title: BMP-2 expression correlates with local failure in head and neck squamous cell carcinoma.
abstract: OBJECTIVE
  Preclinical data show that exogenous administration of recombinant human bone morphogenetic protein-2 (rhBMP-2) to human oral carcinoma cell lines increases pathogenicity using a nude mouse model. The objectives of this study are to (1) describe the characteristics of baseline protein expression of BMP-2 in head and neck squamous cell carcinomas (HNSCC) and (2) determine if BMP-2 expression level correlates with worse oncologic outcomes.
  
  
  METHODS
  Retrospective analysis of previously harvested patient samples.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  In total, 149 patients with oral cavity, oropharynx, larynx, and hypopharynx HNSCC treated between January 1, 1997, and December 31, 2004.
  
  
  METHODS
  A tissue microarray of HNSCC was assembled and immunohistochemistry for BMP-2 performed. Staining was quantified using a standardized scoring system. Specimens were dichotomized into high or low expression level. Statistical analyses using log-rank, Wilcoxon, and Fisher exact test were performed for associations between BMP-2 protein level and clinicopathologic features and patient survival.
  
  
  RESULTS
  BMP-2 expression at any level was noted in 146 of 149 (98%) of samples. Tumors with high BMP-2 expression had higher rates of local failure compared with low-expressing tumors (17.3% vs 6.3%; P = .04). There was no significant association for BMP-2 expression level with tumor location, T stage, N stage, overall survival, regional failure, or distant failure.
  
  
  CONCLUSIONS
  Head and neck squamous cell carcinomas with high baseline BMP-2 protein level are associated with higher rates of local recurrence. These data have important implications for using rhBMP-2 in tissue engineering reconstructive approaches in the setting of cancer-related defects.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA.
authors.forename: Jordan P
authors.initials: JP
authors.lastname: Sand
authors.forename: Natalia A
authors.initials: NA
authors.lastname: Kokorina
authors.forename: Stanislav O
authors.initials: SO
authors.lastname: Zakharkin
authors.forename: James S
authors.initials: JS
authors.lastname: Lewis
authors.forename: Brian
authors.initials: B
authors.lastname: Nussenbaum
mesh_terms: D055396:Bone Morphogenetic Protein 2 / Q000378:metabolism*; D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D015972:Gene Expression Regulation, Neoplastic; D006258:Head and Neck Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D006801:Humans; D007012:Hypopharyngeal Neoplasms; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms; D009062:Mouth Neoplasms / Q000378:metabolism / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000378:metabolism; D009959:Oropharyngeal Neoplasms / Q000378:metabolism; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D046888:Tissue Array Analysis
chemical_list: C525718:BMP2 protein, human; D055396:Bone Morphogenetic Protein 2
keywords: bone morphogenetic protein; squamous cell carcinoma