title: Loss of desmoglein 1 expression associated with worse prognosis in head and neck squamous cell carcinoma patients.
abstract: OBJECTIVE
  Mucosal squamous cell carcinomas are the most common head and neck malignancies. We hypothesised that over-expression of intracellular signalling proteins and decreased expression of desmoglein molecules would be associated with aggressive tumour behaviour in patients with head and neck squamous cell carcinoma.
  
  
  METHODS
  Seventy-eight cases of head and neck squamous cell carcinoma were immunohistochemically stained for desmoglein 1, desmoglein 2, desmoglein 3, p53, bcl-2, vimentin, cyclin D1, p16, p21, p27, E-cadherin, and E2F-1 in paraffin-embedded tissue blocks in a microarray.
  
  
  RESULTS
  The disease-specific survival was 56% at 5 years and 49% at 10 years. Expression of the desmoglein isotypes correlated positively with each other except for desmoglein 2 and desmoglein 3, which did not show a significant correlation. Desmoglein 1 and E-cadherin expression also correlated. On univariate analysis, only expression of desmoglein 1 correlated with patient outcome; lack of expression of desmoglein 1 was associated with a significantly worse disease-specific survival (p = 0.035). Hierarchical clustering analysis identified a subgroup of three patients with an immunophenotype distinct from the other tumours, characterised by co-expression of p16, p27, E2F-1 and bcl-2. Further statistical analysis of the prognostic significance of this small subgroup was not possible, but these three patients are alive and well.
  
  
  CONCLUSIONS
  Decreased expression of desmoglein 1 is associated with a worse prognosis in head and neck squamous cell carcinoma patients. Examination of an extended panel of immunomarkers revealed a rare subtype of squamous cell carcinoma characterised by the expression of multiple proliferation-associated markers and the anti-apoptotic protein, bcl-2; determination of the prognostic significance of this subgroup will require study of a larger case series.
authors.affiliation: Department of Pathology and Genetic Pathology Evaluation Centre of the Prostate Research Centre, University of British Columbia, Vancouver General Hospital, Vancouver, BC, Canada.
authors.forename: Michelle P
authors.initials: MP
authors.lastname: Wong
authors.forename: Maggie
authors.initials: M
authors.lastname: Cheang
authors.forename: Erika
authors.initials: E
authors.lastname: Yorida
authors.forename: Andrew
authors.initials: A
authors.lastname: Coldman
authors.forename: C Blake
authors.initials: CB
authors.lastname: Gilks
authors.forename: David
authors.initials: D
authors.lastname: Huntsman
authors.forename: Ken
authors.initials: K
authors.lastname: Berean