TGFBI Expression Predicts the Survival of Patients With Oropharyngeal Squamous Cell Carcinoma

Abstract

Background/Aim: This study was conducted to investigate transforming growth factor beta-induced protein (TGFBI) expression and analyze the clinical and prognostic significance of TGFBI in oropharyngeal squamous cell carcinoma (OPSCC). Patients and Methods: We evaluated TGFBI expression by immunohistochemistry in 94 patients with OPSCC. For comprehensive analysis, TGFBI expression was subdivided into tumor cell score (T), stroma score (S), and the sum of two scores (TS) calculated using H-score. Clinicopathological features and survival outcomes were compared between groups of high expression and low expression of TGFBI in each area. Results: Overall, 12 patients (12.8%) showed high T score, and 41 patients (43.6%) revealed high S score. Although T score showed no significant difference both in overall survival (OS) (p=0.080) and recurrence free survival (RFS) (p=0.272), high S score patients had significantly worse OS (p=0.003) and worse RFS (p=0.043). High TS score also showed significant association with worse OS (p=0.011) and worse RFS (p=0.021). High S score was an independent prognostic factor predicting shorter OS (HR=6.352, 95%CI=1.206-40.050, p=0.029) and RFS (HR=18.843, 95%CI=1.030-344.799, p=0.048) in the multivariate analysis. Conclusion: High S score of TGFBI was a significant predictor of poor prognosis in OPSCC. TGFBI could be a useful new predictive and prognostic biomarker in OPSCC. Oropharyngeal squamous cell carcinoma (OPSCC) is a distinct subtype of head and neck cancer that occurs in the tonsil, base of tongue, and adenoids. OPSCC is known to be related traditionally to tobacco smoking and alcohol, but the incidence of human papilloma virus (HPV)-associated OPSCC has increased in the last few decades (1-3). Despite the advance in detection and therapies, the survival of OPSCC has not significantly improved in the last decades (4). OPSCC is a biologically heterogeneous disease and the patients' response to treatment is diverse. Although patients with HPV-associated OPSCC tend to be younger and respond better to treatment compared to HPV-negative OPSCC (5), the factors affecting the prognosis and response to treatment of patients with OPSCC have not been fully elucidated. To improve clinical outcomes, new biomarkers and therapeutic targets that help to identify patients who are at the highest risk for poor outcomes are urgently needed. Transforming growth factor beta-induced protein (TGFBI), also known as βig-H3, is a secretory extracellular matrix protein induced by TGF-β that mediates cell adhesion to extracellular proteins such as collagen, fibronectin, and laminin through integrin binding (6). TGFBI plays a role in morphogenesis, cell adhesion, migration, differentiation, inflammation, tumorigenesis and metastasis (7). Recently, researchers have studied the role of TGFBI in different types of tumors, with varying results. Wang et al. (8) have reported that TGFBI promotes tumor growth and is associated with poor prognosis in oral squamous cell carcinoma. Unfortunately, little is known about t...

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Radiomics-based model for prediction of TGF-β1 expression in head and neck squamous cell carcinoma

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