Independent evaluation of a FOXM1-based quantitative malignancy diagnostic system (qMIDS) on head and neck squamous cell carcinomas
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Hong Ma1,*, Haiyan Dai1,*, Xiaofeng Duan1, Zhenglong Tang1, Rui Liu1, Kunjun Sun1, Ke Zhou1, Hao Chen1, Hang Xiang1, Jinsheng Wang1, Qiong Gao1, Yuan Zou1, Hong Wan1,2, Muy-Teck Teh1,2
1China-British Joint Molecular Head and Neck Cancer Research Laboratory, Department of Oral and Maxillofacial Surgery, Hospital and School of Stomatology, Guizhou Medical University, Guizhou, China
2Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, England, United Kingdom
*These authors contributed equally to this work
Muy-Teck Teh, email: [email protected]
Keywords: molecular diagnostics, ethnicity, early cancer biomarkers, squamous cell carcinoma, FOXM1
Received: March 23, 2016 Accepted: May 23, 2016 Published: July 09, 2016
The forkhead box M1 (FOXM1) transcription factor gene has been implicated in almost all human cancer types. It would be an ideal biomarker for cancer detection but, to date, its translation into a cancer diagnostic tool is yet to materialise. The quantitative Malignancy Index Diagnostic System (qMIDS) was the first FOXM1 oncogene-based diagnostic test developed for quantifying squamous cell carcinoma aggressiveness. The test was originally validated using head and neck squamous cell carcinomas (HNSCC) from European patients. The HNSCC gene expression signature across geographical and ethnic differences is unknown. This is the first study evaluated the FOXM1-based qMIDS test using HNSCC specimens donated by ethnic Chinese patients. We tested 50 Chinese HNSCC patients and 18 healthy subjects donated 68 tissues in total. qMIDS scores from the Chinese cohort were compared with the European datasets (n = 228). The median ± SD scores for the Chinese cohort were 1.13 ± 0.66, 4.02 ± 1.66 and 5.83 ± 3.13 in healthy oral tissues, adjacent tumour margin and HNSCC core tissue, respectively. Diagnostic test efficiency between the Chinese and European datasets was almost identical. Consistent with previous European data, qMIDS scores for HNSCC samples were not influenced by gender or age. The degree of HNSCC differentiation, clinical stage and lymphatic metastasis status were found to be correlated with qMIDS scores. This study provided the first evidence that the pathophysiology of HNSCC was molecularly indistinguishable between the Chinese and European specimens. The qMIDS test robustly quantifies a universal FOXM1-driven oncogenic program, at least in HNSCC, which transcends ethnicity, age, gender and geographic origins.
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