QUANTITATIVE GLYCOHISTOCHEMISTRY DEFINES NEW PROGNOSTIC MARKERS FOR CANCERS OF THE ORAL CAVITY

BACKGROUND. Histopathologic grading and clinical staging cannot provid e a precise prognosis of oral cavity cancer patients. The use of glyco histochemical markers may improve the level of prognostic accuracy of such conventional classification systems. METHODS. Computer-assisted m icroscopy was employed in a series of 40 oral cavity cancers to determ ine quantitatively the percentage of positive cells, the staining inte nsity, and the level of staining heterogeneity for 3 glycohistochemica l markers, including peanut agglutinin (PNA), Thomsen-Friedenreich ant igen (T antigen) as part of a neoglycoprotein, and sarcolectin. Data w ere evaluated by discriminant analysis. RESULTS. Although the level of differentiation (P < 0.01 to P < 0.001) and the T variable of the TNM staging system (P < 0.05 to P < 0.01) related mainly to the level of expression of the acceptor sites for PNA and the T antigen, the patien t survival period (P < 0.05) was largely a fraction of the level of ex pression of the acceptor sites for the carrier-immobilized T antigen a nd for sarcolectin. CONCLUSIONS. In oral cavity cancer, determining th e level of acceptor sites for PNA, T antigen, and sarcolectin provides useful information on histopathologic differentiation, clinical stagi ng, and survival. Because these processes of determination were carrie d out quantitatively, a discriminant model was set up, which enabled t he level of oral cavity cancer aggressiveness to be characterized prec isely. The current methodology described in this article should theref ore afford patholo gists original and quantitative (and thus objective ) prognostic markers for oral cavity cancers. (C) 1998 American Cancer Society.