Abstract

Head and neck squamous cell carcinoma (HNSCC) often metastasize to lymph nodes resulting in poor prognosis for patients. Unfortunately, the underlying molecular mechanisms contributing to tumour aggressiveness, recurrences, and metastasis are still not fully understood. However, such knowledge is key to identify biomarkers and drug targets to improve prognosis and treatments. Consequently, we performed genome-wide expression profiling of 15 primary HNSSCs compared to corresponding lymph node metastases and non-malignant tissue of the same patient. Differentially expressed genes were bioinformatically exploited applying stringent filter criteria, allowing the discrimination between normal mucosa, primary tumours, and metastases. Signalling networks involved in invasion contain remodelling of the extracellular matrix, hypoxia-induced transcriptional modulation, and the recruitment of cancer associated fibroblasts, ultimately converging into a broad activation of PI3K/AKT-signalling pathway in lymph node metastasis. Notably, when we compared the diagnostic and prognostic value of sequencing data with our expression analysis significant differences were uncovered concerning the expression of the receptor tyrosine kinases EGFR and ERBB2, as well as other oncogenic regulators. Particularly, upregulated receptor tyrosine kinase combinations for individual patients varied, implying potential compensatory and resistance mechanisms against specific targeted therapies. Collectively, we here provide unique transcriptional profiles for disease predictions and comprehensively analyse involved signalling pathways in advanced HNSCC.

Highlights

  • With over 500,000 new cases per year worldwide, head and neck squamous cell carcinoma (HNSCC) develops from multiple anatomic subsites, including oral cavity, hypopharynx, oropharynx, larynx and nasopharynx[1,2]

  • In contrast to other studies concentrating only on the analysis of primary tumours, we focused on identifying the changes that lead to the dissemination of the primary tumour to lymph node metastasis

  • Gene expression microarray technology was applied to a group of 15 Head and neck squamous cell carcinoma (HNSCC) tumours, their corresponding normal tissue mucosa and lymph node metastases resected by surgery

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Summary

Introduction

With over 500,000 new cases per year worldwide, head and neck squamous cell carcinoma (HNSCC) develops from multiple anatomic subsites, including oral cavity, hypopharynx, oropharynx, larynx and nasopharynx[1,2]. Previous studies allowed the categorization of HNSCC tumours into distinct subtypes[14], discovered a gene expression signature associated with recurrent disease[15], or suggested genes with diagnostic or prognostic potential[16,17,18,19,20,21,22,23]. We analysed differentially expressed genes of HNSCC primary tumours compared to lymph node metastases in order to explore new biomarker candidates and involved signalling pathways. Gene expression microarray technology was applied to a group of 15 HNSCC tumours, their corresponding normal tissue mucosa and lymph node metastases resected by surgery. We focused on obtaining a global view of differential gene expression in HNSCC compared to normal tissue mucosa, the primary tumour and corresponding lymph node metastases. The identification of characteristic gene expression signatures may potentially be exploited for diagnostic, prognostic or therapeutic purposes and promotes the reliability of the corresponding method

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