Abstract
BACKGROUND: Acid mucopolysaccharides (AMPs) are essential components of extracellular matrices and play a significant role in salivary gland tumors. Their differential expression can provide diagnostic insights into tumor behavior. Alician Blue (AB) staining has emerged as a reliable histochemical technique for detecting AMPs, offering enhanced visualization. This study aims to evaluate the utility of AB staining in identifying AMPs across benign and malignant salivary gland tumors, providing a novel diagnostic perspective. MATERIALS AND METHODS: A total of 60 salivary gland tumor samples were analyzed, including 30 benign (e.g., pleomorphic adenoma) and 30 malignant (e.g., mucoepidermoid carcinoma, adenoid cystic carcinoma) cases. Formalin-fixed, paraffin-embedded sections were stained using AB at pH 2.5 to specifically detect AMPs. The intensity of staining was graded on a 0-3 scale: 0 (no staining), 1 (mild), 2 (moderate), and 3 (intense). The distribution of AMPs was compared between benign and malignant groups using a Chi-square test, with a P value < 0.05 considered statistically significant. RESULTS: Benign salivary gland tumors predominantly showed mild to moderate staining (Grade 1-2), with 80% (24/30) of the cases demonstrating moderate AMP accumulation. In contrast, malignant tumors exhibited intense staining (Grade 3) in 73% (22/30) of cases. The staining intensity in malignant tumors was significantly higher (P < 0.01) than in benign counterparts. Additionally, adenoid cystic carcinoma demonstrated diffuse and intense AMP staining, while mucoepidermoid carcinoma exhibited focal, high-intensity AMP deposits. CONCLUSION: AB staining at pH 2.5 is a valuable tool for assessing AMPs in salivary gland tumors, offering diagnostic distinction between benign and malignant lesions. The higher AMP expression in malignant tumors suggests its potential role in tumor aggressiveness and progression. Incorporating AB staining in routine histological evaluation could enhance diagnostic accuracy, particularly in differentiating complex tumor subtypes.