Prognostic Value of Cyclin-D1 Expression in Head-a nd-Neck Squamous Cell Carcinoma: A Half-Decade Follow-Up

Abstract

Objective: To check the expression pattern of cyclin-D1 in stage I head and neck squamous cell carcinoma (H.N.S.C.C.) cases (evaluated based on history, clinical, medical, and radiological records) in our setting and evaluate the role of cyclin-D1 as a prognostic marker of H.N.S.C.C. (considering recurrence within five years and metastasis). Study Design: Retrospective cohort study. Place and Duration of Study: The study was carried out at Armed Forces Institute of Pathology (A.F.I.P.)Rawalpindi working in conjunction with the Department of Radiation Oncology, Rawalpindi. The duration of study was from 7 March 2022-14 October 2022. Materials and Methods: The study comprised 92 patients from year 2015-16 of stage I diagnosed with squamous cell carcinoma of head and neck with complete five-year follow-up after fulfilling the inclusion and exclusion criteria. After collecting and matching the data on follow-up with record of the patients from Department of Radiation Oncology, C.M.H., Rawalpindi; paraffin-embedded blocks of these patients from year 2015/2016 were retrieved. Fresh Hematoxylin and Eosin (H&E) slides were prepared, and diagnosis was reconfirmed, vimentin stain was applied to check the antigenicity of the tissue followed by application of cyclin-D1 immuno-histochemical marker (I.H.C.) marker with controls to check the expression pattern. Results: In our study we included a total of 92 diagnosed cases of stage I H.N.S.C.C. with a complete 5-year follow-up. Out of 92 cases male to female ratio was almost 3:1 with males comprising a total of 68 (73.9%) and females comprising 24 (26.1%). Mean age of patients was 62.48+ 11.439 years. Larynx was the most frequently involved site 34.8% (n=32), followed by tongue 23.9% (n=22) and buccal mucosa 13.0% (n=12). Cyclin-D1expression and tumor grade were revealed to have a statistically significant clinicopathological relationship (p value 0.001). A statistically significant association between the expression of cyclin-D1 and tumor recurrence (p value < 0.001) and duration of tumor recurrence (p value 0.003) was seen. The cyclin-D1 expression was also compared with metastasis which was also statistically significant (p value 0.003). Conclusion: An increased risk of metastasis and recurrence is linked to increased levels of cyclin-D1 expression in the early years. Hence it is valuable to include cyclin-D1 expression in the initial diagnostic work up of H.N.S.C.C. for an early prognostic assessment. Further use of these results could be made for targeted treatment of head and neck malignancies.

Keywords

• cyclin-d1, five-year follow-up, head-and-neck squamous cell carcinoma, immuno-histochemical expression, prognosis.