title: Quantitative analysis of syndecan-1 expression in dysplasia and squamous cell carcinoma of the oral cavity.
abstract: BACKGROUND
  Decreased expression of syndecan-1 has been reported in dysplasia and squamous cell carcinoma (SCCA) of the oral cavity and appears to correlate with decreasing histological differentiation and poor clinical outcome. Assays of syndecan-1 expression to date have utilized manual microscopic analysis with qualitative grading of immunohistochemical staining intensity, which may introduce observer bias. We evaluated syndecan-1 expression in dysplasia and squamous cell carcinoma (SCCA) of the oral cavity, using a novel automated cellular imaging system that incorporates both staining intensity as well as the percentage of positively stained cells to yield a quantitative value for syndecan-1 expression.
  
  
  METHODS
  We performed a quantitative immunohistochemical analysis of syndecan-1 expression using an automated cellular image analysis system. We analyzed specimens from cases of mild dysplasia (N = 55), moderate dysplasia (N = 38), severe dysplasia (N = 25), carcinoma in situ (CIS) (N = 43), and SCCA of the oral cavity (N = 45), using normal mucosal epithelium (N = 21) as a positive control. The SCCA specimens were further subdivided by degree of differentiation. We retrospectively reviewed patient charts to identify tumor stage at diagnosis, recurrence, and disease-specific survival.
  
  
  RESULTS
  Syndecan-1 expression was significantly greater in normal controls than in specimens of mild, moderate, or severe dysplasia, CIS, or invasive SCCA (P < .05). Syndecan-1 expression did not differ significantly among specimens of mild, moderate, or severe dysplasia, CIS or SCCA. There was no significant difference in syndecan-1 expression between specimens from patients with no evidence of disease at 3 years follow-up and patients with local, regional, or distant recurrence.
  
  
  CONCLUSIONS
  Syndecan-1 expression does not appear to be useful as a marker of differentiation or as a prognostic indicator in dysplasia and SCCA of the oral cavity. The search for a suitable and reliable marker of biological aggressiveness is ongoing.
authors.affiliation: Departments of Otolaryngology-Head and Neck Surgery, Medical College of Georgia, Augusta, Georgia 30912, USA.
authors.forename: Lana L
authors.initials: LL
authors.lastname: Jackson
authors.forename: Zane
authors.initials: Z
authors.lastname: Wade
authors.forename: Richard B
authors.initials: RB
authors.lastname: Hessler
authors.forename: Rafik
authors.initials: R
authors.lastname: Abdelsayed
authors.forename: Jeremy B
authors.initials: JB
authors.lastname: Rogers
authors.forename: Christine G
authors.initials: CG
authors.lastname: Gourin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D014408:Biomarkers, Tumor / Q000378:metabolism; D002294:Carcinoma, Squamous Cell / Q000378:metabolism*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000378:metabolism*; D011230:Precancerous Conditions / Q000378:metabolism*; D012189:Retrospective Studies; D013194:Staining and Labeling; D053668:Syndecan-1 / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; C508241:SDC1 protein, human; D053668:Syndecan-1