Objectives: Preclinical data show that exogenous administration of recombinant human bone morphogenetic protein-2 (rhBMP-2) to human oral carcinoma cell lines increases pathogenicity using a nude mouse model. The objectives of this study are to 1) describe the characteristics of baseline protein expression of BMP-2 in head and neck squamous cell carcinomas (HNSCCs), and 2) determine if BMP-2 expression level correlates with worse oncologic outcomes. Methods: Tissue samples from 149 patients with oral, oropharyngeal, and laryngeal/hypopharyngeal squamous cell carcinomas treated at an academic medical center between 1999 and 2010 were assembled into a tissue microarray. Immunohistochemistry for BMP-2 was performed, and staining was quantified using a standardized scoring system. Specimens were categorized by high or low expression level. Statistical analyses using log-rank, Wilcoxon, and Fisher’s exact test were performed for associations between clinical and pathologic features and patient survival. Results: BMP-2 expression at any level was present in 146 of 149 (97.9%) tissue samples. Tumors with high BMP-2 expression had higher rates of local failure compared with low-expressing tumors (17.3% vs 6.3% P = 0.04). However, there was no significant association for BMP-2 expression level and tumor location, T stage, N stage, regional failure, distant failure, or overall survival. Conclusions: HNSCCs with high levels of BMP-2 protein expression are associated with higher rates of local recurrence. These data may have important implications for using rhBMP-2 in tissue engineering reconstructive approaches in the setting of cancer-related defects. Further, the consistent expression of BMP-2 suggests this pathway may be a novel therapeutic target.
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