The use of CA-IX as a diagnostic method for oral leukoplakia
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1
University of Santiago de Compostela, Spain
Background and aim. Leukoplakia is currently defined based on an essentially clinical, giving a provisional diagnosis of "leukoplakia" and a definitive diagnosis that requires the removal of etiologic factors, being considered as a potentially malignant disorder. Although the presence and degree of dysplasia is the most important prognostic criteria, its valuation is difficult and subjective, with a remarkable variability among different observers. CA-IX is expressed primarily in tumor cells, hence it´s considered as a high specificity hypoxia marker in tumors. The aim of this work is to determine the role of CA-IX in the diagnosis, prognosis, course, and treatment protocol/monitoring of leukoplakia.
Methods. The sample consisted of 30 specimens of oral leukoplakia and 35 dysplasias adjacent to tumor resective margin. Clinical variables analyzed included age, sex, degree of dysplasia, smoking, clinical appearance of leukoplakia, number of lesions, location, size, clinical monitoring, malignant transformation and recurrence. For the immunohistochemical study, we used a non-commercial monoclonal antibody against human CA-IX MAb M75
Results. There is a higher positivity for CA-IX in women, non-smokers, erythroplakia-peckled leukoplakia, those located on the tongue, patients with multiple lesions, leukoplakia 2-4 cm and in the recurrent, though no statistically significant differences. The most remarkable thing is that in the whole sample (N = 65) all lesions without dysplasia were negative for CA-IX, however for all other categories of dysplasia there are varying percentages of positivity/negativity (p = 0.05). Regarding the diagnoses index values, we obtain a sensitivity of 32%, specificity 100%, positive predictive value 100% and negative predictive value of 13%.
Conclusions / Discussion. Leukoplakias appear mainly in females and are a potentially malignant disorder, more than 90% have some degree of dysplasia, and therefore require strict clinical (especially those located in the tongue) and histo-pathological monitoring. The guideline should not be based solely on the degree of dysplasia, since many other factors can affect their prognosis. The use of CA-IX as immunohistochemical marker may be useful at the time of screening samples without dysplasia, due to its high specificity as a diagnostic test.
References
1. Neri DCT Supuran (2011) Interfering with pH regulation in tumours as a therapeutic strategy. Nat.Rev.Drug Discov. 10: 767-777.
2. Pastorekova S, Z Zavadova, M Kostal, O BabusikovaJ Zavada (1992) A novel quasi-viral agent, MaTu, is a two-component system. Virology 187: 620-626.
3. Perez-Sayans M, JM Suarez-Penaranda, GD Pilar, CT Supuran, S Pastorekova, F Barros-Angueira, JM Gandara-ReyA Garcia-Garcia (2012) Expression of CA-IX is associated with advanced stage tumors and poor survival in oral squamous cell carcinoma patients. J.Oral Pathol.Med. 41: 667-674.
Keywords:
CA-IX,
oral squamous cell carcinoma,
Leukoplakia, Oral,
Immunohistochemistry,
Head and Neck Neoplasms
Conference:
4th Annual Meeting of the International Society of Proton Dynamics in Cancer, Garching, Germany, 10 Oct - 12 Oct, 2013.
Presentation Type:
Abstract
Topic:
9. Acidity as a target for antitumor therapy
Citation:
Pérez Sayáns
M,
Suárez-Penaranda
JM,
Gándara-Vila
P,
Torres-López
M and
García-García
A
(2014). The use of CA-IX as a diagnostic method for oral leukoplakia.
Front. Pharmacol.
Conference Abstract:
4th Annual Meeting of the International Society of Proton Dynamics in Cancer.
doi: 10.3389/conf.fphar.2014.61.00038
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Received:
14 Jan 2014;
Published Online:
07 Feb 2014.
*
Correspondence:
Prof. Mario Pérez Sayáns, University of Santiago de Compostela, Santiago de Compostela, Spain, perezsayans@gmail.com