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Different topoisomerase IIa protein expression patterns affect prognosis in tongue squamous cell carcinoma: a quantitative digital image analysis study
Author(s) -
Machaira A.,
Tsiambas E.,
Goula K.,
Chrysomali E.,
Nikolatou O.,
Manaios L.,
Rapidis A.D.,
Karameris A.,
Patsouris E.
Publication year - 2008
Publication title -
oral surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.156
H-Index - 11
eISSN - 1752-248X
pISSN - 1752-2471
DOI - 10.1111/j.1752-248x.2008.00033.x
Subject(s) - immunohistochemistry , topoisomerase , medicine , cancer research , pathology , cell , gene , dna , biology , genetics
Aim: Topoisomerases represent a class of nucleic enzymes involved in the DNA replication, transcription and also chromosome topological formation. Topoisomerase IIa (Topo Iia – gene location 17q21) inhibition promotes cell death and for this reason, it is a target for specific chemotherapy (anthracyclines, podophyllotoxines). Our aim was to investigate the potential prognostic significance of its protein expression in squamous cell carcinomas of the tongue (TSCCs) based on a quantitative, digital image analysis method. Materials and methods: We analysed immunohistochemically eighty‐seven ( n = 87) archival, primary TSCCs using a monoclonal anti‐Topo IIa antibody. A computerised image analysis assay was applied for the evaluation of the results [nuclear labelling index (NLI)]. Survival analysis was also performed. Results: Topo IIa protein was overexpressed in 48/87 (55.1%) cases. High NLI values were detected in 17/48 (35.4%), whereas moderate levels of expression were detected in 31/48 (64.6%) cases. Statistical significance was not assessed correlating overall protein expression to grade or stage of the examined tumours ( P = 0.88, P = 0.73, respectively), but only to the anatomical region ( P = 0.04). Cox regression analysis showed that Topo IIa and also the size of the tumours were strongly associated to the survival of the patients ( P = 0.01, P = 0.02, respectively). Conclusions: Topo IIa protein overexpression is a frequent event in TSCCs. Topo IIa may be used as a prognostic factor and also as a basis for targeted chemotherapy strategies in TSCCs. Furthermore, digital image analysis improves the quantification of immunohistochemical stains in an accurate and fast way.