Low CCR-7 expression indicates a poor prognosis in sinonasal adenocarcinomas

Introduction:

Sinonasal squamous carcinoma is a rare disease with an annual incidence of 0,5 newly diagnosed patients in 100 000 inhabitants. However, it is an aggressive disease with a 5-year survival rate of 54,5%. For chemokine receptors, a prognostic relevance has been shown for other entities. CCR7 was related to lymph node metastasis and overall survival. CXCR5 seems to promote distant metastasis.

Methods:

We identified 41 SNSCCs and 15 SACs between the years 2006 and 2016. Histologic sections were cut from formalin fixed paraffin embedded tumor samples and stained for CCR7 and CXCR5. The staining pattern was evaluated according to a well-established immunoscore consisting of staining intensity and percentage of stained tumor cells.

Results:

There was a significant difference in the expression of CCR7 between the two entities (p = 0,02). SNSCC with a high CCR7 expression had lower T-stages (p = 0,01), however there was no influence on overall survival for this entity. Especially for SAC, an association of low CCR7 expression and a worse overall survival could be observed (p = 0,006). CXCR5 had not significant influence on the observed primary end points.

Conclusion:

CCR7 expression pattern is a prognostic factor for overall survival for patients with SAC. This could be due to an increased lymph node homing of tumor cells and activation of the immune system. Because of the difficult anatomic region and a better prognosis than other sinonasal malignancies, small SAC are often lacking adjuvant radiotherapy. An analysis of the chemokine expression pattern could help in identifying high risk patients.

Publication History

Publication Date:
18 April 2018 (online)