Caspase-3 expression in tumorigenesis and prognosis of buccal mucosa squamous cell carcinoma

// Jer-Shyung Huang 1, 2, * , Cheng-Mei Yang 3, 4, * , Jyh-Seng Wang 5 , Huei-Han Liou 6 , I-Chien Hsieh 5 , Guan-Cheng Li 6 , Sin-Jhih Huang 6 , Chih-Wen Shu 6 , Ting-Ying Fu 5 , Yun-Chung Lin 7 , Luo-Ping Ger 6, 8 and Pei-Feng Liu 6, 9 1 Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan 2 National Yang-Ming University School of Medicine, Taipei, Taiwan 3 Department of Stomatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan 4 Department of Dental Technology, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan 5 Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan 6 Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan 7 Department of Pathology, China Medical University Hospital, Taichung, Taiwan 8 Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan 9 Department of Optometry, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan * These authors have contributed equally to this work Correspondence to: Luo-Ping Ger, email: lpger@vghks.gov.tw Pei-Feng Liu, email: pfliu@vghks.gov.tw Keywords: buccal mucosa squamous cell carcinoma, caspase-3, cleaved caspase-3, tumorigenesis, prognosis Received: June 04, 2017      Accepted: July 26, 2017      Published: August 24, 2017 ABSTRACT Buccal mucosa squamous cell carcinoma (BMSCC) is the most common oral cancer in Southeast Asia. Caspase-3, a key molecule in regulating apoptosis, promotes the malignancy of various cancers. However, its role in BMSCC is unknown. Herein, we evaluated the association of caspase-3 expression with tumorigenesis and prognosis in BMSCC patients. Immunohistochemical staining indicated that the expression levels of cleaved caspase-3 ( p <0.001) and caspase-3 ( p <0.001) in 185 BMSCC tissues were significantly higher compared to those in the tumor adjacent normal tissues. Moreover, the high expression of caspase-3 was associated with poor pathological outcomes [advanced pathological stage ( p =0.029) and larger tumor size ( p =0.002)] and poor disease-free survival in patients receiving postoperative radiotherapy ( p =0.030). Moreover, the low co-expression of cleaved caspase-3 and caspase-3 was associated with better disease-specific survival in patients with early pathological stage (I + II, p =0.018) or without lymph node invasion ( p =0.043) compared to the positive/high expression of either or both cleaved caspase-3 and caspase-3. Taken together, cleaved caspase-3 and caspase-3 could be biomarkers for tumorigenesis in BMSCC patients. Cleaved caspase-3 and/or caspase-3 might be prognostic biomarkers for certain stages of BMSCC.