Prognostic markers in stage I oral cavity squamous cell carcinoma

Laryngoscope. 2013 Oct;123(10):2435-41. doi: 10.1002/lary.23888. Epub 2013 Aug 5.

Abstract

Objectives/hypothesis: Early-stage oral squamous cell carcinoma (OSCC) treatment is based on anatomic location, clinical TNM staging, and histological grade. It is a heterogeneous disease group. Classification of patients with OSCC by immunohistochemical analysis of established oncoproteins and evaluate disease course was our primary objective. Characterization of stage I OSCC patients in Southwest Finland was our secondary objective.

Study design: Immunohistochemical analysis of tumor specimens and retrospective analysis of patient data of the patient treated in Turku University Hospital for T1N0M0 OSCC during the years 2000-2004.

Methods: Paraffin-embedded tumor specimens from 35 OSCC patients were collected and analyzed for HIF-1α, CD44, p16, Ki67, and podoplanin by immunohistochemistry and correlated with clinical findings.

Results: Tumoral CD44 and HIF1-α expression levels, in combination, predicted 5-year disease-free survival. Reduced expression of CD44 and elevated expression of HIF1-α is associated with the lowest probability of disease-free survival compared to the population as a whole (P < .001 in Kaplan-Meier analysis). Patients with grade I tumors demonstrated improved disease-specific survival compared to those with grade II tumors (P = .027). No association was seen between p16 expression, Ki67 labeling index, or podoplanin expression and prognosis in our 35 specimens.

Conclusions: HIF-1α and CD44 immunohistochemical detection could potentially serve as a prognostic tool in therapy selection for early-stage OSCC.

Level of evidence: 2b.

Keywords: CD44; HIF-1α; biomarker; head and neck cancer; head and neck squamous cell carcinoma; immunohistochemistry; p16; podoplanin; prognosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / metabolism
  • Carcinoma, Squamous Cell / mortality*
  • Carcinoma, Squamous Cell / virology
  • Disease-Free Survival
  • Female
  • Head and Neck Neoplasms / metabolism
  • Head and Neck Neoplasms / mortality*
  • Head and Neck Neoplasms / virology
  • Humans
  • Hyaluronan Receptors / metabolism
  • Hypoxia-Inducible Factor 1, alpha Subunit / metabolism
  • Immunohistochemistry
  • Male
  • Membrane Glycoproteins / metabolism
  • Middle Aged
  • Mouth Floor
  • Prognosis
  • Squamous Cell Carcinoma of Head and Neck
  • Tongue Neoplasms / metabolism

Substances

  • Hyaluronan Receptors
  • Hypoxia-Inducible Factor 1, alpha Subunit
  • Membrane Glycoproteins
  • PDPN protein, human