The biologic behavior and factors influencing the development of salivary gland mucoepidermoid carcinoma are not fully understood. Alteration of the cyclin-dependant kinase inhibitor p21WAF could cause uncontrolled proliferation leading to cancer. Thirty-five mucoepidermoid carcinomas were graded and immunohistochemically stained for p21WAF. The percentage of positive tumor cells was determined using an eyepiece graticule and a computer-assisted image analyzer, which revealed 8.6% and 22.9% of the cases to be positive for p21WAF, respectively. A statistically significant correlation was not observed between p21WAF and grading. Considering the absence of p21WAF expression in most mucoepidermoid carcinomas, it appears that the inhibitory effect of p21WAF on cell growth is removed in most cases. Given the lack of correlation with tumor grade, it is possible that the impact of p21WAF is in the earlier stages of tumorigenesis. A p53-independent pathway of p21WAF induction may exist for the small proportion of tumors that showed positivity.
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