A gene signature in histologically normal surgical margins is predictive of oral carcinoma recurrence

Oral Squamous Cell Carcinoma (OSCC) is a major cause of cancer death worldwide, which is mainly due to recurrence leading to treatment failure and patient death. Histological status of surgical margins is a currently available assessment for recurrence risk in OSCC; however histological status does...

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Published in:	BMC cancer 2011-10, Vol.11 (1), p.437-437, Article 437
Main Authors:	Reis, Patricia P, Waldron, Levi, Perez-Ordonez, Bayardo, Pintilie, Melania, Galloni, Natalie Naranjo, Xuan, Yali, Cervigne, Nilva K, Warner, Giles C, Makitie, Antti A, Simpson, Colleen, Goldstein, David, Brown, Dale, Gilbert, Ralph, Gullane, Patrick, Irish, Jonathan, Jurisica, Igor, Kamel-Reid, Suzanne
Format:	Article
Language:	eng
Subjects:	Biomarkers, Tumor - genetics Cancer therapies Carcinoma, Squamous Cell - diagnosis Carcinoma, Squamous Cell - genetics Carcinoma, Squamous Cell - pathology Care and treatment Cluster Analysis Computational Biology Computer science DNA microarrays Experiments Gene expression Gene Expression Profiling Gene Expression Regulation, Neoplastic Genetic aspects global gene expression profiling Head & neck cancer Health sciences Hospitals Humans Medical research Microarray Analysis Mouth cancer Mouth Neoplasms - diagnosis Mouth Neoplasms - genetics Mouth Neoplasms - pathology Neoplasm Recurrence, Local - diagnosis Neoplasm Recurrence, Local - genetics Neoplasm Recurrence, Local - pathology oral squamous cell carcinoma Otolaryngology Prognosis prognostic signature recurrence Risk factors Studies surgical resection margins
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Summary:	Oral Squamous Cell Carcinoma (OSCC) is a major cause of cancer death worldwide, which is mainly due to recurrence leading to treatment failure and patient death. Histological status of surgical margins is a currently available assessment for recurrence risk in OSCC; however histological status does not predict recurrence, even in patients with histologically negative margins. Therefore, molecular analysis of histologically normal resection margins and the corresponding OSCC may aid in identifying a gene signature predictive of recurrence. We used a meta-analysis of 199 samples (OSCCs and normal oral tissues) from five public microarray datasets, in addition to our microarray analysis of 96 OSCCs and histologically normal margins from 24 patients, to train a gene signature for recurrence. Validation was performed by quantitative real-time PCR using 136 samples from an independent cohort of 30 patients. We identified 138 significantly over-expressed genes (> 2-fold, false discovery rate of 0.01) in OSCC. By penalized likelihood Cox regression, we identified a 4-gene signature with prognostic value for recurrence in our training set. This signature comprised the invasion-related genes MMP1, COL4A1, P4HA2, and THBS2. Over-expression of this 4-gene signature in histologically normal margins was associated with recurrence in our training cohort (p = 0.0003, logrank test) and in our independent validation cohort (p = 0.04, HR = 6.8, logrank test). Gene expression alterations occur in histologically normal margins in OSCC. Over-expression of the 4-gene signature in histologically normal surgical margins was validated and highly predictive of recurrence in an independent patient cohort. Our findings may be applied to develop a molecular test, which would be clinically useful to help predict which patients are at a higher risk of local recurrence.
ISSN:	1471-2407 1471-2407