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Expression of Human DNA Topoisomerase II-α in Squamous Cell Carcinoma of the Larynx and Its Correlation With Clinicopathologic Variables

Jacob Shvero MD, Rumelia Koren MD, Itzhak Shvili MD, Eitan Yaniv MD, Rima Sadov MD, Tuvia Hadar MD
DOI: http://dx.doi.org/10.1309/AJCPROG61USKCBEI 934-939 First published online: 1 December 2008

Abstract

The aggressiveness of laryngeal squamous cell carcinoma (SCC) is unpredictable. Topoisomerase (Topo) II-α is an essential nuclear enzyme; its expression rises at the end of the S-G2/M phase and drops at completion of mitosis. This study sought to determine if Topo II-α expression can serve as a prognostic factor in laryngeal SCC. Specimens from 56 consecutive patients were immunohistochemically stained for Topo II-α, and the number of positive cells in the areas of highest staining was counted in 3 high-power fields (×400) (Topo II-α index). Differences in the Topo II-α index by the presence or absence of recurrence, tumor stage and grade, and disease course were analyzed statistically. On multivariate Cox regression analysis, the Topo II-α index (>70 or ≤70) (P = .008) and tumor grade (P = .034) independently predicted disease-free survival. These findings suggest that high Topo II-α expression may be a useful indicator of tumor aggressiveness and poor outcome in laryngeal SCC.

Key Words:
  • Topoisomerase II-α index
  • Larynx
  • Squamous cell carcinoma
  • Prognosis