ORIGINAL ARTICLE

Expression profiling and prediction of distant metastases in head and neck squamous cell carcinoma

B J M Braakhuis¹, A Senft¹, R de Bree¹, J de Vries¹, B Ylstra², J Cloos³, D J Kuik⁴, C R Leemans¹ and R H Brakenhoff¹

¹ Department of Otolaryngology/Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands
² Microarray Core Facility, VU University Medical Center
³ Pediatric Oncology/Hematology, VU University Medical Center
⁴ Clinical Epidemiology and Biostatistics, VU University Medical Center

Correspondence to:
Correspondence to:
B J M Braakhuis
Section of Tumor Biology, Department of Otolaryngology/Head and Neck Surgery, Room 1D 116, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands;bjm.braakhuis{at}vumc.nl

Background: For breast and prostate cancer, a gene expression signature of the tumour is associated with the development of distant metastases. Regarding head and neck squamous cell carcinoma (HNSCC), the only known risk factor is the presence of 3 tumour-positive lymph nodes.

Aim: To evaluate whether a HNSCC gene expression signature can discriminate between the patients with and without distant metastases.

Methods: Patients with HNSCC with and without distant metastases had >3 tumour-positive lymph nodes, and did not differ with respect to other risk factors. Statistical analysis was carried out using Student’s t test, as well as statistical analysis of microarrays (SAM), to assess the false discovery rate for each gene. These analyses were supplemented with a newly developed method that computed deviations from gaussian-order statistics (DEGOS). To validate the platform, normal mucosa of the head and neck was included as control.

Results: 2963 genes were differently expressed between HNSCC and normal mucosa (t test; p<0.01). More rigorous statistical analysis with SAM confirmed the differential expression of most genes. The comparison of genes in HNSCC with and without metastases showed 150 differently expressed genes (t test; p<0.01), none of which, however, could be confirmed using SAM or DEGOS.

Conclusions: No evidence for a metastasis signature is found, and gene expression profiling of HNSCC has seemingly no value in determining the risk of developing distant metastases. The absence of such a signature can be understood when it is realised that, for HNSCC in contrast with breast cancer, the lymph nodes are a necessary in-between station for haematogenous spread.

Abbreviations: DEGOS, deviations from gaussian-order statistics; HNSCC, head and neck squamous cell carcinoma; SAM, statistical analysis of microarrays

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