title: Overexpression of prothymosin alpha predicts poor disease outcome in head and neck cancer.
abstract: BACKGROUND
  In our recent study, tissue proteomic analysis of oral pre-malignant lesions (OPLs) and normal oral mucosa led to the identification of a panel of biomarkers, including prothymosin alpha (PTMA), to distinguish OPLs from histologically normal oral tissues. This study aimed to determine the clinical significance of PTMA overexpression in oral squamous cell hyperplasia, dysplasia and head and neck squamous cell carcinoma (HNSCC).
  
  
  METHODS
  Immunohistochemistry of PTMA protein was performed in HNSCCs (n = 100), squamous cell hyperplasia (n = 116), dysplasia (n = 50) and histologically normal oral tissues (n = 100). Statistical analysis was carried out to determine the association of PTMA overexpression with clinicopathological parameters and disease prognosis over 7 years for HNSCC patients.
  
  
  RESULTS
  Our immunohistochemical analysis demonstrated significant overexpression of nuclear PTMA in squamous cell hyperplasia (63.8%), dysplasia (50%) and HNSCC (61%) in comparison with oral normal mucosa (p(trend)<0.001). Chi-square analysis showed significant association of nuclear PTMA with advanced tumor stages (III+IV). Kaplan Meier survival analysis indicated reduced disease free survival (DFS) in HNSCC patients (p<0.001; median survival 11 months). Notably, Cox-multivariate analysis revealed nuclear PTMA as an independent predictor of poor prognosis of HNSCC patients (p<0.001, Hazard's ratio, HR = 5.2, 95% CI = 2.3-11.8) in comparison with the histological grade, T-stage, nodal status and tumor stage.
  
  
  CONCLUSIONS
  Nuclear PTMA may serve as prognostic marker in HNSCC to determine the subset of patients that are likely to show recurrence of the disease.
authors.affiliation: Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Satyendra Chandra
authors.initials: SC
authors.lastname: Tripathi
authors.forename: Ajay
authors.initials: A
authors.lastname: Matta
authors.forename: Jatinder
authors.initials: J
authors.lastname: Kaur
authors.forename: Jorg
authors.initials: J
authors.lastname: Grigull
authors.forename: Shyam Singh
authors.initials: SS
authors.lastname: Chauhan
authors.forename: Alok
authors.initials: A
authors.lastname: Thakar
authors.forename: Nootan Kumar
authors.initials: NK
authors.lastname: Shukla
authors.forename: Ritu
authors.initials: R
authors.lastname: Duggal
authors.forename: Ajoy Roy
authors.initials: AR
authors.lastname: Choudhary
authors.forename: Siddhartha
authors.initials: S
authors.lastname: Dattagupta
authors.forename: Mehar Chand
authors.initials: MC
authors.lastname: Sharma
authors.forename: Ranju
authors.initials: R
authors.lastname: Ralhan
authors.forename: K W Michael
authors.initials: KW
authors.lastname: Siu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006258:Head and Neck Neoplasms / Q000378:metabolism* / Q000473:pathology*; D006801:Humans; D015151:Immunoblotting; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D011498:Protein Precursors / Q000378:metabolism*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013947:Thymosin / Q000031:analogs & derivatives* / Q000378:metabolism; D055815:Young Adult
chemical_list: D011498:Protein Precursors; C040782:prothymosin alpha; D013947:Thymosin