Oropharyngeal cancer (OSCC) is one of the leading cancers in incidence and mortality in India. Early detection and treatment of OSCC cancers is needed as most of them present in advanced stages especially in developing countries like India, which may decrease morbidity and mortality. We evaluated the clinical role of CR-1 in patients of squamous cell carcinoma of oropharynx. We present an updated data on outcomes and their association with serum CR-1 levels with a median follow up of two years.
Fifty healthy volunteers(controls) and fifty biopsy proven cases of OSCC were recruited in the study after using inclusion and exclusion criteria. All patients were treated with radical chemo-radiation and response was assessed at 6 weeks post therapy and from then every 3 months till last follow up. Serum CR-1 levels were analyzed by ELISA in patients, both before and after treatment, and also in controls. Expression of CR-1 was compared between controls and patients. Pre- and post-treatment CR-1 levels in patients were compared and correlated with clinic-pathological findings. SPSSv16.0 was used for statistical analysis.
Complete response (CR) was observed in 42% of the patients, partial response (PR)/stable disease (SD) in 22%, while 26% of the patients had progressive disease (PD) Though the median fall of serum CR-1 levels after treatment was higher in patients who achieved CR compared to those who had PR/SD/PD, the correlation was not significant on multivariate analysis (p = 0.18). CR-1 levels are significantly raised in patients (207 pg/ml Vs 497 pg/ml, p=.003) and are significantly higher in patients with well differentiated and early stage tumors as compared to controls and decreased significantly after treatment at first follow up (497 pg/ml Vs 228 pg/ml, p=.046).
Though the median fall in CR-1 level is higher in patients with CR, a statistically significant correlation could not be established in our study, between median fall of CR-1 levels and long-term outcomes in OSCC but merits larger prospective studies. CR-1 may be useful in early diagnosis of OSCC and as a potential tumor marker.
PGIMER, Chandigarh, India
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All authors have declared no conflicts of interest.