title: Expression of secreted protein acidic and rich in cysteine is an independent prognostic indicator of a poor clinical outcome in oropharyngeal carcinoma patients.
abstract: CONCLUSIONS
  SPARC-expression is an indicator of the prognosis in terms of OS, independent of HPV-infection. HPV-negative patients with SPARC-Low show survival as favorable as HPV-positive patients, probably because of their higher salvage rate after relapse than SPARC-High patients.
  
  
  OBJECTIVE
  The objectives of the study were to clarify the correlation between the expression of secreted protein acidic and rich in cysteine (SPARC) and HPV-status, and to determine the prognostic value of SPARC-expression in oropharyngeal squamous cell carcinoma (OPSCC) patients.
  
  
  METHODS
  Fifty-three formalin-fixed and paraffin-embedded tissues were obtained from patients with OPSCC who underwent curative treatment. The SPARC protein was detected by immunohistochemistry. SPARC-expression level was divided into two categories, SPARC-High and SPARC-Low, according to the staining index.
  
  
  RESULTS
  Twenty-two out of the 53 OPSCC patients were HPV-positive. There was no significant correlation between the HPV-status and SPARC-expression level. Multivariate Cox proportional hazards regression analysis revealed that the HPV-status and SPARC-expression are independent prognostic indicators of favorable and unfavorable overall survival (OS) (p = 0.021 and p = 0.012), respectively. For disease-free survival, the HPV-status was the only predictive factor (p = 0.022). After stratification by the HPV-status, high SPARC-expression was a significant predictor of poor OS in HPV-negative OPSCC patients using Kaplan-Meier analysis and the log-rank test (p = 0.014). Ten out of 28 SPARC-Low patients relapsed, among which six patients (60%) were salvaged. However, 14 out of 25 SPARC-High patients relapsed, and only three patients (21.4%) were salvaged.
authors.affiliation: a Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science , Kanazawa University , Kanazawa , Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Yoshida
authors.affiliation: a Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science , Kanazawa University , Kanazawa , Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Wakisaka
authors.affiliation: a Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science , Kanazawa University , Kanazawa , Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Kondo
authors.affiliation: a Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science , Kanazawa University , Kanazawa , Japan.
authors.forename: Makiko
authors.initials: M
authors.lastname: Moriyama-Kita
authors.affiliation: a Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science , Kanazawa University , Kanazawa , Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Hirai
authors.affiliation: a Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science , Kanazawa University , Kanazawa , Japan.
authors.forename: Kazuhira
authors.initials: K
authors.lastname: Endo
authors.affiliation: a Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science , Kanazawa University , Kanazawa , Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Tsuji
authors.affiliation: a Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science , Kanazawa University , Kanazawa , Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Nakanishi
authors.affiliation: a Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science , Kanazawa University , Kanazawa , Japan.
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Murono
authors.affiliation: a Division of Otolaryngology-Head and Neck Surgery, Graduate School of Medical Science , Kanazawa University , Kanazawa , Japan.
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Yoshizaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000096:biosynthesis / Q000235:genetics; D004273:DNA, Neoplasm / Q000235:genetics*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000235:genetics* / Q000401:mortality / Q000473:pathology; D015676:Osteonectin / Q000096:biosynthesis / Q000235:genetics*; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; D015676:Osteonectin; C577241:SPARC protein, human
keywords: Oropharyngeal carcinoma; human papillomavirus; prognostic indicator; secreted protein acidic and rich in cysteine