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Nomogram for risk prediction of malignant transformation in oral leukoplakia patients using combined biomarkers

Authors
 Xianglan Zhang  ;  Ki-Yeol Kim  ;  Zhenlong Zheng  ;  Shadavlonjid Bazarsad  ;  Jin Kim 
Citation
 ORAL ONCOLOGY, Vol.72 : 132-139, 2017 
Journal Title
 ORAL ONCOLOGY 
ISSN
 1368-8375 
Issue Date
2017
MeSH
Adult ; Aged ; Aged, 80 and over ; Biomarkers/metabolism* ; Carcinoma, Squamous Cell/metabolism ; Carcinoma, Squamous Cell/pathology* ; Cell Transformation, Neoplastic* ; Female ; Humans ; Leukoplakia, Oral/metabolism ; Leukoplakia, Oral/pathology* ; Male ; Middle Aged ; Mouth Neoplasms/pathology* ; Retrospective Studies ; Risk Factors
Keywords
Carbonic anhydrase (CA9) ; Nomogram ; Oral leukoplakia ; P53 ; Risk prediction
Abstract
OBJECTIVE: Squamous cell carcinomas (SCC) are the most common malignancies in the oral mucosa; these carcinomas have been preceded by potentially malignant oral disorders (PMODs), mostly oral leukoplakia (OL). No specific biomarker has been widely accepted for predicting the risk of malignant transformation of PMODs. The aim of this study was to develop an accurate prediction model for the malignant transformation of OL using clinical variables and candidate biomarkers. MATERIALS AND METHODS: To achieve this goal, 10 candidate biomarkers that had previously been reported as useful molecules were investigated: P53, Ki-67, P16, β-catenin, c-jun, c-met, insulin like growth factor II mRNA-binding protein (IMP-3), cyclooxygenase (COX-2), podoplanin (PDPN) and carbonic anhydrase 9 (CA9). For this study, malignant transformed (n=22, median interval of malignant conversion: 3.3years) and untransformed (n=138) OL specimens with median follow-up period of 11.3years (range: 4.6-23.2years) were immunohistochemically stained. RESULTS: Using univariate Cox regression analysis, all biomarkers were proven to be significant for predicting malignant transformation in OL. To reach the highest prediction accuracy, the repeated simulation was performed, revealing that the combination of P53 and CA9 with the clinical factors including age and degree of dysplasia achieved the highest prediction accuracy. We constructed a nomogram with the identified prognostic factors for predicting the 5-, 10-, and 15-year progression free survival of OL. CONCLUSIONS: The proposed nomogram may be useful for the accurate and individual prediction of the transformation to SCC in OL patients and may help clinicians offer appropriate treatments and follow up.
Full Text
https://www.sciencedirect.com/science/article/pii/S1368837517302063
DOI
10.1016/j.oraloncology.2017.07.015
Appears in Collections:
2. College of Dentistry (치과대학) > Others (기타) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Oral Pathology (구강병리학교실) > 1. Journal Papers
5. Research Institutes (연구소) > Oral Cancer Research Institute (구강종양연구소) > 1. Journal Papers
Yonsei Authors
Kim, Ki Yeol(김기열) ORCID logo https://orcid.org/0000-0001-5357-1067
Kim, Jin(김진)
Zhang, Xiang Lan(장향란)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160448
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