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AXIN2 and SNAIL expression predict the risk of recurrence in cutaneous squamous cell carcinoma after Mohs micrographic surgery

Authors
 Guohua Zhao  ;  Ki-Yeol Kim  ;  Zhenlong Zheng  ;  Yeongjoo Oh  ;  Dae San Yoo  ;  Myung Eun Lee  ;  Kee Yang Chung  ;  Mi Ryung Roh  ;  Zhehu Jin 
Citation
 ONCOLOGY LETTERS, Vol.19(3) : 2133-2140, 2020-03 
Journal Title
 ONCOLOGY LETTERS 
ISSN
 1792-1074 
Issue Date
2020-03
Keywords
SNAIL ; axis inhibition protein 2 ; cutaneous squamous cell carcinoma patients ; mohs micrographic surgery ; predictive nomogram ; recurrence
Abstract
Recurrence is a common complication observed during cutaneous squamous cell carcinoma (cSCC) treatment; however, biomarkers for predicting recurrence in cSCC remain unknown. The present study aimed to investigate the predictive value of axis inhibition protein 2 (AXIN2) and SNAIL expression in cSCC recurrence. AXIN2 and SNAIL expression was evaluated using immunohistochemistry in 111 cSCC tissue samples obtained from 18 patients who presented recurrence (recurrence interval, 1-91 months) and 93 patients who did not experience recurrence following Mohs micrographic surgery (MMS) during the follow-up period (156 months). Nomogram construction was performed using patients' clinicopathological characteristics and AXIN2 and SNAIL protein expression. The results demonstrated that high AXIN2 (histoscore >100) and SNAIL (histoscore >100) expression was detected in 35 and 44 cSCC tissues, respectively. Furthermore, the expression levels of AXIN2 and SNAIL were significantly associated in patients with cSCC (P=0.001). AXIN2 and SNAIL expression levels were significantly associated with tumor size (P=0.021 and P=0.044, respectively) and recurrence of cSCC (P=0.017 and P=0.042, respectively). In addition, the results of the Kaplan-Meier curve analysis revealed that recurrence-free survival was significantly associated with tumor size (P=0.025), differentiation status (P<0.001), AXIN2 expression (P=0.001) and SNAIL expression (P=0.001). Furthermore, the results of the multivariate analysis demonstrated that age (P=0.043), AXIN2 expression (P=0.001) and SNAIL expression (P=0.045) were independent risk factors for cSCC recurrence in the present cohort. A nomogram for predicting the 1-, 2-, 3-, and 5-year recurrence-free survival was developed for patients with cSCC by including independent risk factors with a concordance index of 0.75. The results suggested that high AXIN2 and SNAIL expression may be considered as potential risk factors for cSCC recurrence. This nomogram may therefore be useful to assess the probability of recurrence in patients with cSCC following MMS.
Files in This Item:
T202001183.pdf Download
DOI
10.3892/ol.2020.11324
Appears in Collections:
2. College of Dentistry (치과대학) > Others (기타) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Dermatology (피부과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ki Yeol(김기열) ORCID logo https://orcid.org/0000-0001-5357-1067
Roh, Mi Ryung(노미령) ORCID logo https://orcid.org/0000-0002-6285-2490
Oh, Yeongjoo(오영주) ORCID logo https://orcid.org/0000-0003-4973-9335
Chung, Kee Yang(정기양) ORCID logo https://orcid.org/0000-0003-3257-0297
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/176013
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