Expression analysis of <scp>SOX2</scp> and <scp>SOX9</scp> in patients with oral squamous cell carcinoma
Sonja Steen, Dominik Horn, Christa Flechtenmacher, Jürgen Hoffmann, Kolja Freier, Oliver Ristow, Jochen Heß, Julius Moratin
Abstract
Abstract Background Lately SOX2 and SOX9, transcription factors associated with stemness‐like phenotypes of cancer cells, have been linked to tumor growth, metastasis, and resistance to therapy. Methods This study aimed on evaluating the expression of SOX2 and SOX9 in a large cohort of patients with OSCC including primary and recurrent tumors and corresponding lymph node metastases. Semiautomatic digital pathology scoring was used to determine protein expression and survival analysis was performed to evaluate its prognostic significance. Results We found a significant downregulation of SOX9 from primary disease to lymph node metastases ( p < 0.001). SOX9 expression and the subgroup SOX2 low SOX9 high were significantly correlated with worse overall survival ( p < 0.05). Additionally, SOX2 low SOX9 high expression pattern was confirmed as independent prognosticator for overall survival. Conclusions These results indicate the relevant role of SOX2 and SOX9 in patients with OSCC and show the clinical relevance for further investigation on the molecular mechanisms underlying SOX‐related gene expression.