Psoriasin expression is associated with survival in patients with human papillomavirus-positive base of tongue squamous cell carcinoma

Abstract

Patients with human papillomavirus-positive (HPV+) base of tongue squamous cell carcinomas (BOTSCC) have an improved survival compared with patients with HPV-negative BOTSCC and it has been suggested that treatment should be tailored. Before individualized treatment can be introduced, additional prognostic markers are required. A prognostic role of psoriasin has previously been demonstrated outside BOTSCC. Therefore, the present study aimed to examine psoriasin in BOTSCC, with focus on HPV+ BOTSCC, in relation to prognosis. A total of 72 BOTSCC samples were stained for psoriasin by immunohistochemistry, and the association between expression and clinical outcomes was analyzed. Patients with low psoriasin expression exhibited significantly improved overall survival (OS; P=0.001) and disease-free survival (DFS; P=0.007), which also was observed in patients with HPV+ BOTSCC (OS, P<0.001; DFS, P= 0.02). Furthermore, psoriasin was a significant prognostic factor in univariable and multivariable analyses. In conclusion, psoriasin could be used as a prognostic marker in HPV+ BOTSCC.

Prognostic Markers and Driver Genes and Options for Targeted Therapy in Human-Papillomavirus-Positive Tonsillar and Base-of-Tongue Squamous Cell Carcinoma

“…Immunological and stem cell markers have been examined extensively, and are still being examined, by IHC and by other means in HPV + and HPV − OPSCC, TSCC, and BOTSCC [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 45 , 46 , 48 , 50 ]. Moreover, recently, an extensive review on the OPSCC tumor microenvironment with regard to options for immunotherapy presented a detailed overview of immune cells present in the microenvironment and their potential role in the promotion of active or suppressive immune responses in OPSCC [ 90 ].…”

“…Early on, it was shown that having low CD44 intensity expression or CD98 expression was correlated with better survival irrespective of the HPV status in the tumors, while for tumor suppressor genes LRIG1-3 , only high LRIG1 expression was correlated with a better clinical outcome [ 33 , 34 , 42 ]. More recently, having low psoriasin expression was correlated with better survival in HPV + BOTSCC [ 50 ].…”

“…Therefore, better-tailored therapy is definitely required [ 1 , 2 , 3 , 4 , 8 , 16 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ]. To enable the stratification of patients for de-escalated or targeted therapy, recent research has focused on exploring the role of HPV + status in survival per OPSCC subsite and identifying predictive biomarkers and driver genes optimal for targeted therapy [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ]. Below, efforts to reach these goals as well as an introduction to some experimental progress and some clinical trials with targeted therapy for these specific cancers are presented.…”

Whole-Exome Sequencing of HPV Positive Tonsillar and Base of Tongue Squamous Cell Carcinomas Reveals a Global Mutational Pattern along with Relapse-Specific Somatic Variants

“…To improve patient stratification and individual tailoring of therapy, efforts have been made to uncover novel prognostic markers in HPV + TSCC/BOTSCC/OPSCC [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ]. Stage, age, HPV16 E2 mRNA expression, high CD8 + tumour infiltrating lymphocyte (TIL) counts, and many other molecular markers have been proposed as predictive of prognosis, and models combining multiple markers have been shown to identify 20–56% of all patients with a >95% probability of 3-year disease-free survival [ 15 , 17 , 19 , 20 , 22 , 26 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ]. However, more biomarkers are required to improve these models and accurately identify a larger proportion of patients with a likely excellent prognosis so that these can receive de-escalated treatments.…”