Abstract

Lymphovascular invasion (LVI) is an important prognostic indicator of lymph node metastasis and disease aggressiveness but clear molecular mechanisms mediating this in head and neck cancers (HNSC) remain undefined. To identify important microRNAs (miRNAs) in HNSC that associate with and are also predictive of increased risk of LVI, we used a combination of clustering algorithms, multiple regression analyses and machine learning approaches and analyzed miRNA expression profiles in the TCGA HNSC database. As the first step, we identified miRNAs with increased association with LVI as a binary variable. In order to determine whether the identified miRNAs would show functional clusters that are also indicative of increased risk for LVI, we carried out unsupervised as well as supervised clustering. Our results identified distinct clusters of miRNAs that are predictive of increased LVI. We further refined these findings using a Random forest approach, and miR-203a-3p, mir-10a-5p, and miR-194-5p to be most strongly associated with LVI. Pathway enrichment analysis showed these miRNAs targeted genes involved in Hippo signaling and fatty acid oxidation pathways that are mediators of lymph node metastasis. Specific association was also identified between the miRNAs associated with LVI and expression of several lymphangiogenic genes that could be critical for determination of therapeutic strategies.

Highlights

  • Recurrent or metastatic head and neck cancer (HNSC) that includes tumors of oral cavity, paranasal sinuses, nasal cavity, pharynx, and larynx is associated with poor patient outcome, tumor aggressiveness and is characterized by early metastasis to the regional lymph nodes [1]

  • Increased lymphangiogenesis is closely related with enhanced Lymphovascular invasion (LVI) and subsequent distant dissemination [10]

  • MiRNA expression signatures related to prognosis have been found in a number of malignancies [30]

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Summary

Introduction

Recurrent or metastatic head and neck cancer (HNSC) that includes tumors of oral cavity, paranasal sinuses, nasal cavity, pharynx, and larynx is associated with poor patient outcome, tumor aggressiveness and is characterized by early metastasis to the regional lymph nodes [1]. It is the 6th most common cancer worldwide and has a 5-year survival rate of less than 50% which is one of the lowest among major cancers [2]. LVI is a histopathological feature that established as an independent predictor of poor prognosis and lymph node metastasis (LNM) in several solid tumors. Different molecular signatures are associated with HNSCC, most studies have typically overlooked the association of any molecular, genetic or clinical features with LVI and the factors contributing to LVI remain very poorly understood [11,12,13]

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