Abstract
BackgroundThe main cause of treatment failure and death in laryngeal squamous cell carcinoma is metastasis to the regional lymph nodes. The current clinical staging criteria fail to differentiate patients with occult metastasis from patients without metastasis. Identifying molecular markers of the disease might improve our understanding of the molecular mechanisms underlying the pathogenesis and development of laryngeal carcinoma and may help improve clinical staging and treatment.MethodsSixty-four previously untreated patients who underwent surgical excision of laryngeal squamous cell carcinoma with neck dissection were included in this study. The expression of B cell-specific Moloney murine leukemia virus integration site 1 (BMI-1) was examined immunohistochemically on formalin-fixed paraffin-embedded primary tissue specimens.ResultsNuclear expression of BMI-1 (nBMI-1) was detected in 32 of the 64 tumors (50%), cytoplasmic expression of BMI-1 (cBMI-1) was detected in 22 (34.4%), and 10 tumors (15.6%) showed no BMI-1 immunoreactivity. High nBMI-1 expression levels (≥10) were detected in 28 of the 32 (87.5%) nBMI-1-positive patients. Multivariate analysis including age at diagnosis, grade, tumor location, TNM status, and nBMI-1 expression showed that a high nBMI-1 expression level was an independent prognostic factor for lymph node metastasis.ConclusionThe expression of BMI-1 in patients with laryngeal carcinoma seems to correlate with lymph node metastasis.
Highlights
The main cause of treatment failure and death in laryngeal squamous cell carcinoma is metastasis to the regional lymph nodes
High expression of Nuclear expression of BMI-1 (nBMI-1) was detected in 39.1% of the glottic tumors and in 46.2% of the supraglottic tumors, this difference was not significant (P = 0.61)
Clinical determination of lymph node metastasis made by palpation, computed tomography (CT), and magnetic resonance imaging (MRI) has a sensitivity of 38% to 78% for occult metastatic lymph nodes [14,15] and a 7% to 37% probability of metastatic lymph nodes in patients classified with N0 disease [16]
Summary
The main cause of treatment failure and death in laryngeal squamous cell carcinoma is metastasis to the regional lymph nodes. Identifying molecular markers of the disease might improve our understanding of the molecular mechanisms underlying the pathogenesis and development of laryngeal carcinoma and may help improve clinical staging and treatment. BMI-1 is highly expressed in breast cancer [4], colorectal cancer [5], prostate cancer [6], metastatic melanoma [7] and non-small cell lung cancer [8]. At this time very few studies have been made on BMI-1 expression in head and neck tumors. Because of discordant results with regard to nasopharyngeal carcinoma [9], oral squamous cell carcinoma [10] and laryngeal carcinoma [11] no definitive conclusions can be made
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