Purpose: Survival rates for squamous cell carcinoma of the head and neck (SCCHN) have remained unchanged for several decades due to local tumor recurrences as well as regional and distant metastases. Recent evidence has shown that RhoC GTPase is overexpressed in stages III and IV regionally metastatic SCCHN compared with stages I and II localized disease. This study evaluated the expression of RhoC in head and neck carcinoma and investigated the prognostic use of this marker on a large cohort of previously untreated patients with SCCHN. Experimental Design: Standard Western blot techniques were used to evaluate RhoC protein expression in nine established head and neck cancer cell lines and in normal oral epithelium. In vivo expression of RhoC in metastatic and nonmetastatic SCCHN was investigated using immunohistochemical analysis on a tissue microarray composed of 113 independent tumor samples. RhoC expression was analyzed as it related to clinical and pathologic variables of interest. Results: Levels of RhoC protein were increased in the SCCHN cell lines compared with normal oral epithelium.The in vivo expression of RhoC correlated with advanced clinical stage and lymph node metastases for the entire patient cohort as well as in small primary tumors (T 1 and T 2 ). Conclusions:This study is the first to examine the expression of RhoC GTPase protein in SCCHN and normal squamous epithelium. It is clear from the results that RhoC is a specific marker of lymph node metastases in patients with this challenging form of carcinoma. RhoC levels seem to identify a subset of patients with early tumor stage primary tumors and high metastatic potential that might benefit from more aggressive therapy. Through continued investigation, blockade of RhoC activity may be a potential target in the development of novel strategies for treating metastases of head and neck cancer.
Squamous cell carcinoma of the head and neck (SCCHN)accounts for >95% of all head and neck malignancies and is responsible for f40,000 incident cases yearly in the United States. Unfortunately, the majority of SCCHN patients present with advanced-stage disease (stages III and IV), requiring multimodality therapy. Even with combinations of chemotherapy, radiotherapy, and surgery, cure rates are only 30% for advanced-stage disease and have remained unchanged for decades. This poor survival is due mainly to the development of local tumor recurrences as well as regional and distant metastases. Novel molecular predictors of regional and distant metastatic potential at the time of diagnosis are needed to help guide clinical therapy decisions.Many of the factors necessary to convey the metastatic phenotype to cancer cells are controlled by the members of the Ras superfamily of small GTP-binding proteins. RhoC GTPase is a member of the Ras superfamily, and its activation results in the assembly of the actin-myosin contractile filaments into focal adhesion complexes that, ultimately, lead to cell polarity and facilitate motility (1 -3). Our laboratory has d...