title: High stromal versican expression predicts unfavourable outcome in oral squamous cell carcinoma.
abstract: BACKGROUND
  Versican, an extracellular matrix proteoglycan, has been noted to be expressed in several malignant tumours and has been suggested to play an important role in cancer development and tumour growth.
  
  
  OBJECTIVE
  To investigate whether the versican expression level in the peritumoural stromal tissue of primary oral squamous cell carcinoma (OSCC) predicts relapse-free or disease-specific survival. Also, to study the associations between versican expression and several other clinicopathological variables, as well as tumour cell proliferation.
  
  
  METHODS
  Immunohistochemistry was used to study the expression of versican and tumour cell proliferative activity in 139 OSCCs. All pertinent clinical data were collected retrospectively from the hospital records.
  
  
  RESULTS
  In this cohort, versican expression did not correlate with the clinicopathological factors or tumour cell proliferation. In univariate analyses, higher risk for disease recurrence was associated with higher stromal versican expression score (p = 0.02), positive neck node status (p = 0.02), lower Karnofsky performance status (p = 0.03) and higher tumour cell proliferation index (p = 0.04). Increased disease-specific risk of death was associated with high stromal versican expression score (p = 0.005) higher T class (p = 0.002), positive neck node status (p<0.001), higher stage (p<0.001), poorer histological differentiation (p = 0.005), worse general condition of the patient (p = 0.049) and increased tumour cell proliferative index (p = 0.02). In multivariate disease-specific survival analysis, high stromal versican expression score (p = 0.048), poorer histological differentiation (p = 0.047) and higher stage (p = 0.002) independently predicted poorer disease outcome.
  
  
  CONCLUSIONS
  In this cohort, increased stromal versican expression correlated with both increased risk for disease recurrence and shortened survival. High stromal versican expression may thus be considered an independent and adverse prognostic marker in OSCC.
authors.affiliation: Otorhinolaryngology-Head and Neck Surgery, Institute of Clinical Medicine, University of Kuopio and Kuopio University Hospital, Kuopio, Finland.
authors.forename: Matti
authors.initials: M
authors.lastname: Pukkila
authors.forename: Ari
authors.initials: A
authors.lastname: Kosunen
authors.forename: Kirsi
authors.initials: K
authors.lastname: Ropponen
authors.forename: Jukka
authors.initials: J
authors.lastname: Virtaniemi
authors.forename: Jari
authors.initials: J
authors.lastname: Kellokoski
authors.forename: Eero
authors.initials: E
authors.lastname: Kumpulainen
authors.forename: Risto
authors.initials: R
authors.lastname: Pirinen
authors.forename: Juhani
authors.initials: J
authors.lastname: Nuutinen
authors.forename: Risto
authors.initials: R
authors.lastname: Johansson
authors.forename: Veli-Matti
authors.initials: VM
authors.lastname: Kosma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000473:pathology / Q000628:therapy; D049109:Cell Proliferation; D002648:Child; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000628:therapy; D009363:Neoplasm Proteins / Q000378:metabolism; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D053675:Versicans / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D053675:Versicans