Low expression of pRB predicts disease relapse in early glottic cancer treated with transoral laser microsurgery

Abstract

Objectives/Hypothesis To elucidate the associations among the immunohistochemical expression of tumor markers, clinicopathological variables, and disease‐free survival (DFS) in patients with early‐stage glottic squamous cell carcinoma (SCC) who underwent transoral laser microsurgery (TLM) as the primary treatment. Study Design Retrospective chart review. Methods The records of consecutive patients with Tis‒T2N0 glottic SCC who underwent TLM between August 1, 2012 and October 31, 2015 were reviewed. Expression of Bcl‐2, pRB, p16INK4A, p53, c‐Myc, E‐cadherin, and EGFR was examined using tissue microarrays containing tumor specimens through immunohistochemistry. Three‐year DFS rates were calculated. Results A total of 65 consecutive patients were identified, of which 28 were excluded due to insufficient tissue (n = 22) and low biomarker quality (n = 6). Therefore, 37 patients with complete records were included. The included patients were significantly older and had a more advanced type of cordectomy than did the excluded patients (P = .015 and .009, respectively). According to the findings of univariate analysis, age, betel quid chewing, type of cordectomy, BCL‐2 expression, and pRB expression significantly predicted 3‐year DFS. According to the findings of multivariate analysis, age (adjusted hazard ratio: 0.94, 95% CI: 0.88‐1.00), betel quid chewing (adjusted hazard ratio: 5.07, 95% CI: 1.32‐19.44), and pRB expression (adjusted hazard ratio: 0.02, 95% CI: 0.00‐0.28) were independent predictors of 3‐year DFS. Conclusions Low pRB expression is a potential biomarker for predicting disease relapse after primary TLM for early‐stage glottic SCC and may help to identify high‐risk patients who can subsequently undergo intensive management. Level of Evidence 4 Laryngoscope, 129:E220–E226, 2019

Laryngeal Helicobacter pylori Infection and Laryngeal Cancer-Case Series and a Systematic Review

“…A total of 105 consecutive patients with newly diagnosed, histologically confirmed laryngeal lesions who underwent laryngeal surgery at the Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan, between 1 August 2012 and 31 December 2015, were recruited. This study protocol has been reported elsewhere [ 36 , 37 ]. The sample size ( n = 105) was estimated using a priori calculations [Fisher’s exact test, OR = 2.9, two-tailed α = 0.05, power = 0.90; allocation ratio = 0.4], as reported in a previous meta-analysis of H. pylori infection in patients with laryngeal cancer and controls [ 17 ].…”

Effects of Epstein-Barr Virus Infection on the Risk and Prognosis of Primary Laryngeal Squamous Cell Carcinoma: A Hospital-Based Case-Control Study in Taiwan

“…En bloc resection was attempted for all lesions, and tumorfree margins were confirmed using frozen-section analysis during the operation [3,23,24]. If positive primary excision margins were noted, additional extended resections were performed until all secondary margins were negative for malignancy [25]. Patients for whom complete resection was not possible, as determined by a multidisciplinary tumor board at the hospital, were suggested for adjuvant RT or CCRT [23].…”

“…All routine hematoxylin and eosin-stained sections of FFPE tissue blocks that had been histologically evaluated for lesion type and tumor tissue adequacy were used for tissue microarray (TMA) construction, the protocol of which is described elsewhere [7,25]. Briefly, two regions within LSCC or NMLL foci per case were marked on hematoxylin and eosin-stained slides by a pathologist (TCC) blinded to the patient's clinical information and used to assemble the recipient blocks.…”

“…TMA tissue sections were stained using the same immunostains noted above, according to the manufacturer's instructions. Detailed IHC procedures have been previously described [7,25]. For optimal detection, antibodies were diluted at the following ratios: 1:10 (p16INK4a), 1:500 (BCL-2), 1:50 (MYC), 1:100 (B2M), 1:200 (CD3), and 1:100 (CD161).…”

“…Stained slides were digitalized at 40× magnification using an Aperio ScanScope scanner (Leica Biosystems, Richmond, IL, USA). Expression levels of EBER and histological marker proteins were digitally assessed in four specified regions of interest (ROIs), which contained the laryngeal mucosal lesion and submucosal tissue, using semi-quantitative image analysis (Tissue Studio v2.1; Definiens AG, Münich, Germany) [7,25,33]. The image analysis software allowed for the specific mining of staining intensities in the cell nuclei (EBER and MYC) or whole cells (p16INK4a, BCL-2, B2M, CD3, and CD161); nuclei and cells were categorized as "negative" or "positive" (weak, moderate, or high staining intensity).…”