Open Access

AXIN2 and SNAIL expression predict the risk of recurrence in cutaneous squamous cell carcinoma after Mohs micrographic surgery

  • Authors:
    • Guohua Zhao
    • Ki‑Yeol Kim
    • Zhenlong Zheng
    • Yeongjoo Oh
    • Dae San Yoo
    • Myung Eun Lee
    • Kee Yang Chung
    • Mi Ryung Roh
    • Zhehu Jin
  • View Affiliations

  • Published online on: January 21, 2020     https://doi.org/10.3892/ol.2020.11324
  • Pages: 2133-2140
  • Copyright: © Zhao et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Recurrence is a common complication observed during cutaneous squamous cell carcinoma (cSCC) treatment; however, biomarkers for predicting recurrence in cSCC remain unknown. The present study aimed to investigate the predictive value of axis inhibition protein 2 (AXIN2) and SNAIL expression in cSCC recurrence. AXIN2 and SNAIL expression was evaluated using immunohistochemistry in 111 cSCC tissue samples obtained from 18 patients who presented recurrence (recurrence interval, 1‑91 months) and 93 patients who did not experience recurrence following Mohs micrographic surgery (MMS) during the follow‑up period (156 months). Nomogram construction was performed using patients' clinicopathological characteristics and AXIN2 and SNAIL protein expression. The results demonstrated that high AXIN2 (histoscore >100) and SNAIL (histoscore >100) expression was detected in 35 and 44 cSCC tissues, respectively. Furthermore, the expression levels of AXIN2 and SNAIL were significantly associated in patients with cSCC (P=0.001). AXIN2 and SNAIL expression levels were significantly associated with tumor size (P=0.021 and P=0.044, respectively) and recurrence of cSCC (P=0.017 and P=0.042, respectively). In addition, the results of the Kaplan‑Meier curve analysis revealed that recurrence‑free survival was significantly associated with tumor size (P=0.025), differentiation status (P<0.001), AXIN2 expression (P=0.001) and SNAIL expression (P=0.001). Furthermore, the results of the multivariate analysis demonstrated that age (P=0.043), AXIN2 expression (P=0.001) and SNAIL expression (P=0.045) were independent risk factors for cSCC recurrence in the present cohort. A nomogram for predicting the 1‑, 2‑, 3‑, and 5‑year recurrence‑free survival was developed for patients with cSCC by including independent risk factors with a concordance index of 0.75. The results suggested that high AXIN2 and SNAIL expression may be considered as potential risk factors for cSCC recurrence. This nomogram may therefore be useful to assess the probability of recurrence in patients with cSCC following MMS.

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March 2020
Volume 19 Issue 3

Print ISSN: 1792-1074
Online ISSN:1792-1082

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APA
Zhao, G., Kim, K., Zheng, Z., Oh, Y., Yoo, D.S., Lee, M.E. ... Jin, Z. (2020). AXIN2 and SNAIL expression predict the risk of recurrence in cutaneous squamous cell carcinoma after Mohs micrographic surgery. Oncology Letters, 19, 2133-2140. https://doi.org/10.3892/ol.2020.11324
MLA
Zhao, G., Kim, K., Zheng, Z., Oh, Y., Yoo, D. S., Lee, M. E., Chung, K. Y., Roh, M. R., Jin, Z."AXIN2 and SNAIL expression predict the risk of recurrence in cutaneous squamous cell carcinoma after Mohs micrographic surgery". Oncology Letters 19.3 (2020): 2133-2140.
Chicago
Zhao, G., Kim, K., Zheng, Z., Oh, Y., Yoo, D. S., Lee, M. E., Chung, K. Y., Roh, M. R., Jin, Z."AXIN2 and SNAIL expression predict the risk of recurrence in cutaneous squamous cell carcinoma after Mohs micrographic surgery". Oncology Letters 19, no. 3 (2020): 2133-2140. https://doi.org/10.3892/ol.2020.11324