Objectives: We investigated the expression and clinical significance of activin receptor-like kinase 1 (ACVRL1) in patients with head and neck squamous cell carcinoma (HNSCC).
Study design: Case series with chart review.
Setting: Academic Institute of Otolaryngology, Kaohsiung, Taiwan.
Subjects and methods: Patients diagnosed with HNSCC (n = 169) underwent surgical resection followed by radiotherapy and/or chemotherapy for aggressive tumors between November 2000 and March 2004. ACVRL1 expression was assessed using quantitative reverse transcription polymerase chain reaction (qRT-PCR) and immunohistochemistry approaches.
Results: High levels of ACVRL1 expression were significantly correlated with advanced T classification (P < .001), positive N classification (P = .002), advanced TNM stage (P < .001), lymphovascular invasion (P < .001), and extracapsular spread of lymph node metastasis (P = .021). A poor 5-year overall survival rate was correlated with high ACVRL1 expression (P = .0048), advanced T classification (P = .0075), positive N classification (P = .0024), advanced TNM stage (P = .0077), and extracapsular spread of lymph node (P = .0002), but a multivariate analysis using the Cox regression model revealed that the only independent prognostic factors for survival were ACVRL1 expression (P = .043; odds ratio [OR], 1.635; 95% confidence interval [CI], 1.017-2.629) and extracapsular spread of lymph node metastasis (P = .003; OR, 2.052; 95% CI, 1.270-3.315).
Conclusion: A high level of ACVRL1 expression in tumor tissue is significantly correlated with advanced T classification, positive N classification, advanced TNM stage, and poorer prognosis.
Keywords: activin receptor–like kinase 1; extracapsular spread of lymph node; head and neck squamous cell carcinoma; lymph node metastasis; neck metastasis.