Dufffy Antigen Receptor For Chemokines (DARC) And Cytoskeletal Protein Fascin Expression In Laryngeal Squamous Cell Carcinoma And Its Significance

Dufffy antigen receptor for chemokines(DARC) and Cytoskeletal protein Fascin expression in laryngeal squamous cell carcinoma and its significanceObjective:This study was designed to observe the expression of Duffy antigen receptor for chemokines(DARC) and cytoskeletal protein Fascin in laryngeal squamous cell carcinoma(LSCC) tissue,to investigate the relationship between DARC,Fascin and different clinicopathological parameters,prognosis,and further to explore clinical significance.It was to provide a theoretical basis for new treatment of LSCC.Methods:Expressions of DARC and Fascin were examined by immunostaining in 65 LSCC patients,divided into two groups,lymph node metastasis group and lymph node negative group.Expression of microvessel density(MVD) in primary LSCC tissue and normal laryngeal tissue(away from the edge of the tumor＞0.8cm,and no tumor cell infiltration) was also detected for identifying the relationship between DARC and MVD.In addition,expression of Fascin was tested in normal laryngeal tissue of each case,33 metastasitic lymph nodes and 32 negative lymph nodes.Then our conclusion was drawn from statistical analysis.Results:Strong DARC expression was detected in 32 cases(49.2%),while, weak DARC expression in 33 cases(50.8%).Strong DARC expression in lymph node negative and positive groups was examined in 24 cases(72.7%) and 8 cases(25%),respectively(P＜0.01).MVD was(24.75±5.45) / HP and(32.58±5.23) / HP in DARC strong and weak expression cases(P＜0.01).DARC expression in primary tumor was negatively related with lymph node metastasis,MVD,clincal stage,local recurrence and distant metastasis(correlation coefficient was -0.612,-0.477,-0.419, -0.320,respectively),no relationship was found between DARC expression and other clinicopathological parameters.Fascin expression in primary tumors was significantly higher than laryngeal normal tissue(Z=-6.000,P=0.000).strong Fascin expression was 23 cases(71.9%) and 13 cases(39.4%) in lymph node metastasis group and lymph node negative group,respectively(p=0.008).In 32 cases with lymph node metastasis,the rate of strong Fascin expression in metastatic lymph nodes was 40.6%(13/32),no difference was found from corresponding primary tumor(65.6%,21/32,P=0.066).strong Fascin expression in primary tumors was positively correlated with T stage,lymph node metastasis,tumor site,tumor size and local recurrence and distant metastasis.Increased expression of DARC or decreased expression of Fascin tended to predict good outcomes by univariate survival analysis(P=0.0021,P =0.0026,respectively).Moreover,mean survival time in patients with strong and weak DARC expression was 74.05 months and 58.27 months,respectively;mean survival time in patients with strong and weak Fascin expression was 56.59 months and 84.22 months,respectively.In addition,lymph node metastasis,tumor site,tumor size,TNM stage and local recurrence and distant metastasis were significantly associated with poor prognosis.Finally,it was showed that there was no significant difference between DARC and Fascin expression in LSCC(P=0.398,correlation coefficient r=-0.107) by correlation analysis.In multivariate analysis,the independent prognostic factors for tumor-specific survival included Fascin expression((P=0.04;HR=10.043; 95%confidence interval,1.106-91.163);T stage(P=0.049;HR=0.424; 95%confidence interval,0.180-0.998),N stage(P=0.012;HR=3.664; 95%confidence interval,1.331-10.084)as well as local recurrence and distant metastasis(P=0.001;HR=46.928;95%confidence interval, 5.123-429.839).Conclusion:DARC may play a negative role in the process of LSCC progression and probably has an association with the lymph node status by reducing microvessel density in tumor and suppressing tumor formation and metastasis.However,Fascin plays a positive role in promoting tumor invasion and metastasis in LSCC,and primary tumor with strong Fascin expression has a higher invasion and more likely metastasis to lymph node,which is an independent prognostic factor.Therefore,DARC or Fascin expression in LSCC may be regarded both as a prognostic factor and a therapeutic target.