Head and neck squamous cell carcinoma (HNSCC) is one of the leading causes of cancer as well as cancer related deaths. Most patients present in a locally advanced state which lead to significant morbidity and mortality. A biomarker for HNSCC has potential for earlier detection and better treatment of cases but it’s search has been elusive so far. In a previous analysis by investigators as well as at our centre, the levels of Prosaposin A (PSAP) were found to be differentially expressed in the serum of HNSCC patients when compared to age and sex matched healthy controls.
Multiple investigators have reported numerous probable biomarkers in HNSCC patients over the years but few have been tested in the clinical scenario. While differential expression of PSAP has led to it being tested as a biomarker in various sites, but no such study has been reported in HNSCC so far. Serum of biopsy proven HNSCC patients (n=91) were obtained before and after their treatment. Patients treated with both radical and palliative intent were included. Serum samples of a cohort of age and sex matched healthy volunteers (n=42) were also obtained. An ELISA assay was run to measure the PSAP levels in serum in ng/ml.
Serum PSAP levels of cases at baseline (median: 2.762) were found to be significantly elevated when compared to healthy controls (median: 2.053) (p=0.0123). A Wilcoxan matched pairs signed rank analysis was run to evaluate ELISA values pre- and post-treatment. A significant decrease in PSAP levels (median: 1.610) were found irrespective of complete/partial response to treatment (p<0.0001); for patients having residual disease (n=62) (median: 2.622 vs 1.476) post treatment (p=0.0007) and for patients having complete clinical response (n=29) (median: 2.948 vs 2.359) post treatment (p=0.0075).
Serum PSAP levels were significantly elevated in HNSCC patients at baseline compared to healthy controls which decreased post treatment. We hereby propose serum PSAP as a possible biomarker in HNSCC patients. Further large-scale clinical studies are warranted to establish serum PSAP as a diagnostic/prognostic marker in HNSCC patients.
The authors.
Post Graduate Institute of Medical Education and Research.
All authors have declared no conflicts of interest.