A prognostic role for Nm23-H1 in laryngeal carcinoma treated with postoperative radiotherapy: an introductory investigation

Maspin expression and anti-apoptotic pathway regulation by bcl2 in laryngeal cancer

OBJECTIVES

Comprehension of the interplay of pro-apoptotic and anti-apoptotic stimuli in laryngeal squamous cell carcinoma (LSCC) is crucial to understand tumor development, biological behavior and treatment response. Bcl-2 family proteins mainly regulate the apoptotic signal cascade. In some cancers, maspin seems to influence the balance between pro-apoptosis and anti-apoptosis bcl-2 family proteins. The aim of this study was to investigate the potential relationship between bcl-2 anti-apoptotic factor and the tumor suppressor maspin in LSCC.

MATERIALS AND METHODS

31 consecutive patients who underwent primary surgery and post-operative radiotherapy for LSCC were evaluated retrospectively. For each case, immunohistochemistry assays for bcl-2 and maspin were performed. Data were also collected on N-status, pT stage, grading, recurrence and disease-free survival (DFS).

RESULTS

Patients with nuclear maspin pattern of expression showed a significantly lower recurrence rate (p = 0.04) and longer DFS (p = 0.0018). The expression of bcl-2 was not associated with recurrence rate or DFS either in the whole cohort or in cases with nuclear maspin pattern, while in patients with non-nuclear maspin pattern, a statistical trend was found toward a shorter DFS for bcl-2 positive cases (p = 0.062). In the multivariate model, only maspin expression pattern retained its independent prognostic significance (p = 0.006).

CONCLUSIONS

Nuclear maspin pattern seemed to be an independent positive prognostic factor, while bcl-2 prognostic value was related to maspin expression pattern. Further investigations are needed to support the use of bcl-2 inhibitors in multimodality or multitarget strategies against advanced LSCCs, also considering the role and expression of tumor suppressor genes.

Correlation of nm 23 expression with pharyngeal cancer and patient prognoses

The present study investigated the expression of non-metastasis 23 (nm 23) in laryngeal cancer tissues and analyzed its correlation with the prognoses of laryngeal cancer patients. A total of 122 laryngeal cancer patients who were admitted to The Affiliated Hospital of Jining Medical College from June 2009 to June 2012, and 30 normal laryngeal mucosal tissues were selected as the control group. Immunohistochemical staining method was used to test the expression of nm 23 in tissues. Quantitative-polymerase chain reaction (q-PCR) and western blotting were conducted to test the expression of nm 23 in tissues at the gene and protein levels, respectively. Moreover, the prognoses of patients were analyzed. The positive expression rate (90.00%) of nm 23 in the normal laryngeal mucosal tissues was markedly higher than that in laryngeal cancer tissues (56.56%) (p<0.05). The expression of nm 23 proteins was correlated with the clinical staging of laryngeal cancer and the metastasis of lymph nodes (p<0.05). The expression of both nm 23 genes and proteins in the laryngeal cancer tissues were significantly lower than those in the normal laryngeal mucosal tissues (p<0.05). The survival rate of the positive nm 23 expression was substantially higher than that of the negative expression with a statistically significant difference (p<0.01). In conclusion, the expression of nm 23 proteins plays an important role in the development and metastasis of laryngeal cancer and may be taken as one of the indicators to evaluate the prognoses of such patients.

A panel of biomarkers for predicting response to postoperative RT for laryngeal cancer?

OBJECTIVES

Postoperative radiotherapy (PORT) improves locoregional control and survival rates for patients with advanced laryngeal carcinoma (LSCC), but reported outcomes after PORT for LSCC vary considerably. Predictive markers (including biomarkers) are needed for LSCC to orient the choice of the most appropriate adjuvant therapy for individual patients. The aim of this study was to identify a panel of LSCC tissue markers (considering EGFR, mTOR, survivin, Bcl-2, angiogenin, endoglin [CD105], nm23-H1) capable of pinpointing patients at higher risk of recurrence among 33 LSCC cases treated with PORT.

METHODS/RESULTS

Univariate analysis found 4 biomarkers (mTOR, nuclear survivin, CD105, non-nuclear nm23-H1) significantly associated with LSCC recurrence. A collinearity emerged between mTOR and CD105 expressions. The predictive role of two different panels (panel 1: mTOR, nuclear survivin, non-nuclear nm23-H1; panel 2: CD105, nuclear survivin, non-nuclear nm23-H1) was considered. According to the Hosmer and Lemeshow scale, panel 1 demonstrated an outstanding discriminatory power (AUC 0.903) in predicting LSCC recurrence after PORT. Panel 2 had an excellent discriminatory power too (AUC 0.899).

CONCLUSIONS

Both panels of biomarkers showed an important discriminatory power in pinpointing patients at higher risk of recurrence after PORT for LSCC who could reasonably benefit from adjuvant postoperative chemo-RT.