CATHEPSIN-D CONCENTRATION IN PRIMARY LARYNGEAL-CANCER - CORRELATION WITH CLINICOPATHOLOGICAL PARAMETERS, EGFR STATUS AND PROGNOSIS

Sixty-three patients with primary laryngeal squamous-cell carcinoma we re followed up for a median of 33 months after surgery. Cathepsin D (C ath D) concentration was assayed using a solid phase 2-site immunoradi ometric assay in which the first monoclonal antibody (MAb) was coated on the ELISA solid phase and the second one, M1G8 radiolabeled with 11 25-ECF, was used as the tracer. The median value of Cath D (13.8 pM/mg protein) was chosen as cut-off. Cath D greater than or equal to media n value was closely related to neck lymph node involvement at presenta tion and to a short metastasis-free survival (MFS) and actual overall survival (OS). The 5-year MFS was 71% for patients with Cath D < media n value tumors as compared with 0% for patients with Cath D greater th an or equal to median value tumors. Lymph node status at presentation was not related to a short MFS and OS. Cox's univariate regression ana lysis using Cath D as a continuous variable showed that Cath D levels are correlated with neck lymph node metastasis. On multivariate analys is, Cath D status proved to be an independent factor for predicting a short MFS. Cath D assay may prove to be particularly useful in identif ying laryngeal cancer patients who, with or without neck lymph node in volvement at presentation, are at high risk of metastatic disease and poor outcome. (C) 1996 Wiley-Liss, Inc.