Immunohistochemical Expression Of TERT In Laryngeal Carcinoma And Its Clinical Significance

Objective Laryngeal cancer is a common kind of head and neck cancers.Laryngeal squamous cell carcinoma(LSCC)accounts for more than 90% of laryngeal cancer.The5-year survival rate of laryngeal cancer has fallen from 66% to 63% in the past 40 years,so it is very important for the early diagnosis and treatment of laryngeal cancer.Specific biomarkers are helpful for the diagnosis,treatment and prognosis of laryngeal cancer,but there is still a lack of widely recognized and used clinical biomarker.We wanted to evaluate the expression of telomerase reverse transcriptase(TERT)in LSCC and its relationship with tumor invasion and lymph node metastasis in order to discover a new marker for laryngeal cancer.Methods We collected 64 specimens of pathologically diagnosed laryngeal cancer patients from March 5,2011 to December 20,2013 in Department of Otolaryngology Head and Neck Surgery at the First Affiliated Hospital of Anhui Medical University.We collected a total of 64 laryngeal cancer tissues and their corresponding adjacent tissues.The expression of TERT protein in laryngeal cancer tissues and adjacent tissues was detected by immunohistochemical methods.The average optical density value of cell staining intensity was calculated using Image-Pro Plus 6.0 software.When the selected area is constant,a higher average optical density value indicates a higher TERT expression level.SPSS19.0 was used to analyze the expression of TERT in different groups,and survival analysis was performed based on the 5-year follow-up of patients.Results We found that TERT protein is mainly expressed in the cytoplasm,showing a diffuse distribution of brown-yellow granules,and is also expressed in a small amountin the nucleus.The expression intensity of TERT in laryngeal cancer tissues was significantly higher than that of the corresponding adjacent tissues,and the difference was statistically significant(t = 16.58,p <0.05);the expression level of TERT in smoking group was higher than that in non-smoking group,and the difference was statistical significant(t = 2.06,p <0.05);the expression level of TERT in the drinking group was higher than that in the non-drinking group,the difference was statistically significant(t = 2.66,p <0.05);The expression of TERT in the well differentiated group,the moderately differentiated group and the poorly differentiated group gradually increased,and the differences between the three groups were statistically significant(F= 20.50,p <0.05);the expression of TERT in the III + IV group was significantly higher than that in the I + II group,and the difference was statistically significant(t =5.22,p <0.05).The expression level of TERT in the lymph node metastasis positive group was significantly higher than that in the lymph node metastasis negative group.And it was statistically significant(t = 6.88,p <0.05).Kaplan-Meier method was used to draw the survival curve.The mortality rate of TERT expression ≥ P50(78.18%)was significantly higher than the mortality rate of TERT expression <P50(25.95%),and the difference was statistically significant(2 = 18.33,P <0.0001).Cox multivariate analysis showed that expression intensity of TERT and recurrence were independent factors affecting the prognosis of patients with laryngeal cancer.Conclusions 1.The expression intensity of TERT protein in laryngeal cancer tissues is higher than that in adjacent tissues,suggesting that TERT is related to the occurrence of laryngeal squamous cell carcinoma.2.The expression level of TERT is related to smoking history,drinking history,clinical stage,histological grade,and lymph node metastasis in patients with laryngeal cancer,suggesting that overexpression of TERT is related to tumor invasion and metastasis.3.The survival rate of patients with high expression of TERT is lower than that ofpatients with low expression intensity,suggesting that the expression of TERT is related to the prognosis of patients with laryngeal cancer.4.In clinical work,the determination of TERT content may help the early diagnosis,treatment,and prognosis of laryngeal cancer.TERT is expected to become a widely used laryngeal cancer marker and a new target for targeted therapy of laryngeal cancer.