Stefin a and stefin B: markers for prognosis in operable squamous cell carcinoma of the head and neck.
OBJECTIVE
The aim of this study was to test the hypothesis about the protective role of high stefin A and stefin B concentrations in operable carcinoma of the head and neck.


METHODS
Stefins A and B concentrations were measured in tissue cytosols of nontumorous mucosa and primary tumors from 92 patients. For quantitative analysis of stefins in tumor cytosols, commercially available enzyme-linked immunosorbent assays were used.


RESULTS
Stefin A was upregulated in 53 patients (higher concentrations were measured in tumor samples than in nontumorous mucosa) and was downregulated in 39 patients. The corresponding numbers for stefin B were 49 and 43, respectively. A significantly higher proportion of downregulated cases were found among patients with disease re-appearance. In the Cox model, high stefin A concentrations appeared as independent predictors for favorable disease-free survival. Assuming a "broken stick" model, a significant increase in the recurrence rate after the threshold of 1063 ng/mgp (the 64th percentile in the group) was found, the hazard ratio reaching 3% of the reference value with doubling of the level of stefin A. These results were reconfirmed after pooling the data with two historical data sets into a uniform series involving 182 patients.


CONCLUSIONS
A group of patients at high risk for disease progression was identified, characterized by the downregulated stefin A protein in the tumor compared with the nontumorous mucosa. Stefin A was recognized as a promising candidate marker for prognosis in patients with operable carcinoma of the head and neck.
Strojan
Primoz
P
Department of Radiotherapy, Institute of Oncology, Ljubljana, Slovenia. pstrojan@onko-i.si
Anicin
Aleksandar
A
Svetic
Branka
B
Pohar
Maja
M
Smid
Lojze
L
Kos
Janko
J
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000532:radiotherapy / Q000601:surgery; D055312:Cystatin A; D055313:Cystatin B; D015891:Cystatins / Q000097:blood*; D005260:Female; D006258:Head and Neck Neoplasms / Q000097:blood* / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000097:blood*; D011379:Prognosis; D011446:Prospective Studies; D018709:Statistics, Nonparametric
C524994:CSTB protein, human; D055312:Cystatin A; D015891:Cystatins; D009363:Neoplasm Proteins; C026407:CSTA protein, human; D055313:Cystatin B