Nuclear BMI-1 expression in laryngeal carcinoma correlates with lymph node pathological status

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WORLD JOURNAL OF SURGICAL ONCOLOGY

RESEARCH

Open Access

Nuclear BMI-1 expression in laryngeal carcinoma correlates with lymph node pathological status Eugenia Allegra1*, Lidia Puzzo2, Valeria Zuccalà3, Serena Trapasso1, Enrico Vasquez2, Aldo Garozzo1 and Rosario Caltabiano2

Abstract Background: The main cause of treatment failure and death in laryngeal squamous cell carcinoma is metastasis to the regional lymph nodes. The current clinical staging criteria fail to differentiate patients with occult metastasis from patients without metastasis. Identifying molecular markers of the disease might improve our understanding of the molecular mechanisms underlying the pathogenesis and development of laryngeal carcinoma and may help improve clinical staging and treatment. Methods: Sixty-four previously untreated patients who underwent surgical excision of laryngeal squamous cell carcinoma with neck dissection were included in this study. The expression of B cell-specific Moloney murine leukemia virus integration site 1 (BMI-1) was examined immunohistochemically on formalin-fixed paraffin-embedded primary tissue specimens. Results: Nuclear expression of BMI-1 (nBMI-1) was detected in 32 of the 64 tumors (50%), cytoplasmic expression of BMI-1 (cBMI-1) was detected in 22 (34.4%), and 10 tumors (15.6%) showed no BMI-1 immunoreactivity. High nBMI-1 expression levels (≥10) were detected in 28 of the 32 (87.5%) nBMI-1-positive patients. Multivariate analysis including age at diagnosis, grade, tumor location, TNM status, and nBMI-1 expression showed that a high nBMI-1 expression level was an independent prognostic factor for lymph node metastasis. Conclusion: The expression of BMI-1 in patients with laryngeal carcinoma seems to correlate with lymph node metastasis. Keywords: BMI-1, Laryngeal cancer, Lymph node metastasis, Squamous cell carcinoma

Background Laryngeal squamous cell carcinoma is the most common type of head and neck cancer, and its incidence rate in Italy is approximately 5,000 new cases per year [1]. Most patients affected by laryngeal cancer are in the locoregionally advanced stage of disease at the time of diagnosis. The main cause of treatment failure and death is metastasis to the regional lymph nodes and distant metastasis [2]. The current clinical staging criteria fail to differentiate patients with occult metastasis from patients without metastasis. Many investigators are currently working to identify molecular markers of the disease to improve our understanding of the molecular * Correspondence: [email protected] 1 Department of Otolaryngology-Head and Neck Surgery, University of Catanzaro, Catanzaro, Italy Full list of author information is available at the end of the article

mechanisms underlying the pathogenesis and development of laryngeal carcinoma and to improve its clinical staging. Recently, B cell-specific Moloney murine leukemia virus integration site 1 (BMI-1) seems to be a new putative marker for head and neck solid tumors. BMI-1 is an essential constituent of the polycomb repressive complex-1,