title: Immunopositivity of Beclin-1 and ATG5 as indicators of survival and disease recurrence in oral squamous cell carcinoma.
abstract: OBJECTIVE
  To evaluate the expression and prognostic value of two autophagy-related (Atg) proteins, Beclin-1 and Atg5, in human oral squamous cell carcinoma (OSCC) and to correlate findings with clinical outcomes.
  
  
  METHODS
  Immunohistochemistry for Beclin-1 and Atg5 was assessed in tumor specimens from 90 patients with OSCC. Immunopositivity was semi-quantitatively scored and receiver-operating characteristic curve analysis was used to determine the cut-off positivity score.
  
  
  RESULTS
  55 (61.1%) and 52 (57.8%) cases showed positive Beclin-1 and Atg5 staining, respectively. 40 tumors (44.4%) were positive for both Beclin-1 and Atg5 expression and 23 cases (25.6%) showed absence of both proteins. Beclin-1 expression significantly correlated with tumor grade (p=0.008) and lymph node metastasis (p=0.009). The expression of Atg5 was associated with tumor grade (p=0.016), advanced clinical stage (p<0.001), large tumor size (p=0.002), and lymph node metastasis (p<0.001). A significant difference in 3-year OS (p=0.050) and TTR (p=0.049) between the patients with Beclin-1 expression and those not showing Beclin-1 expression was found whereas the difference did not reach a statistical significance for Atg5 expression. 3-year OS and TTR differed significantly between patients with dual expression and those with double-negative expression (p=0.022 and p=0.026, respectively).
  
  
  CONCLUSIONS
  Dual expression of tumor Beclin-1 and Atg5 expression may be an adverse prognostic indicator for OSCC.
authors: Department of Pathology, St. Martin De Porres Hospital, No. 565, Sec. 2, Daya Road, Chiayi, Taiwan. chu.peiyi@msa.hinet.net or Dr. Chee-Yin Chai, Department of Pathology, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Kaohsiung, Taiwan. E-mail: cychai@kmu.edu.tw.
authors: Jen-Yang
authors: JY
authors: Tang
authors: Yong-Yuan
authors: YY
authors: Fang
authors: Edward
authors: E
authors: Hsi
authors: Ya-Chun
authors: YC
authors: Huang
authors: Nicholas Chung-Heng
authors: NC
authors: Hsu
authors: Wen-Chi
authors: WC
authors: Yang
authors: Hsueh-Wei
authors: HW
authors: Chang
authors: Chee-Yin
authors: CY
authors: Chai
authors: Pei-Yi
authors: PY
authors: Chu
mesh_terms: D000368:Aged; D051017:Apoptosis Regulatory Proteins / Q000378:metabolism*; D000071187:Autophagy-Related Protein 5; D000071186:Beclin-1; D002294:Carcinoma, Squamous Cell / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008565:Membrane Proteins / Q000378:metabolism*; D008869:Microtubule-Associated Proteins / Q000378:metabolism*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000378:metabolism / Q000473:pathology*; D012008:Recurrence
chemical_list: C502778:ATG5 protein, human; D051017:Apoptosis Regulatory Proteins; D000071187:Autophagy-Related Protein 5; C491997:BECN1 protein, human; D000071186:Beclin-1; D008565:Membrane Proteins; D008869:Microtubule-Associated Proteins
keywords: ATG5; Autophagy; beclin-1; immunohistochemistry; oral cancer