Prognostic factors in pharyngeal squamous cell carcinoma with special reference to cell adhesion, p53 protein expression and nitric oxide synthase expression (Nielun alueen syövän ennustetekijöistä: soluadhesio, p53 sekä typpioksidi syntaasi)

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Figure IVA-D. IHC stainings in PSCC; S, stroma; T, tumor. (A) Nuclear β-catenin expression (arrowheads). (B) Nuclear p53 expression. (C) Cytoplasmic iNOS expression. (D) Stromal versican expression.

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5.2.4. Versican (IV)

In the tumor surroundings, there was immunoreactivity for versican in the blood vessel walls and in the peritumoral connective tissue. In carcinoma, strong stromal versican expression was graded according to median percentage (10%). It was high in 59 (50%) (Figure IVD), but low in 59 (50%) primary tumors. Cytoplasmic versican staining was present in the carcinoma cells in 9 (8%) tumors. Intracellular versican accumulation was more common in association with high strong stromal versican expression, though this association was statistically insignificantly. Of the 14 local lymph node metastases, in only one case was strong stromal versican expression graded low (<10%), while in the remaining 13 cases, the grade was high (≥10%). Strong stromal versican expression in the local metastases was statistically significantly more common than that in the primary tumors (Wilcoxon’s

nonparametric test for two related samples, p=0.018). A high percentage of strong versican staining was also more common in less advanced tumors (SI-II vs. SIII-IV; χ² test for independence, p<0.001) as well as in oropharyngeal tumors (χ² test for independence, p=0.013).

5.2.5. Interrelations between variables

A high iNOS score was significantly associated with a high nuclear p53 expression index (χ² test for independence, p=0.006) and positive cytoplasmic p53 expression (χ² test for independence, p=0.025). Nuclear p53 overexpression (index>240) or cytoplasmic p53 expression was not related to either membranous catenin expression (α-, β-, or γ-catenin) or nuclear β-catenin expression. No association was seen between versican expression and p53, catenins, or any other tested variable.

5.3. Disease-specific survival (DSS)

Complete follow-up data were available for the whole cohort (n=138). The median follow-up time was 20 months (range 1-332; 95% CI 11-29). Of the 138 patients, 45 (33%) remained free of the disease during the follow-up. Forty-two (30%) patients did not achieve complete

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