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Japanese Journal of Clinical Oncology 2007 37(11):812-819; doi:10.1093/jjco/hym121
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© 2007 Foundation for Promotion of Cancer Research

Prognostic Value of Carbonic Anhydrase IX and Ki-67 Expression in Squamous Cell Carcinoma of the Tongue

Seok Jin Kim1,, Hye Jin Shin4, Kwang-Yoon Jung2, Seung-Kuk Baek2, Bong Kyung Shin3, Jungwoo Choi3, Byung Soo Kim1, Sang Won Shin1, Yeul Hong Kim1, Jun Suk Kim1 and Egbert Oosterwijk5

1 Department of Internal Medicine
2 Department of Otorhinolaryngology—Head and Neck Surgery
3 Department of Pathology, Korea University Medical Center, Seoul, South Korea
4 Graduate School of Korea University, Seoul, South Korea
5 Department of Urology, University Hospital Nijmegen, The Netherlands

For reprints and all correspondence: Seok Jin Kim, Department of Internal Medicine, Korea University Medical Center, 126-1 Anamdong-5-ga, Seongbuk-ku, Seoul 136-705, South Korea. E-mail: kstwoh{at}korea.ac.kr

Received May 30, 2007; accepted August 1, 2007

Background: Hypoxia-induced changes may allow tumor cells to survive under sustained hypoxic microenvironments resulting in achievement of more aggressive phenotypes. The purpose of this study is to determine the prognostic relevance of the expression of carbonic anhydrase IX (CA IX), a hypoxia-related protein in surgically resected squamous cell carcinoma of the tongue. We also relate CA IX to Ki-67 expression representing tumor cell proliferation to provide a prognostic model.

Methods: We analysed the expression of CA IX and Ki-67 with immunohistochemistry in 60 patients with squamous cell carcinoma of the tongue.

Results: The percentage of CA IX-positive tumor cells had a wide variation from 0.0 to 77.5%, and the Ki-67 expression was 1.50–75.1%. High CA IX and Ki-67 expression (≥10.0% of tumor cells positively stained with CA IX and Ki-67) was associated with a poorer overall survival (P < 0.05). High CA IX and Ki-67 expression showed shorter disease-free survival (DFS), although they are not statistically significant. To make a risk model based on the expression of CA IX and Ki-67, we divided the patients into three groups: high risk (high CA IX and Ki-67), low risk (low CA IX and Ki-67) and intermediate risk (either high CA IX or Ki-67). Being in the high-risk group was found to be an independent prognostic factor for overall survival and DFS in multivariate analysis (P < 0.05).

Conclusion: The expression of CA IX and Ki-67 may be useful for predicting prognosis in squamous cell carcinoma of the tongue.

Key Words: carbonic anhydrase IX • Ki-67 • hypoxia • squamous cell carcinoma • tongue


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