Biomarker and Pathologic Predictors of Cutaneous Squamous Cell Carcinoma Aggressiveness.
Aggressive cutaneous squamous cell carcinoma (cSCC) patients are at increased risk of metastasis. Currently, there are no accepted criteria or biomarkers for reliably predicting individuals at risk for recurrence and metastasis. Our objective is to determine if pS6 and pERK can predict cSCC aggressiveness and to identify primary tumor characteristics that may predict parotid metastasis.



Retrospective case series.



Tertiary care center.



An Institutional Review Board-approved retrospective review was performed for patients with facial cSCC, with and without metastasis to the parotids. Subjects for the study were identified through the Louisiana Tumor Registry, Veterans Medical Records, and LSU Health-Shreveport pathology database. Tumor specimens from patients with cSCC and cSCC with parotid metastasis were analyzed for pERK and pS6 expression through immunohistochemistry. To identify risk factors for tumor aggressiveness, multiple logistic regression analysis was used to evaluate patients with cSCC that was metastatic to the parotid and managed surgically.



cSCC with parotid metastasis specimens exhibited significantly higher average pS6 but not pERK positivity than those from cSCC without metastasis (P < .05). Primary lesion-positive margins (P < .01), size of the skin tumor (P < .01) and degree of tumor differentiation (P < .01) were significantly associated with parotid metastasis.



Surgical history of cSCC, primary lesion-positive margins, degree of differentiation, and lesion size together with pS6 positivity appear to be predictors of cSCC aggressiveness and should prompt increased monitoring or elective parotidectomy.
Department of Otolaryngology-Head and Neck Surgery, LSU-Health Shreveport, Shreveport, Louisiana, USA.
Alok R
AR
Khandelwal
Department of Otolaryngology-Head and Neck Surgery, LSU-Health Shreveport, Shreveport, Louisiana, USA.
Xiaohui
X
Ma
Department of Otolaryngology-Head and Neck Surgery, LSU-Health Shreveport, Shreveport, Louisiana, USA Department of Surgery, Overton Brooks Veterans Medical Center, Shreveport, Louisiana, USA.
Paige
P
Egan
School of Medicine, LSU Health-Shreveport, Shreveport, Louisiana, USA.
Nadine M
NM
Kaskas
Department of Otolaryngology-Head and Neck Surgery, LSU-Health Shreveport, Shreveport, Louisiana, USA.
Tara
T
Moore-Medlin
Department of Neurology and Biometry, LSU-Health Shreveport, Shreveport, Louisiana, USA.
Gloria
G
Caldito
Department of Pathology, LSU-Health Shreveport, Shreveport, Louisiana, USA.
Fleurette
F
Abreo
Department of Pathology, LSU-Health Shreveport, Shreveport, Louisiana, USA.
Xin
X
Gu
Department of Surgery, Overton Brooks Veterans Medical Center, Shreveport, Louisiana, USA.
Lurie
L
Aubrey
Department of Surgery, Overton Brooks Veterans Medical Center, Shreveport, Louisiana, USA.
Edward
E
Milligan
Department of Otolaryngology-Head and Neck Surgery, LSU-Health Shreveport, Shreveport, Louisiana, USA Department of Surgery, Overton Brooks Veterans Medical Center, Shreveport, Louisiana, USA cnatha@lsuhsc.edu.
Cherie-Ann O
CA
Nathan
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D002294:Carcinoma, Squamous Cell / Q000556:secondary* / Q000601:surgery; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008145:Louisiana / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D010307:Parotid Neoplasms / Q000556:secondary* / Q000601:surgery; D012042:Registries; D012189:Retrospective Studies; D019893:Ribosomal Protein S6 Kinases / Q000032:analysis; D018570:Risk Assessment; D012307:Risk Factors; D012878:Skin Neoplasms / Q000473:pathology*; D019892:eIF-2 Kinase / Q000032:analysis
D014408:Biomarkers, Tumor; D019893:Ribosomal Protein S6 Kinases; D019892:eIF-2 Kinase
biomarker; cutaneous squamous cell carcinoma; pERK; ps6