Immunoexpression of HSP27 does not seem to influence the prognosis of oral tongue squamous cell carcinoma

Torres, Ondina Karla Mousinho Rocha; Silva, Luiz Arthur Barbosa da; Freitas, Roseana de Almeida; Silveira, Éricka Janine Dantas da; Miguel, Márcia Cristina da Costa

doi:10.1590/0103-6440202305036

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ARTICLE • Braz. Dent. J. 34 (5) • Sep-Oct 2023 • https://doi.org/10.1590/0103-6440202305036 copy

Immunoexpression of HSP27 does not seem to influence the prognosis of oral tongue squamous cell carcinoma

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

New methods of early detection and risk assessment have been studied aiming to predict the prognosis of patients and directing a specialized treatment of the oral tongue squamous cell carcinoma (OTSCC). In this context, several molecular biomarkers have been investigated for this purpose, and, among them, the heat shock protein 27 (HSP27) can be named. The study aimed to analyze whether heat shock protein 27 (HSP27) exerts any influence on OTSCC, correlating its immunoexpression with clinicopathological parameters, and patient survival. The sample comprised 55 OTSCC cases and 20 normal oral mucosa specimens. The malignancy grading systems proposed by the WHO in 2005, Brandwein-Gensler et al., and Almangush et al. were applied in a histomorphological study. HSP27 expressions were evaluated through the Immunoreactivity Score System (IRS). Significant values were considered at p <0.05 for all statistical tests. Higher IRS results were observed for normal oral mucosa specimens when compared to OTSCC cases (p <0.001). No significant associations between HSP27 immunostaining, the analyzed clinicopathological parameters and patient survival were observed. The results of the present study indicate lower HSP27 expression in OTSCC cases compared to normal oral mucosa specimens. Thus, HSP27 expression does not seem to influence patient prognosis.

Key Words:
squamous cell carcinoma; tongue; immunohistochemistry; heat-shock proteins; prognosis

Parameter	n (%)
Sex
Male	37 (67.3)
Female	18 (32.7)
Age
Up to 60 years old	22 (40.0)
≥ 60 years old	33 (60.0)
Smoking
No	4 (7.3)
Yes	42 (76.4)
Not informed	9 (16.3)
Alcoholics
No	17 (31.0)
Yes	29 (52.7)
Not informed	9 (16.3)
Tumor size (T)
T₁ -T₂	34 (61.8)
T₃ -T₄	17 (30.1)
Not informed	4 (8.1)
Lymph node involvement (N)
N(-)	31 (56.4)
N(+)	20 (36.3)
Not informed	4 (7.3)
Distant metastasis (M)
M(-)	50 (90.9)
M(+)	0 (0.0)
Not informed	5 (9.1)
Local recurrence
Absent	42 (76.4)
Present	13 (23.6)
Second primary tumor
Absent	50 (90.9)
Present	5 (9.1)
Lymph node metastasis after treatment
Absent	50 (90.9)
Present	5 (9.1)
WHO grading
Well differentiated	31 (56.4)
Moderately differentiated	16 (29.1)
Poorly differentiated	8 (14.5)
Brandwein-Gensler risk
Low risk	1 (1.8)
Intermediate Risk	30 (54.5)
High risk	24 (43.6)
BD model
Low risk	3 (5.5)
Intermediate Risk	14 (25.5)
High risk	38 (69.0)

	Group	N	Median	Q25-75	Ranks	P
IRS	OTSCC	55	3.0	2.0-4.0	30.34	<0.001*
IRS	Normal oral mucosa	20	8.0	4.5-11.0	59.08	<0.001*

Parameter	HSP27		P
Parameter	Up to 4.0n (%)	>4.0n (%)	P
Categorized T *
T1-T2	28 (82,3)	6 (17.7)	1.000
T3-T4	14 (82.3)	3 (17.7)	1.000
Categorized N *
N(-)	27 (87.0)	4 (13.0)	0.289
N(+)	15 (75.0)	5 (25.0)	0.289
Clinical Staging *
I-II	20 (86.9)	3 (13.1)	0.487
III-IV	22 (78.5)	6 (21.5)	0.487
Local recurrence
Absent	35 (83.3)	7 (16.7)	0.100
Present	11 (84.6)	2 (15.4)	0.100
Second primary tumor
Absent	42 (84.0)	8(16.0)	1.000
Present	4 (80.0)	1 (20.0)	1.000
Lymph node metastasis after treatment
Absent	43 (86.0)	7 (14.0)	0.184
Present	3 (60.0)	2 (40.0)	0.184
Distant metastasis after treatment
Absent	45 (84.9)	8 (15.1)	0.303
Present	1 (50.0)	1 (50.0)	0.303
WHO staging
Well / Moderate	38 (80.8)	9 (19.2)	0.327
Poorly	8 (100.0)	0 (0.0)	0.327
Brandwein-Gensler risk
Low / Intermediate	25 (80.6)	6 (19.4)	0.716
High	21 (87.5)	3 (12.5)	0.716
BD model
Low / Intermediate	15(88.2)	2(11.8)	0.705
High	31(81.5)	7(18.5)	0.705

Parameter	Death			p
Parameter	No n (%)		Yes n (%)	p
WHO staging Well / Moderate Poorly	32(80.0) 8(20.0)		15(100.0) 0(0.0)	0.091
Brandwein-Gensler risk Low / Intermediate High	25 (62.5) 15 (37.5)		6 (40.0) 9 (60.0)	0.134
BD model Low / Intermediate High	16 (40.0) 24 (60.0)		1 (6.7) 14 (93.3)	0.022*
HSP27 Up to 4 Over 4	33 (82.5) 7 (17.5)		13 (86.7) 2 (13.3)	1.000
Parameter	No. of deaths	Overall survival in 5 years (95% CI)	HR (95% CI)	P
WHO staging Well / Moderate Poorly	15 0	60.37 (42.31-74.37) 100.0	a	0.062
Brandwein-Gensler risk Low / Intermediate High	6 9	74.68 (50.93 - 88.13) 57.43 (33.70 - 75.37)	1.93 (0.68 - 5.43)	0.197
BD model Low / Intermediate High	1 14	88.89 (43.30 - 98.36) 56.96 (37.94 - 72.12)	7.62 (1.01 - 58.14)	0.019*
HSP27 Up to 4 Over 4	13 2	65.20 (47.24 - 78.35) 76.19 (33.22 - 93.51)	0.78 (0.17 - 3.49)	0.751
Parameter	No. of events	Five-year disease-free survival (95% CI)	HR (95% CI)	P
WHO staging Well / Moderate Poorly	25 2	35.98 (20.96-51.23) 71.43 (25.82-91.98)	0.27 (0.06-1.15)	0.054
Brandwein-Gensler risk Low / Intermediate High	14 13	42.50 (22.36 -61.35) 38.79 (18.55 -58.72)	1.27 (0.59 - 2.70)	0.526
BD model Low / Intermediate High	7 20	41.79 (14.51-67.40) 39.76 (23.08 -55.98)	1.62 (0.68 - 3.85)	0.257
HSP27 Up to 4 Over 4	22 5	42.05 (25.95-57.32) 33.86 (5.75 -66.35)	1.28 (0.48 - 3.39)	0.612

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[1] Correspondence: Márcia Cristina da Costa Miguel; Postgraduate Program in Dental Sciences, Federal University of Rio Grande do Norte; Address: Av. Salgado Filho, 1787, Lagoa Nova - Natal/RN. Zip code: 59056-000. Telephone: 55 84 3215-4138. E-mail: mccmiguel@hotmail.com