title: ERCC1 protein expression is associated with differential survival in oropharyngeal head and neck squamous cell carcinoma.
abstract: OBJECTIVE
  To investigate ERCC1 protein expression and its relationship to clinical factors and treatment outcomes in patients with head and neck squamous cell carcinoma (HNSCC).
  
  
  METHODS
  Case series.
  
  
  METHODS
  Tertiary care academic center.
  
  
  METHODS
  One hundred and seventy-six patients diagnosed with HNSCC and treated with intent to cure between 2002 and 2008 were analyzed with respect to clinical data and tumor pathology.
  
  
  METHODS
  Tissue microarrays were constructed from tumor blocks and immunohistochemical staining for ERCC1 performed. ERCC1 expression status was dichotomized into high and low using the Allred score. Clinical characteristics of patients with high versus low ERCC1 expression were compared. Distributions of overall survival (OS) and progression-free survival (PFS) were analyzed using the Kaplan-Meier method.
  
  
  RESULTS
  Of 176 patients, ERCC1 showed baseline nuclear staining in 148 patients (84.1%). Lower staining intensity ERCC1 expression was prominent in parabasal cells in the lower half of the epithelium, while at high staining intensity, ERCC1 expression was present throughout the epithelium. The median H-score was 50. No significant differences in age, gender, smoking status, tumor site, or stage were seen between the high and low ERCC1 expression groups. Expression of ERCC1 stratified by tumor site correlates with OS. Patients with oropharyngeal HNSCC and high ERCC1 expression (H-score > 120) were more likely to survive (P < .01) and remain disease free when compared to non-oropharyngeal squamous cell carcinoma (SCCa) patients with high ERCC1 expression despite treatment modality and human papillomavirus virus (HPV) status.
  
  
  CONCLUSIONS
  Patients with oropharyngeal SCCa and high ERCC1 expression may have better outcomes despite HPV status.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
authors.forename: Mihir R
authors.initials: MR
authors.lastname: Patel
authors.forename: Ni
authors.initials: N
authors.lastname: Zhao
authors.forename: Mei-Kim
authors.initials: MK
authors.lastname: Ang
authors.forename: Michael E
authors.initials: ME
authors.lastname: Stadler
authors.forename: Karen
authors.initials: K
authors.lastname: Fritchie
authors.forename: Mark C
authors.initials: MC
authors.lastname: Weissler
authors.forename: Adam M
authors.initials: AM
authors.lastname: Zanation
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Harris
authors.forename: William K
authors.initials: WK
authors.lastname: Funkhouser
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Olshan
authors.forename: Carol G
authors.initials: CG
authors.lastname: Shores
authors.forename: D Neil
authors.initials: DN
authors.lastname: Hayes
mesh_terms: D052685:Alphapapillomavirus / Q000302:isolation & purification; D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000401:mortality* / Q000821:virology; D004268:DNA-Binding Proteins / Q000378:metabolism*; D018572:Disease-Free Survival; D004720:Endonucleases / Q000378:metabolism*; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006258:Head and Neck Neoplasms / Q000378:metabolism* / Q000401:mortality* / Q000821:virology; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000378:metabolism / Q000401:mortality / Q000821:virology; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000378:metabolism* / Q000401:mortality* / Q000821:virology; D011379:Prognosis; D000077195:Squamous Cell Carcinoma of Head and Neck; D046888:Tissue Array Analysis; D016896:Treatment Outcome
chemical_list: D004268:DNA-Binding Proteins; C071447:ERCC1 protein, human; D004720:Endonucleases
keywords: ERCC1; HNSCC; HPV; head and neck squamous cell carcinoma; oropharyngeal cancer