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Open AccessArticle

The Emerging Role of NANOG as an Early Cancer Risk Biomarker in Patients with Oral Potentially Malignant Disorders

1
Department of Oral and Maxillofacial Surgery, Hospital Universitario Central de Asturias (HUCA), C/Carretera de Rubín, s/n, 33011 Oviedo, Asturias, Spain
2
Department of Surgery, University of Oviedo, Asturias 33006, Spain
3
Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), C/Carretera de Rubín, s/n, 33011 Oviedo, Asturias, Spain
4
Instituto Universitario de Oncología del Principado de Asturias (IUOPA), University of Oviedo, Asturias 33006, Spain
5
Department of Otolaryngology, Hospital Universitario Central de Asturias (HUCA), C/Carretera de Rubín, s/n, 33011 Oviedo, Asturias, Spain
6
Ciber de Cáncer (CIBERONC), Instituto de Salud Carlos III, Av. Monforte de Lemos, 3-5, 28029 Madrid, Spain
7
Department of Pathology, Hospital Universitario Central de Asturias (HUCA), IUOPA, C/Carretera de Rubín, s/n, 33011 Oviedo, Asturias, Spain
8
Christian Medical College and Hospital, Ludhiana 141008, Punjab, India
*
Authors to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(9), 1376; https://doi.org/10.3390/jcm8091376
Received: 29 July 2019 / Revised: 28 August 2019 / Accepted: 30 August 2019 / Published: 3 September 2019
NANOG, a key regulator of pluripotency and self-renewal in embryonic and adult stem cells, is frequently overexpressed in multiple cancers, including oral squamous cell carcinoma (OSCC). It has been frequently associated with poor outcomes in epithelial cancers, and recently implicated in laryngeal tumorigenesis. On this basis, we investigated the role of NANOG protein expression as an early cancer risk biomarker in oral potentially malignant disorders (OPMD), and the impact on prognosis and disease outcomes in OSCC patients. NANOG expression was evaluated by immunohistochemistry in 55 patients with oral epithelial dysplasia, and 125 OSCC patients. Correlations with clinical and follow-up data were assessed. Nuclear NANOG expression was detected in 2 (3.6%) and cytoplasmic NANOG expression in 9 (16.4%) oral dysplasias. NANOG expression increased with the grade of dysplasia. Cytoplasmic NANOG expression and the histopathological grading were significantly correlated with oral cancer risk, although dysplasia grading was the only significant independent predictor of oral cancer development in multivariate analyses. Cytoplasmic NANOG expression was also detected in 39 (31%) OSCC samples. Positive NANOG expression was significantly associated with tobacco and alcohol consumption, and was more frequent in pN0 tumors, early I-II stages. These data unveil the clinical relevance of NANOG in early stages of OSCC tumorigenesis rather than in advanced neoplastic disease. NANOG expression emerges as an early predictor of oral cancer risk in patients with OPMD. View Full-Text
Keywords: oral squamous cell carcinoma; oral cancer risk; oral epithelial dysplasia; NANOG; immunohistochemistry oral squamous cell carcinoma; oral cancer risk; oral epithelial dysplasia; NANOG; immunohistochemistry
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de Vicente, J.C.; Rodríguez-Santamarta, T.; Rodrigo, J.P.; Allonca, E.; Vallina, A.; Singhania, A.; Donate-Pérez del Molino, P.; García-Pedrero, J.M. The Emerging Role of NANOG as an Early Cancer Risk Biomarker in Patients with Oral Potentially Malignant Disorders. J. Clin. Med. 2019, 8, 1376.

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