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Snail and Axin2 expression predict the malignant transformation of oral leukoplakia

 Xianglan Zhang  ;  Ki-Yeol Kim  ;  Zhenlong Zheng  ;  Hyun Sil Kim  ;  In Ho Cha  ;  Jong In Yook 
 ORAL ONCOLOGY, Vol.73 : 48-55, 2017 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Axin Protein/genetics* ; Biomarkers, Tumor/metabolism* ; Cell Transformation, Neoplastic/genetics* ; Epithelial-Mesenchymal Transition ; Female ; Humans ; Leukoplakia, Oral/genetics ; Leukoplakia, Oral/pathology* ; Male ; Middle Aged ; Retrospective Studies ; Snail Family Transcription Factors/genetics* ; Young Adult
Axin2 ; Malignant transformation ; Nomogram ; Oral leukoplakia ; Risk prediction ; Snail
OBJECTIVES: Oral leukoplakia (OL) has a well-documented potential risk of malignant transformation into oral squamous cell carcinoma (OSCC), although biomarker(s) predicting malignant potential are limited in capability. The aim of this cross-sectional and retrospective cohort study was to investigate the predictive role of canonical Wnt genes Axin2 and Snail (SNAI1) expression in the malignant transformation of OL lesions.

MATERIALS AND METHODS: The expression of epithelial-mesenchymal transition (EMT) genes Snail and Axin2, which are regulated by the canonical Wnt pathway, were determined using immunohistochemical staining in an OL cohort consisting of 154 samples of patients with long-term follow-up and then evaluated as risk factors for malignant transformation of OL.

RESULTS: Increased Axin2 and Snail abundance were found in 107 (69.5%) and 58 (37.7%) of OL patients, respectively. In a multivariate analysis using gender, age, lesion site, Axin2, and Snail as cofactors, both Axin2 and Snail were independent risk factors for malignant transformation with a hazard ratio of 7.47 (95% confidence interval, 2.23-25.02; P=0.001) and 4.41 (95% confidence interval, 1.78-10.93; P=0.001), respectively. A nomogram for predicting 5-, 10-, and 15-year cancer-free survival probability was developed in patients with OL by including gender, age, lesion site, Axin2, and Snail expression with ac-index of 0.760.

CONCLUSION: The increased abundance of Snail and Axin2 is highly correlated to malignant transformation of OL, making them novel biomarker(s) predicting oral cancer development.
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2. College of Dentistry (치과대학) > Research Institute (부설연구소) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Oral Pathology (구강병리학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Oral and Maxillofacial Surgery (구강악안면외과학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Others (기타) > 1. Journal Papers
Yonsei Authors
Kim, Ki Yeol(김기열) ORCID logo
Kim, Hyun Sil(김현실) ORCID logo
Yook, Jong In(육종인) ORCID logo
Zhang, Xiang Lan(장향란)
Zheng, Zhen Long(정진룡)
Cha, In Ho(차인호) ORCID logo
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