Prediction of lymphatic metastasis based on gene expression profile analysis after brachytherapy for early-stage oral tongue carcinoma.
OBJECTIVE
The management of lymphatic metastasis of early-stage oral tongue carcinoma patients is crucial for its prognosis. The purpose of this study was to evaluate the predictive ability of lymphatic metastasis after brachytherapy (BRT) for early-stage tongue carcinoma based on gene expression profiling.


METHODS
Pre-therapeutic biopsies from 39 patients with T1 or T2 tongue cancer were analyzed for gene expression signatures using Codelink Uniset Human 20K Bioarray. All patients were treated with low dose-rate BRT for their primary lesions and underwent strict follow-up under a wait-and-see policy for cervical lymphatic metastasis. Candidate genes were selected for predicting lymph-node status in the reference group by the permutation test. Predictive accuracy was further evaluated by the prediction strength (PS) scoring system using an independent validation group.


RESULTS
We selected a set of 19 genes whose expression differed significantly between classes with or without lymphatic metastasis in the reference group. The lymph-node status in the validation group was predicted by the PS scoring system with an accuracy of 76%.


CONCLUSIONS
Gene expression profiling using 19 genes in primary tumor tissues may allow prediction of lymphatic metastasis after BRT for early-stage oral tongue carcinoma.
Watanabe
Hiroshi
H
Department of Oral Restitution, Tokyo Medical and Dental University, Tokyo, Japan.
Mogushi
Kaoru
K
Miura
Masahiko
M
Yoshimura
Ryo-Ichi
R
Kurabayashi
Tohru
T
Shibuya
Hitoshi
H
Tanaka
Hiroshi
H
Noda
Shuhei
S
Iwakawa
Mayumi
M
Imai
Takashi
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D002277:Carcinoma / Q000235:genetics* / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D020869:Gene Expression Profiling; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D014062:Tongue Neoplasms / Q000235:genetics* / Q000473:pathology / Q000532:radiotherapy*