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Molecular Marker Expression in Oral and Oropharyngeal Squamous Cell Carcinoma
Benjamin D. Smith, BA;
Grace L. Smith, MPH;
Darryl Carter, MD;
Michael P. DiGiovanna, MD, PhD;
Katherine M. Kasowitz, BS;
Clarence T. Sasaki, MD;
Bruce G. Haffty, MD
Arch Otolaryngol Head Neck Surg. 2001;127:780-785.
Objective To determine the relative prognostic value of p53, cyclin D1, epidermal
growth factor receptor (EGFR), and vascular endothelial growth factor (VEGF)
expression in patients with oral and oropharyngeal squamous cell carcinoma.
Design Retrospective cohort study.
Patients Fifty-six patients with oral and oropharyngeal squamous cell carcinoma
referred to the Department of Therapeutic Radiology at Yale–New Haven
Hospital (Conn) between 1981 and 1992 who were treated with gross total surgical
resection and postoperative external beam radiotherapy.
Results Archival tumor tissue was stained with monoclonal antibodies directed
against these 4 oncoproteins and scored for staining intensity and percent
distribution by a pathologist blinded to the patients' clinical outcomes.
Frequency of marker expression was 48% for p53, 20% for cyclin D1, 64% for
EGFR, and 41% for VEGF. In multivariate analysis, EGFR positivity was protective
against locoregional relapse (relative risk [RR], 0.27; 95% confidence interval
[CI], 0.11-0.66; P = .002). In contrast, advanced
N stage predicted poor locoregional relapse-free survival (RR, 1.94; 95% CI,
1.03-3.66; P = .04). Predictors of poor overall survival
in multivariate analysis included VEGF positivity (RR, 3.53; 95% CI, 1.75-7.13; P<.001) and black race (RR, 2.48; 95% CI, 1.05-5.85; P = .04). Cyclin D1 and p53 expression were not significantly
associated with prognosis in this cohort.
Conclusions In oral and oropharyngeal squamous cell carcinoma treated with surgery
and postoperative radiotherapy, VEGF and EGFR expression may influence clinical
outcome. If confirmed, these results have potential implications for the determination
of patient prognosis and the development of biologically based pharmacotherapies.
From the Departments of Therapeutic Radiology (Mr B. D. Smith, Ms G.
L. Smith, and Dr Haffty), Pathology (Dr Carter), Internal Medicine, Section
of Medical Oncology (Dr DiGiovanna and Ms Kasowitz), and Surgery, Section
of Otolaryngology (Dr Sasaki), Yale University School of Medicine, New Haven,
Conn.
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