Prognostic markers in stage I oral cavity squamous cell carcinoma.

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.