The Expression of Activin Receptor-Like Kinase 1 among Patients with Head and Neck Cancer

ObjectivesWe investigated the expression and clinical significance of activin receptor-like kinase 1 (ACVRL1) in patients with head and neck squamous cell carcinoma (HNSCC). Study DesignCase series with chart review. SettingAcademic Institute of Otolaryngology, Kaohsiung, Taiwan. Subjects and MethodsPatients 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. ResultsHigh 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). ConclusionA high level of ACVRL1 expression in tumor tissue is significantly correlated with advanced T classification, positive N classification, advanced TNM stage, and poorer prognosis.