Clinical and morphologic classification of squamous cell carcinomas of the oral cavity and oropharynx based on phenotypic and genotypic predictors

Head and neck squamous cell cancer (HNSCC) is a multifactorial disease with phenotypic and clinical heterogeneity. Currently, the choice of treatment method for HNSCC is based on anatomical localization, tumor stage (T) and lymph node involvement (N) without taking into account the biological heterogeneity of the tumors. The most important genetic alterations in HNSCC are described in the TCGA study with the delineation of two large cohorts of patients according to HPV (human papillomavirus) status and different carcinogenesis pathways. As a result of genetic profiling of squamous cell carcinomas using high-throughput transcriptomic analysis, studying individual predictive markers, variants of molecular classifications have been proposed, the use of which is limited in clinical practice. The aim of the study was to investigate the peculiarities of the molecular pattern of squamous cell carcinoma (SCC) of the tongue and oropharynx with the formation of a predictive surrogate classification of SCC.
Material and Methods. The study presents a variant of surrogate SCC classification according to specific molecular patterns, HPV status, immune response, and morphological predictors with the distinction of groups allowing to personalize the treatment strategy for patients with HNSCC. The results of the study have shown that patients with tongue and oropharyngeal SCC could be classified into 6 subtypes based on the protein expression characteristics indicative of fundamental genetic defects and peculiarities of the immune environment. Each subtype is characterized by different clinical and morphological characteristics, biological functions, features of immune response, and prognosis. The prognostic models are predictive in nature.
Keywords: squamous cell cancer, oropharyngeal carcinoma, surrogate classification, p16, p53, PD-L1, treatment pathomorphosis
Conflicts of interest. The authors have no conflicts of interest to declare. Funding. There was no funding for this study