Tumoral Expression Of Cd44 And Hif1 Alpha Predict Stage I Oral Cavity Squamous Cell Carcinoma Outcome

Objectives/Hypothesis: No biomarkers are used to estimate the prognosis in oral cavity squamous cell carcinoma (OSCC). In our previously published work, we have reported the prognostic value of CD44 and hypoxia inducible factor (HIF)-1 alpha in patients with stage I disease.Study Design: In this study, we tested our previous observations in a larger cohort. We also studied the predictive value of common lymphatic endothelial and vascular endothelial receptor (CLEVER) 21 in this material.Methods: CD44, HIF1 alpha, and CLEVER-1 were immunohistochemically analyzed in paraffin-embedded tissue material of stage I OSCC patients treated at three Finnish university hospitals. Microscopy results were correlated with OSCC outcome.Results: As in our pilot study, the CD44(low) HIF1 alpha(high) signature was associated with poorer disease-free survival. Clear correlations between CLEVER-1 expression and clinical outcome were not evident.Conclusion: Our results suggest that immunohistochemistry of CD44 and HIF1 alpha may be useful in identification of patients with poor prognoses. These parameters could be used to select the optimal treatment modalities for stage I OSCC patients.