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PubMed1999

Is history of squamous-cell skin cancer a marker of poor prognosis in patients with cancer?

BACKGROUND: Nonmelanoma skin cancer is associated with increased occurrence of subsequent cancer and death from cancer, but it is not known whether a history of skin cancer is associated with poor prognosis after a second diagnosis of cancer. OBJECTIVE: To determine whether history of squamous-cell skin cancer is a marker of poor prognosis in patients with cancer. DESIGN: Population-based cohort study. SETTING: Sweden, 1958 to 1996. PATIENTS: All patients in the Swedish Cancer Registry with or without a first diagnosis of squamous-cell skin cancer and a subsequent or first diagnosis of non-Hodgkin lymphoma (including chronic lymphocytic leukemia) or cancer of the colon, breast, prostate, or lung. MEASUREMENTS: Relative risk (RR) for death determined by using Cox proportional hazards regression analysis. RESULTS: Patients with a history of squamous-cell skin cancer had a significantly greater risk for death than those with no such history after receiving a diagnosis of non-Hodgkin lymphoma (RR, 1.33), colon cancer (RR, 1.24), breast cancer (RR, 1.19), or prostate cancer (RR, 1.17). Patients with lung cancer and a history of squamous-cell skin cancer who survived for 1 year after diagnosis of lung cancer also had an increased risk for death (RR, 1.29). CONCLUSION: Patients with a registered history of squamous-cell skin cancer have a poor prognosis after diagnosis of subsequent cancer and warrant careful medical attention.

Adult↗

PubMed1999

Expression of transforming growth factor beta type II receptors in head and neck squamous cell carcinoma.

Transforming growth factor (TGF)-beta is a potent regulator of growth and differentiation in normal squamous epithelium. TGF-beta exerts its antiproliferative effect via the TGF-beta type II receptor (TbetaR-II). A decrease in TbetaR-II expression is believed to be responsible, in part, for the resistance of squamous cell carcinoma (SqCC) to the anti-proliferative effects of TGF-beta. In the present study, we used immunohistochemistry and in situ hybridization to analyze the expression of TbetaR-II along the successive oncogenic stages of head and neck squamous neoplasia, from normal epithelium to dysplasia to carcinoma. Quantitation of TbetaR-II expression in 38 SqCCs was assessed on a visual scale ranging from negative (absence of staining) to 3+ (strong staining). Normal squamous epithelium and squamous epithelium in the vicinity of the tumors showed homogenous receptor expression with moderate intensity. Dysplastic epithelium and carcinoma in situ showed a mild decrease in receptor expression intensity. Well-differentiated to moderately differentiated carcinomas showed heterogeneous expression of variable intensity, and poorly differentiated carcinomas were completely devoid of TbetaR-II. In every tumor, the superficial component showed more intense receptor expression than the invasive component. These results indicate that TbetaR-II expression inversely correlates with disease aggressiveness and suggest that aberrant TbetaR-II expression is a contributing factor to the pathogenesis of SqCC.

Activin Receptors, Type I↗

PubMedDate not supplied

Topoisomerase II alpha expression in esophageal squamous cell carcinoma.

BACKGROUND: DNA topoisomerase II alpha (topo II alpha) is associated with active cell proliferation of mammalian cells. Topo II alpha overexpression has been reported in a number of human malignancies and is considered to be related to their biological behaviors. MATERIALS AND METHODS: We examined the expression of topo II alpha immunohistochemically in 136 cases of human esophageal squamous cell carcinoma, 10 foci of squamous dysplasia and 10 non-pathologic squamous epithelium. We calculated the labeling index (LI) or the percentage of immunopositive cells for Topo II alpha and Ki67, and Topo II alpha LI/Ki67 LI (T/K ratio). These findings were then correlated with clinicopathological features of the patients including their clinical outcome. RESULTS: Both topo II alpha and Ki67 immunoreactivity were detected in the nuclei. A significant positive correlation was obtained between Topo II alpha and Ki67 LIs in all the specimens examined. Topo II alpha LI and T/K ratio were 24.5 +/- 8.0% and 1.04 +/- 0.64 for carcinoma, 19.1 +/- 15.2% and 0.68 +/- 0.29 for dysplasia and 14.0 +/- 14.1% and 0.55 +/- 0.17 for non-pathologic epithelium, respectively. Topo II alpha LI and T/K ratio in carcinoma cases were significantly higher than those of normal epithelium. Topo II alpha LI alone did not correlate with any of clinicopathological parameters examined but among carcinoma cases, cases with lymph nodes metastasis or higher histological stages had significantly higher T/K ratio than those without lymph node metastasis or lower histological stages. In addition, carcinoma cases with T/K ratio of greater than 0.8 demonstrated significantly worse prognosis than those with T/K ratio of smaller than 0.8. CONCLUSIONS: The relative overexpression of topo II alpha as compared with Ki67, i.e., increased T/K ratio was detected in esophageal squamous cell carcinoma and is considered to represent a dysregulation or qualitative alteration in topo II alpha, possibly associated with malignances, as reported in other human cancers. In addition, topo II alpha overexpression may also be correlated with the aggressive biological behavior of the patients with esophageal squamous cell carcinoma.

Adult↗

PubMedDate not supplied

Primary squamous cell carcinoma of the stomach: a case report with a review of Japanese and Western literature.

A case of a 75 year-old male with primary squamous cell carcinoma of the stomach is reported. It is extremely rare to see squamous cell carcinoma developing in the stomach, without being accompanied by a component of adenocarcinoma. Up to the present, 18 Japanese and 62 Western cases of this type of carcinoma have been reported in the literature. The origin of this malignancy has not been well elucidated yet and thus, several plausible hypotheses have been proposed. In this presented case, the tumor consisted of only squamous cell carcinoma and the focus of squamous metaplasia was not found histologically in the adjacent mucosa. Therefore, it may be considered that the carcinoma arises from misplaced squamous cell nests of the stomach.

Aged↗

PubMed1999

Oral contraceptives as risk factors for cervical adenocarcinomas and squamous cell carcinomas.

To assess the hypothesis that oral contraceptives (OCs) increase the risk of cervical adenocarcinomas, we conducted a six-center case-control study of 124 patients with adenocarcinomas, 139 with squamous cell carcinomas, and 307 population controls. Women between the ages of 18 and 69 who were newly diagnosed with cervical adenocarcinomas between 1992 and 1996 were eligible. Healthy female controls and a second case group of incident cervical squamous cell carcinomas were matched to the adenocarcinoma cases. All participants were interviewed regarding OCs, other risk factors for cervical carcinoma, and utilization of cytological screening, and a PCR-based test determined HPV genotype of cervical samples for both case groups and controls. Use of OCs was positively and significantly associated with adenocarcinomas and positively but weakly associated with squamous cell carcinomas. Associations between OCs and invasive adenocarcinomas (n = 91), squamous cell carcinoma in situ (n = 48), and invasive squamous cell carcinomas (n = 91) disappeared after accounting for HPV infection, sexual history, and cytological screening, but a positive association remained between current use of OCs and cervical adenocarcinoma in situ (n = 33). This association persisted after stratification by screening and sexual history and after restriction according to HPV status, but small numbers made it difficult to exclude detection bias, selection bias, or residual confounding by HPV as potential explanations Current OC use was associated with cervical adenocarcinomas in situ, but we saw no other evidence that OCs independently increase the risk of cervical carcinomas.

Adenocarcinoma↗

PubMedDate not supplied

Enhanced antitumor efficacy of nedaplatin with 5-fluorouracil against human squamous carcinoma xenografts.

BACKGROUND: The antitumor efficacy of a combination of Nedaplatin (NDP) with 5-fluorouracil (5-FU) was evaluated using human squamous carcinomas in vivo. Because NDP was developed as a second generation platinum complex, we also compared the antitumor activity of NDP with 5-FU with that of Cisplatin (CDDP) with 5-FU. MATERIALS AND METHODS: 5-FU was injected daily for five days and either NDP or CDDP was injected once via the tail vein of mice implanted with KB3-1, OCC-1-JCK, LJC-1-JCK and Ma44 human squamous carcinomas. In some experiments, continuous administration of 5-FU using an osmotic pump was utilized. RESULTS: The sequential administration of 5-FU prior to NDP or CDDP (FN or FC therapy) resulted in enhanced inhibition of tumor growth in comparison with NDP, CDDP or 5-FU monotherapy against KB3-1, OCC-1-JCK and LJC-1-JCK squamous carcinomas. The combination of FN treatment was synergistic and as effective as that of FC treatment. FN treatment with continuous infusion of 5-FU using an osmotic pump, also led to enhanced tumor growth inhibition and prolonged survival against Ma44 squamous carcinoma. CONCLUSION: The results demonstrated the antitumor efficacy NDP with 5-FU against four human squamous carcinoma xenografts and suggested the clinical effectiveness of FN treatment.

Animals↗

PubMed2000

Up-regulation of cyclooxygenase-2 in squamous carcinogenesis of the esophagus.

Cyclooxygenase-2 (COX-2) is overexpressed in various types of human malignancies including squamous cell carcinomas (SCCs) of the esophagus, but little is known about COX-2 expression in premalignant esophageal squamous dysplasia. To elucidate the role of COX-2 in esophageal carcinogenesis, we examined the expression of this enzyme in normal squamous epithelium (n = 42), squamous dysplasia [high-grade dysplasia (HGD, n = 41; low-grade dysplasia (LGD, n = 33)]; carcinoma in situ (n = 16), mucosal invasive carcinoma (n = 18), and advanced SCC (n = 45). Immunohistochemistry showed a significantly high COX-2 expression in HGD compared with other lesions. The COX-2 score, an index determined by intensity and positivity of COX-2 staining (maximum 3.0), was 0.29 +/- 0.04 in normal esophagus, 1.75 +/- 0.11 in LGD, 2.89 +/- 0.05 in HGD, 2.17 +/-0.18 in CIS, 1.95 +/- 0.22 in mucosal invasive carcinoma, and 1.81 +/- 0.08 in advanced SCC. Results of reverse transcription-PCR assays confirmed those obtained by immunohistochemistry. COX-2 expression correlated with proliferation activity assessed by the proliferating cell nuclear antigen index in dysplastic lesions (P = 0.001) but not in SCCs. COX-2 expression in SCC did not correlate with various clinicopathological parameters including prognosis. Our results indicate that COX-2 is a sensitive marker for HGD and suggest that COX-2 may be involved in early stages of squamous carcinogenesis of the esophagus.

Antibodies, Monoclonal↗

PubMed2000

AgNORs in hyperplasia, papilloma and oral squamous cell carcinoma.

Ten inflammatory fibrous hyperplasias, ten papillomas, and nineteen oral squamous cell carcinomas were analyzed by the AgNOR technique to determine if different disturbances of oral epithelia presented different AgNOR counts. The papilloma group showed higher mean AgNOR counts (3.15 +/- 0.58) than the hyperplasia group (1.98 +/- 0.24) and smaller than the well-differentiated oral squamous cell carcinoma group (6.56 +/- 1.25) and poorly differentiated oral squamous cell carcinoma group (7.07 +/- 1.60). The differences among the groups of lesions were statistically significant (P < 0.05) except between the well differentiated oral squamous cell carcinoma group and the poorly differentiated oral squamous cell carcinoma group. Our findings suggest that the cellular proliferation ratio in papillomas is greater than hyperplasias and smaller than carcinomas.

Carcinoma, Squamous Cell↗

PubMed2000

Human papillomavirus infection and p53 alteration in oral squamous cell carcinoma.

OBJECTIVE: The aim of this study was to examine human papillomavirus 16/18 infection incidence and p53 alteration in oral squamous cell carcinoma and to determine whether a correlation existed between HPV infection incidence and p53 alteration in this disease. METHODS: A series of 60 oral tissues (40 oral squamous cell carcinomas, 20 normal oral mucosas) was studied by polymerase chain reaction (PCR) to detect HPV 16 and 18 infection, and was studied by single strand conformation polymorphism (SSCP) and immunohistochemistry (IHC) to detect p53 mutation and accumulation, respectively. RESULTS: HPV sequences were detected in 29 of 40 (72.5%) tumor specimens. A higher incidence (P = 0.037) of HPV 16/18 infection was observed in oral squamous cell carcinomas than in normal oral mucosas. Altered p53, either in genetic sequence or protein overexpression, was observed in 18 of 40 (45%) oral squamous cell carcinomas. Eleven of the 29 HPV-positive tumors contained observed alterations in either p53 protein expression or DNA sequence. No significant correlation (P = 0.145) was observed between HPV infection and p53 alteration. CONCLUSIONS: These data suggest that HPV16/18 infection and/or p53 alterations are associated with oral squamous cell carcinoma. No inverse correlation exists between oncogenic HPV infection and p53 alteration.

Adult↗

PubMed2001

Primary squamous cell carcinoma of the endometrium. A report of 3 cases.

Primary squamous cell carcinoma of the endometrium (PSCCE) is a rare disease of unknown etiology. Diagnosis is based on the identification of squamous cell carcinoma in the endometrium with no coexisting analogous cervical component or endometrial adenocarcinoma. There must also be no connection between the endometrial tumour and the squamous epithelium of the cervix. Although the majority of patients are classified as stage I disease, prognosis is rather dismal. We report two new cases of primary squamous cell carcinoma of the endometrium which fulfill all the above criteria and we discuss another interesting case of squamous cell carcinoma of questionable endometrial origin. Management by abdominal hysterectomy and adjuvant pelvic irradiation resulted in long-term survival of our patients.

Aged↗

PubMed2000

Head and neck squamous cell carcinoma in Hajjah, Yemen.

OBJECTIVE: Incidence of head and neck squamous cell carcinoma seems to be relatively high in Yemen but not well documented. The purpose of this study is to analyze the clinical profile of the Yemeni patients of squamous cell carcinoma of the head and neck and to evaluate the possible relationship to kath chewing. METHODS: With the help of a special protocol, all the patients of head and neck squamous cell carcinoma seen between October 1997 and December 1998 at the Ear, Nose and Throat and Dermatology Clinics of Saudi Hospital, Hajjah, Yemen Republic were subjected to detailed analysis. The diagnosis was confirmed by histopathologic studies in all the cases. RESULTS: All the 36 patients (23 male and 13 female) were Yemani nationals, aged 18 to 80 years (median age 50 years). Thirty patients were Kath addicts. The tumor was localized to the oral cavity in 17 (47%) patients, oropharynx in 1 (3%) patient, nasopharynx in 15 (42%) patients and larynx in 3 (8%) patients. CONCLUSION: The incidence of head and neck squamous cell carcinoma seems to be relatively high, especially the oral squamous cell carcinoma, all of whom had a habit of kath chewing, which may be considered as an important contributing factor.

Adolescent↗

PubMed2001

[Expression of vascular endothelial growth factor in primary esophageal squamous cell carcinoma and its significance in angiogenesis and prognosis of the tumor].

OBJECTIVE: To study the expression of vascular endothelial growth factor (VEGF) and microvessel density (MVD) in primary esophageal squamous cell carcinoma and to clarify the association of VEGF expression with the angiogenesis and prognosis of this tumor. METHODS: VEGF expression and MVD in 82 specimens of primary esophageal squamous cell carcinoma, resected from Jan 1981 through May 1994, were examined by immunohistochemistry staining (SP method), using anti-VEGF polyclonal antibody and anti-factor VIII monoclonal antibody. The relationship between VEGF expression and MVD and postoperative survival of patient was analyzed. RESULTS: Fifty-two out of the eighty-two specimens of esophageal squamous cell carcinoma (63.4%) showed positive expression of VEGF. The median of MVD in tumor was 37/mm2 (9-150/mm2). There was a close correlation between MVD and VEGF expression (P = 0.001). The survival rate of patients with high MVD in the tumor was significantly lower than that of patients with low MVD (P = 0.017). The higher the level of expression of VEGF in tumor, the poorer prognosis for the patients (P = 0.000). CONCLUSION: In primary esophageal squamous cell carcinoma, angiogenesis is mediated mainly by VEGF. VEGF is associated with tumor progression and may increase the malignancy via angiogenesis. It may be used as an independent indicator for prognosis of esophageal squamous cell carcinoma.

Adult↗

PubMed2001

Squamous cell carcinoma of the vulva and adjacent lesions treated at Nagoya University Hospital from 1965 to 1997.

Japan has a lower incidence of vulvar squamous cell carcinoma (VSCC) than Western nations. To pin-point the reasons for this, we reviewed biopsy samples from all cases treated at Nagoya University Hospital over the past 33 years in order to investigate the background lesions for VSCC. Two of 36 VSCC patients had adjacent or coexisting lichen sclerosus (LS), 5 had squamous cell hyperplasia (SCH), and 16 had vulvar intraepithelial neoplasia (VIN). There were 8 cases in which these lesions were thought to be the origin of the VSCC, 1 in which keratinizing squamous cell carcinoma (KSC) was seen in LS, 1 in which verrucous SCH was the origin, and 6 in which 4 basaloid carcinoma and 2 warty carcinoma developed from basaloid VIN and warty VIN, respectively. Although 8 other cases of keratinizing or non-keratinizing squamous cell carcinomas (NSC) coexisted with VIN NOS (not otherwise specified), differentiated VIN or basaloid VIN, we could not be histologically certain of the origin. Among 22 VSCC patients tested for HPV DNA, only an 84-year-old woman presenting a histological feature of KSC tested positive by in situ hybridization (ISH). It was considered that LS and SCH had little and VIN considerable capacity to cause the malignancy of VSCC. We surmise that in Japan the majority of squamous cell carcinoma is unrelated to HPV. One reason for the low incidence of VSCC is largely due to race; the homogeneous, monoethnic Japanese population, as well as the few cases of HPV-related VSCC.

Adult↗

PubMed2002

The RAG 2 mouse model for xenografted human oral squamous cell carcinoma.

Animal tumor models are still essential for the development of new medication and therapy concepts. In the field of human oral squamous cell cancer, there are few reliable xenografted tumor models available. Therefore, during a two-course experiment, we established a new xenografted tumor model of human oral squamous cell cancer. The tumor growth rates of two different tumor cell lines were compared in the inbred immunodeficient CD-17-RAG 2 mouse, NMRI-SCID mouse (scid/scid), and Swiss nude mouse (nu/nu). The tumor cell line from a lymphnode metastasis of an oral squamous cell carcinoma (XF 354) had a faster growth rate and a more characteristic histology than did the cell line from the primary tumor of a squamous cell carcinoma of the floor of the mouth (UM-SCC-14C). The highest tumor growth rate was observed in the RAG 2 mouse, followed by the SCID mouse. The Swiss nude mouse showed no tumor growth. The combination of the XF 354 tumor cell line and the RAG 2 mouse was most successful, with a tumor growth rate of 95%. Our animal model is very reliable and allows manipulations for as long as 30 min under anesthesia outside of microbiologic safety cabinets, where the handling of animals is much more comfortable and less time-consuming. The tumor histology was easily interpreted by using light microscopy. Steps for cell cultivation and tumor implantation are described and discussed. Therefore we strongly recommend the use of the model comprising the RAG 2 mouse with the xenografted cell line XF 354 for research in the field of human oral squamous cell carcinoma.

Animals↗

PubMed2000

[The expression of p16 and Rb protein in the tissue of cervical squamous carcinoma].

OBJECTIVE: To study the aberrant expression and coexpression of protein p16 and Rb in cervical squamous carcinomas, and to evaluate whether these alterations provide causative information. METHODS: The expressions of p16 and Rb protein were detected by treptavidin-peroxidase(S-P) immunohistochemical methods. RESULTS: 1. The p16 protein expression was mainly found in cytoplasm. The positive rate in carcinoma, CIN and normal cervix were 43.1%(25/58), 62.5%(5/8) and 70%(14/20), respectively; the positive expression were decreased in lower grade and clinical advanced cases(P < 0.05). 2. The Rb protein expression was detected in nucleus. The positive rate of Rb protein were 37.9%(22/58), 75%(6/8) and 85(17/20) in tum. The difference of the expression of Rb protein between the cervical squamous carcinoma and the normal cervix was significant(P < 0.05). The positive expression were increased in lower grade cancers(P < 0.05), and decreased in advanced cases(P > 0.05). 3. The positive rates of p16 and Rb protein in cervical squamous carcinoma showed an inverse correlation (vs = -0.4301, P < 0.01). CONCLUSIONS: 1. The abnormal p16 and Rbn expression might play an important role in the tumor genesis and the development of cervical squamous carcinoma. 2. Loss of function of both tumor suppressor genes may be an advanced event in cervical squamous carcinomas and might involve a bad prognosis.

Carcinoma, Squamous Cell↗

PubMed2002

Molecular detection of circulating esophageal squamous cell cancer cells in the peripheral blood.

PURPOSE AND EXPERIMENTAL DESIGN: To detect surgically resectable tumors earlier and improve the prognosis of esophageal squamous cell carcinoma patients, we examined deltaNp63 expression that was specific for squamous cell carcinoma in blood samples obtained from 43 esophageal cancer patients. RESULTS: Seventeen of 33 (52%) patients with primary esophageal squamous cell carcinoma and 6 of 10 (60%) patients with postoperative recurrent squamous cell carcinoma had detectable deltaNp63 expression in their peripheral blood using deltaNp63-specific reverse transcription-PCR. Furthermore, deltaNp63 is a more sensitive marker compared with other commonly used tumor markers such as squamous cell carcinoma-associated antigen and carcinoembryonic antigen. CONCLUSIONS: This approach would be potentially useful for the monitoring of patients with this aggressive disease.

Adult↗

PubMed2002

[Expression of inducible nitric oxide synthase mRNA in squamous cell carcinoma of tongue].

BACKGROUND & OBJECTIVE: Recently, most of studies have indicated that nitric oxide (NO) plays an important role in carcinogenesis and tumor progression. Inducible nitric oxide synthase(iNOS) has been found at significantly higher expression levels in head and neck squamous cell carcinoma (HNSCCA) specimens as compared with that in normal tissue. Furthermore, these data provided strong evidance for the role of iNOS generating NO in HNSCCA progression. However, there was no report about whether expression of iNOS mRNA in oral carcinoma is associated with its biological behavior. This study was designed to investigate the correlation between expression of inducible nitric oxide synthase mRNA (iNOS mRNA) in squamous cell carcinoma of tongue tissue and its invasive growth, neck lymph node metastasis, and prognosis. METHODS: Sixty-eight cases with squamous cell carcinoma of tongue tissues were investigated. All cases with tongue carcinoma were followed up to obtain the information of prognosis. In situ hybridization assay was used to detect the expression of iNOS mRNA in tongue carcinoma tissues. The correlation between expression of iNOS mRNA in squamous cell carcinoma of tongue tissue and its invasive growth, neck lymph node metastasis, and prognosis was analyzed. RESULTS: 1. The positive expression rate of iNOS mRNA was 86.1% and 48.0% in the group of invasive growth and no invasive growth respectively. The difference between the two groups was significant with coefficient of 0.3. 2. The positive expression rate of iNOS mRNA was 85.7% and 62.5% in the group of positive lymph node metastasis and negative lymph node metastasis respectively. The difference between the two groups was significant, which the correlation coefficient was 0.3. 3. Three-year survival rate was significantly lower in the group of positive expression of iNOS mRNA than that in the group of negative expression of iNOS mRNA in the tongue carcinoma. CONCLUSIONS: 1. A positive correlation was found between the positive expression of iNOS mRNA and invasive growth as well as neck lymph node metastatsis of squamous cell carcinoma of tongue. 2. The patient's prognosis of the positive expression of iNOS mRNA would be worse than that of the negative expression of iNOS mRNA in tongue carcinoma tissue.

Adult↗

PubMed2002

Expression of CD44V6 and PCNA in squamous cell carcinomas.

OBJECTIVE: To investigate the expression of cluster of differentiation 44 variant 6 (CD(44V6)) and proliferating cell nuclear antigen (PCNA) in ocular squamous cell carcinomas. METHODS: Streptavidin-biotin complex (SABC) immunohistochemistry was used to explore the expression of CD(44V6) and PCNA in 35 cases of ocular squamous cell carcinomas, 20 cases of papillomas, and 11 cases of normal eyelid tissue. RESULTS: The CD(44V6) positive rate was 62.9% (22/35) in ocular squamous cell carcinomas, 15.0% (3/20) in papillomas, but not detectable in the 11 cases of normal eyelid tissue. The positive expression rates of CD(44V6) in ocular squamous cell carcinomas were significantly higher than in benign tumors (chi(2) = 11.57, P < 0.01) or control tissue (P = 0.001), and the positive expression rates of CD(44V6) in metastasis were significantly higher than without metastasis (P = 0.049). PCNA labeling indexes (PI) in tumors with CD(44V6) expression were significantly higher than those without (t = 20.21, P < 0.01). CONCLUSIONS: Overexpression of CD(44V6) is correlated with the progress and metastasis of ocular squamous cell carcinomas. CD(44V6) protein positive staining is associated with high PI. CD(44V6) and PCNA are useful for evaluating prognosis.

Carcinoma, Squamous Cell↗