Prognostic significance of fascin and Wilm’s tumor 1 (WT1) in oral squamous cell carcinomas – case control study

Abstract

Aims: To elucidate the role of fascin and WT1 expression in oral squamous cell carcinoma (OSCC) by correlation with clinicopathological parameters.Subjects and methods: Paraffin sections of 27 OSCC tissue were immunohistochemically stained with fascin and WT1 using the avidin-biotin-peroxidase staining method. Correlations between fascin and WT1 and various clinicopathological features, and prognosis were studied.Results: Immunohistochemical study revealed significant increase of fascin and WT1 in OSCC in relation to control group (p< 0.000). Receiver operating characteristic (ROC) curve for fascin and WT1 were conducted for detection of recurrence. Fascin showed fair area under curve (AUC) (AUC=0.66), with sensitivity of 63.6 % and specificity of 50.0 % at cutoff value of 42.5 %. WT1 also showed fair AUC (AUC=0.63), with sensitivity of 63.6 % and specificity 68.8 % at cutoff value of 40.0 %. ROC curve for WT1 and fascin were conducted for detection of lymph node infiltration. While fascin showed excellent AUC (AUC=0.865), cutoff value of 52.5 %, with sensitivity of 70.0 % and specificity of 94.1%. WT1 also showed excellent AUC (AUC=0.791), cutoff value of 42.2 %, with sensitivity of 70.0 % and specificity 70.6%. Significant associations were detected between median fascin cutoff value at 45% and well differentiated tumor (P=0.04), T3&T4 tumor size (P= 0.01), LN infiltration (P=0.05), and tumor-node metastasis 3 and 4 (TNM3 &TNM4) staging (P=0.02). Significant associations were found between the median cutoff value of WT1 and moderately differentiated tumor (P=0.02), and LN infiltration (P=0.01). The 2-year survival rate of patients with fascin of ≥ 45% and WT1 ≥ 40% were nonsignificantly higher than that of patients with fascin of < 45% and WT1 <40% (P=0.09, P=0.55). Univariate analysis demonstrated that Fascin, WT1 were significant risk factors of LN (p=0.005, 0.02) but not considered as risk factors of tumor recurrence. Conclusion: Fascin and WT1 have oncogenic effects playing an important role in progression of OSCC. Overexpression of them contributes to a more aggressive clinical course. Understanding their role on OSCC and other tumors will facilitate the development of new treatment strategies.