Get access

Prognostic markers in stage I oral cavity squamous cell carcinoma


  • This work was supported by Turku Doctoral Programme of Biomedical Sciences, The Finnish Medical Foundation, Turku University Foundation, The Finnish Otolaryngology Foundation, Turku University Hospital, and Kirsti and Tor Johansson Cancer and Heart Foundation.

  • The authors have no other funding, financial relationships, or conflicts of interest to disclose.

PhD, MD, Department of Otorhinolaryngology, Turku University Hospital, Kiinamyllynkatu 4-8, P.O. Box 52, 20521 Turku, Finland. E-mail:



Early-stage oral squamous cell carcinoma (OSCC) treatment is based on anatomic location, clinical TNM staging, and histological grade. It is a heterogeneous disease group. Classification of patients with OSCC by immunohistochemical analysis of established oncoproteins and evaluate disease course was our primary objective. Characterization of stage I OSCC patients in Southwest Finland was our secondary objective.

Study Design

Immunohistochemical analysis of tumor specimens and retrospective analysis of patient data of the patient treated in Turku University Hospital for T1N0M0 OSCC during the years 2000-2004.


Paraffin-embedded tumor specimens from 35 OSCC patients were collected and analyzed for HIF-1α, CD44, p16, Ki67, and podoplanin by immunohistochemistry and correlated with clinical findings.


Tumoral CD44 and HIF1-α expression levels, in combination, predicted 5-year disease-free survival. Reduced expression of CD44 and elevated expression of HIF1-α is associated with the lowest probability of disease-free survival compared to the population as a whole (P < .001 in Kaplan-Meier analysis). Patients with grade I tumors demonstrated improved disease-specific survival compared to those with grade II tumors (P = .027). No association was seen between p16 expression, Ki67 labeling index, or podoplanin expression and prognosis in our 35 specimens.


HIF-1α and CD44 immunohistochemical detection could potentially serve as a prognostic tool in therapy selection for early-stage OSCC. Laryngoscope, 123:2435–2441, 2013