A 4-gene signature from histologically normal surgical margins predicts local recurrence in patients with oral carcinoma: clinical validation

Prognostic biomarkers for recurrence of Oral Squamous Cell Carcinoma (OSCC) are urgently needed. We aimed to independently validate a 4-gene expression signature (MMP1, COL4A1, P4HA2, THBS2) predictive of OSCC recurrence risk. Gene expression was measured using Nanostring nCounter in 245 histologica...

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Published in:	Scientific reports 2020-02, Vol.10 (1), p.1713-1713, Article 1713
Main Authors:	Reis, Patricia P, Tokar, Tomas, Goswami, Rashmi S, Xuan, Yali, Sukhai, Mahadeo, Seneda, Ana Laura, Móz, Luis E S, Perez-Ordonez, Bayardo, Simpson, Colleen, Goldstein, David, Brown, Dale, Gilbert, Ralph, Gullane, Patrick, Irish, Jonathan, Jurisica, Igor, Kamel-Reid, Suzanne
Format:	Article
Language:	eng
Subjects:	Adult Aged Aged, 80 and over Carcinoma, Squamous Cell - diagnosis Carcinoma, Squamous Cell - genetics Collagen Type IV - genetics Decision making Female Follow-Up Studies Gene expression Humans Male Margins of Excision Matrix Metalloproteinase 1 - genetics Middle Aged Mouth Neoplasms - diagnosis Mouth Neoplasms - genetics Neoplasm Recurrence, Local Oral cancer Oral carcinoma Oral squamous cell carcinoma Patients Prognosis Prolyl Hydroxylases - genetics Squamous cell carcinoma Thrombospondins - genetics Transcriptome
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Summary:	Prognostic biomarkers for recurrence of Oral Squamous Cell Carcinoma (OSCC) are urgently needed. We aimed to independently validate a 4-gene expression signature (MMP1, COL4A1, P4HA2, THBS2) predictive of OSCC recurrence risk. Gene expression was measured using Nanostring nCounter in 245 histologically normal surgical resection margins from 62 patients. Association between risk scores for individual patients and recurrence was assessed by Kaplan-Meier analysis. Signature performance was quantified by concordance index (CI), hazard ratio (HR) and the area under receiver operating characteristics (AUC). Risk scores for recurrence were significantly higher than recurrence-free patients (p = 9.58e-7, Welch's t-test). A solid performance of the 4-gene signature was determined: CI = 0.64, HR = 3.38 (p = 1.4E-4; log-rank test), AUC = 0.71. We showed that three margins per patient are sufficient to preserve predictive performance (CI = 0.65; HR = 2.92; p = 2.94e-3; AUC = 0.71). Association between the predicted risk scores and recurrence was assessed and showed HR = 2.44 (p = 9.6E-3; log-rank test, N = 62). Signature performance analysis was repeated using an optimized threshold (70 percentile of risks), resulting in HR = 3.38 (p = 1.4E-4; log-rank test, N = 62). The 4-gene signature was validated as predictive of recurrence risk in an independent cohort of patients with resected OSCC and histologically negative margins, and is potentially applicable for clinical decision making on adjuvant treatment and disease monitoring.
ISSN:	2045-2322 2045-2322