an independent prognostic marker for overall survival in ACC. Unlike traditional staging systems, the GLUT-1 score provides superior accuracy in risk stratification. Incorporating GLUT-1 scoring into routine pathological evaluation may facilitate the identification of high-risk patients and guide more personalized therapeutic strategies.