title: MCM2/TOP2A (ProExC) immunohistochemistry as a predictive marker in head and neck mucosal biopsies.
abstract: Mucosal biopsies from the head and neck are often small and poorly oriented, which impedes diagnostic interpretation, especially in patients with a history of cancer, being monitored for recurrence. A cocktail of antibodies targeted against DNA topoisomerase IIA and mini-chromosome maintenance protein 2 (MCM2/TOP2A, ProExC), markers of aberrant S-phase induction, have been used with success as a diagnostic adjunct in the evaluation of squamous dysplasia of the uterine cervix. We tested the utility in head and neck biopsies to see if ProExC could be used to discriminate reactive/inflammatory from true pre-neoplasia. Sixty-four archival biopsies were selected from patients who presented to the surgeon with an indication for biopsy to "rule out" dysplasia. Histologically, all biopsies showed nonspecific atypia that was difficult to discriminate from dysplasia. Twenty-three of the patients progressed to squamous carcinoma and the rest remained benign over five years follow-up. Cases stained with ProExC by IHC methods showed a significant pattern of expression (p=0.026). The staining was greatest in patients without a history of prior head and neck cancer but was not significant. Our results show that ProExC, used in conjunction with the H&E slide, can enhance the predictive power of a mucosal biopsy in a cohort of patients.
authors.affiliation: Department of Pathology, Dartmouth Hitchcock Medical Center, United States.
authors.forename: Erik G
authors.initials: EG
authors.lastname: Jenson
authors.affiliation: Department of Pathology, Cincinnati Children's Hospital Medical Center, United States.
authors.forename: Michael
authors.initials: M
authors.lastname: Baker
authors.affiliation: Head and Neck Surgery, Dartmouth Hitchcock Medical Center, United States.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Paydarfar
authors.affiliation: Head and Neck Surgery, Dartmouth Hitchcock Medical Center, United States.
authors.forename: Benoit J
authors.initials: BJ
authors.lastname: Gosselin
authors.affiliation: Section of Biostatistics and Epidemiology, Norris Cotton Cancer Center, United States.
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Pathology, Dartmouth Hitchcock Medical Center, United States. Electronic address: Candice.C.Black@hitchcock.org.
authors.forename: Candice C
authors.initials: CC
authors.lastname: Black
mesh_terms: D000951:Antigens, Neoplasm / Q000032:analysis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000737:chemistry* / Q000473:pathology; D016022:Case-Control Studies; D004250:DNA Topoisomerases, Type II / Q000032:analysis*; D004268:DNA-Binding Proteins / Q000032:analysis*; D003937:Diagnosis, Differential; D018450:Disease Progression; D006258:Head and Neck Neoplasms / Q000737:chemistry* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D064111:Minichromosome Maintenance Complex Component 2 / Q000032:analysis*; D009092:Mucous Membrane / Q000737:chemistry* / Q000473:pathology; D000075223:Poly-ADP-Ribose Binding Proteins; D011230:Precancerous Conditions / Q000737:chemistry* / Q000473:pathology; D011237:Predictive Value of Tests; D000077195:Squamous Cell Carcinoma of Head and Neck; D013997:Time Factors
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D004268:DNA-Binding Proteins; D000075223:Poly-ADP-Ribose Binding Proteins; C084859:MCM2 protein, human; D064111:Minichromosome Maintenance Complex Component 2; D004250:DNA Topoisomerases, Type II; C000618811:TOP2A protein, human
keywords: Biopsy interpretation; Dysplasia; Head and Neck; Immunohistochemisty; ProExC