Positive expression of NANOG, mutant p53, and CD44 is directly associated with clinicopathological features and poor prognosis of oral squamous cell carcinoma.

Hye-Jin Lee,Bong-Wook Park,Uk-Kyu Kim,Young-Hoon Kang,June-Ho Byun,Jong-Sil Lee,Si-Jung Jang,Gyu-Jin Rho

doi:10.1186/s12903-015-0120-9

Hye-Jin Lee, Bong-Wook Park + Show 6 more

Open Access

https://doi.org/10.1186/s12903-015-0120-9

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Abstract

BackgroundIn order to predict long-term prognosis and define individual treatment modalities for patients with oral squamous cell carcinoma (OSCC), more reliable tumor biomarkers are needed during the pretreatment workup period. The present study aimed to identify more reliable immunohistochemical tumor prognostic markers in the pretreatment biopsy specimens of patients with OSCC.MethodsWe selected 57 patients who were diagnosed with primary OSCC through histopathological analysis. Pretreatment biopsy specimens were immunohistochemically analyzed for the transcription factor NANOG, cancer stem cell marker CD44, and mutant tumor protein 53 (mutant p53). The immunostaining patterns were assessed for their association with the clinicopathological features of OSCC and overall survival rates.ResultsLate tumor stage, positive neck node metastasis, and high-grade differentiation were associated with significantly poorer survival rates. Enhanced expression of NANOG and mutant p53 positivity were significantly associated with clinically late-stage tumors, positive neck node metastasis, histologically high-grade tumors, and poor overall survival rates. OSCCs with strong co-detection of NANOG and mutant p53 were linked to significantly lower survival rates than those with both weak NANOG expression and p53 negativity. Increased expression of CD44 had a limited correlation with unfavorable clinicopathological features.ConclusionHigh expression of NANOG and positive expression of mutant p53 in the pretreatment biopsy specimens of patients with OSCC were associated with poor survival rates and unfavorable clinicopathological features. These results demonstrate that NANOG, mutant p53, and CD44 could be used as immunohistochemical markers in the pretreatment specimens of OSCC. In particular, analysis for co-expression of NANOG and mutant p53 should be made highly available as a tool for prognosis and selecting individual treatment modalities.

Highlights

In order to predict long-term prognosis and define individual treatment modalities for patients with oral squamous cell carcinoma (OSCC), more reliable tumor biomarkers are needed during the pretreatment workup period
The early transcription factor NANOG, the cancer stem cell (CSC) marker CD44, and human mutant p53 were immunohistochemically investigated in the pretreatment biopsy specimens of 57 patients with OSCC to identify any relationship of their expression patterns with clinicopathological tumor features and patient prognosis
The results of this study demonstrated that the immunohistochemical expression patterns of NANOG and mutant p53 were directly associated with overall survival rates as well as clinicopathological features, including tumor stage, neck node metastasis, and histological grade

Summary

Introduction

In order to predict long-term prognosis and define individual treatment modalities for patients with oral squamous cell carcinoma (OSCC), more reliable tumor biomarkers are needed during the pretreatment workup period. Oral squamous cell carcinoma (OSCC) is a common malignant tumor of the head and neck region; patients with OSCC have a 5-year survival rate of less than 50 %. CD44 was the first CSC marker described in a solid malignancy [5], and a high frequency of CD44 positive cells in HNSCC strongly correlates with recurrence and tumor aggressiveness [11]. Tumor protein 53 (p53) is considered a traditional tumor biomarker in squamous cell carcinoma (SCC); its usefulness as a prognostic indicator remains unclear [1]. Mutant p53 protein is usually detectable via immunohistochemistry (IHC) [14, 15]

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