Abstract
ObjectivesTo establish a prognostic signature for locally advanced tongue squamous cell carcinoma (TSCC) patients treated with surgery.ResultsIn the discovery study, unsupervised hierarchical clustering analysis identified two clusters which differentiated the Kaplan-Meier curves of RFS [median RFS, 111 days vs. not reached; log-rank test, P = 0.023]. The 30 genes identified were combined into a dichotomous PI. In the validation cohort, classification according to the PI was associated with RFS [median RFS, 754 days vs. not reached; log-rank test, P = 0.026 in GSE31056] and DSS [median DSS, 540 days vs. not reached; log-rank test, P = 0.046 in GSE42743 and 443 days vs. not reached; P < 0.001 in GSE41613]. Among genes, positive immunohistochemical staining of cytokeratin 4 was associated with favorable prognostic values for RFS (hazard ratio (HR), 0.591, P = 0.045) and DSS (HR, 0.333, P = 0.004).Materials and methodsWe conducted gene expression profiling of 26 clinicopathologically homogeneous advanced TSCC tissue samples using cDNA microarray as a discovery study. Candidate genes were screened using clustering analysis and univariate Cox regression analysis for relapse-free survival (RFS). These were combined into a prognostic index (PI), which was validated using three public microarray datasets of tongue and oral cancer (123 patients). Some genes identified in discovery were immunohistochemically examined for protein expression in another 127 TSCC patients.ConclusionWe identified robust molecular markers that showed significant associations with prognosis in TSCC patients. Gene expression profiling data were successfully converted to protein expression profiling data.
Highlights
Cancer of the oral cavity is the most common malignancy of the head and neck, accounting for about 263,900 new cases and 128,000 deaths each year worldwide [1]
Gene expression profiling data were successfully converted to protein expression profiling data
Unsupervised hierarchical clustering of microarray data sets derived from 26 tongue squamous cell carcinoma (TSCC) patients in the discovery study
Summary
Cancer of the oral cavity is the most common malignancy of the head and neck, accounting for about 263,900 new cases and 128,000 deaths each year worldwide [1]. The most common malignancy arising from the oral cavity is squamous cell carcinoma of the tongue (TSCC). Almost half of patients are initially diagnosed at an advanced clinical stage, such as c-Stage III and IV [2], and 40%-60% of all cases recur after local treatment within two years [3, 4]. Accurate prediction of recurrence based on clinicopathological factors only such as delayed lymph node metastasis is difficult, which is in turn reflected in the difficulty of establishing customized therapy for patients which considers the risk of recurrence
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