Do cytokeratins play a role as a prognostic biomarker in squamous cell carcinoma of larynx

Abstract Aim . In this prospective study, expressions of distinct cytokeratin (CK) subtypes in larynx cancer (LC) were examined by immunohistochemistry (IHC) and these findings were correlated with known prognostic factors. Method . Thirty LC patients were enrolled into study. Tumor sections were examined and graded according to Broder’s criteria. For examining the CK expression, polyclonal low molecular weight CK (LMWCK) and high molecular weight CK (HMWCK) antibody cocktails, and monoclonal CK18 and CK19 antibodies were applied into tumoral and non-neoplastic mucosa sections with streptavidin-biotin peroxidase technique. Result . Tumors included squamous cell (SC), adenosquamous cell, verrucous, basaloid carcinomas and sarcomatoid carcinoma. Grade 2 SC cancer was the most prevalent type (63.3 %). On IHC, LMWCK and HMWCK were found to have diffuse expression that disables any prognostic implication. CK-18 expression seemed to diminish by grade but to increase by stage. CK-19 expression had positive correlation with both grade and stage (p=0.064). Conclusion . This study is first research evaluating the correlation of CK staining findings with pathologic prognostic factors. Findings of this CK cocktail study suggest that these markers are not optimal for decision making of hyperplastic mucosa and differentiation degree in neoplasias, as they include a variety of CK classes that result in diffuse cytoplasmic staining. However with the addition of certain monoclonal CKs, CK-18 and 19 could have prognostic implications in SC carcinomas of larynx. Key words : Larynx cancer, squamous cell carcinoma, tumor markers, cytokeratins, prognosis Ozet Amac . Larenks kanserinde belirli sitokeratin (SK) subtiplerinin immunhistokimya (IHK) ile ekspresyon derecelerine bakilarak sonuclarin prognostik faktorlerle korelasyonu amaclandi. Yontem. Bu prospektif calismaya, 30 larenks kanseri olgusu dahil edildi. Tumor kesitleri histopatolojik olarak incelenerek Broder sistemine gore derecelendirildi. Ardindan poliklonal yuksek molekul agirlikli SK (YMASK), dusuk molekul agirlikli SK (DMASK) antikorlari ve monoklonal SK 18 ve SK 19 antikorlari streptavidin-biotin peroksidaz yontemi ile tumoral ve non-neoplastik dokulara tatbik edilerek ekspresyon dereceleri incelendi. Bulgular. Tumorler yassi hucreli karsinoma (YHK), adenoskuamoz hucreli, verrukoz, bazaloid ve sarkomatoid karsinomlardan olusmaktaydi. Grade 2 YHK en sik gorulen tumor idi ( % 63,3). IHK ile YMASK ve DMASK’ler herhangi bir prognostik incelemeye izin vermeyecek derecede yogun ve yaygin boyandilar. SK-18 ekspresyon derecesi, tomorde grade artisi ile azalirken, evre artisi ile artmaktaydi. SK-19 ekspresyonunda ise hem evre, hem de grade artisi ile pozitif korelasyon izlendi. Prognostik degerlendirmede daha genis bir seride SK-18 ekspresyonunun boyun metaztazi uzerine tahmin degeri bulunabilecegi dusunuldu (p=0,064). Sonuclar. Bu calisma SK boyanma derecelerini patolojik prognostik faktorlerle iliskilendirme acisindan ozgundur. Poliklonal SK’ler icerdikleri SK cesitliliginden dolayi farklilasma derecesinin tayininde ve hiperplastik mukozalarin degerlendirilmesinde uygun gorulmemistir. Ancak SK-18 ve 19, antikor paneline bazi SK antikorlar eklendigi takdirde larenks kanserinde prognostik degere sahip olabilir. Anahtar sozcukler : Larenks kanseri, yassi hucreli karsinom, tumor belirtecleri, sitokeratinler, prognoz.