Abstract
Larynx cancer organ preservation treatments with chemo and radiotherapy have substantially improved laryngoesophageal dysfunction-free survival. However, both of them lead to a high incidence of acute and chronic toxicities and a significant number of patients relapse. To date, there is no evidence available to establish the group of patients that may benefit from preservation approaches and clinical criteria such as primary tumor extension or pretreatment tracheotomy are not validated. MAP17 is a small non-glycosylated membrane protein overexpressed in carcinomas. The tumoral behavior induced by MAP17 is associated with reactive oxygen species production in which SGLT1 seems involved. In this study we found that the levels of MAP17 were related to clinical findings and survival in a cohort of 58 patients with larynx cancer. MAP17 expression is associated with overall survival (p<0.001) and laryngoesophageal dysfunction-free survival (p=0.002). Locoregional control in patients with high MAP17 showed better outcomes than those with low MAP17 (p=0.016). Besides, a positive correlation was observed between MAP17 expression and SGLT (p=0.022) and the combination of high levels of MAP17/SGLT also led to an increased overall survival (p=0,028). These findings suggest that MAP17, alone or in combination with SGLT1, may become a novel predictive biomarker for laryngeal carcinoma.
Highlights
Squamous cell carcinoma of the head and neck represents 4% of all cancers diagnosed worldwide, with >500.000 new cases recorded in 2008
MAP17 expression is associated with an SGLT-dependent reactive oxygen species (ROS) increase that acts as a second messenger enhancing tumorigenesis
The hypothesis is that tumors expressing high levels of ROS producing MAP17 and SGLT1 proteins can benefit from therapies such as cisplatin or radiotherapy that increase oxidative stress and could sensitize them to cell death
Summary
Squamous cell carcinoma of the head and neck represents 4% of all cancers diagnosed worldwide, with >500.000 new cases recorded in 2008. 151.000 cases (130.000 men and 21.000 women) were laryngeal cancer with an estimated age-standardized world mortality rate of 2.3/100.000 habitants. The role of Human Papilomavirus (HPV) is well established for squamous cell carcinoma of the oropharynx but it remains unclear for laryngeal cancer [5]. These patients are at risk of developing second primary tumors due to chronic aerodigestive tract carcinogen exposure: 14% in 5 years, 26% in 10 years and 37% in 15 years [6]
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