High HMGA2 Expression Correlates with Reduced Recurrence-free Survival and Poor Overall Survival in Oral Squamous Cell Carcinoma

Background/Aim: High-mobility group AT-hook 2 (HMGA2) is an architectural transcription factor that is expressed in many human neoplasms. Oral squamous cell carcinoma (OSCC) is one of the leading cancers in the world, particularly in Southeast Asia. In this study, the expression level of HMGA2 was determined on tissue microarray of OSCC and its correlation with prognosis of patients was studied. Materials and Methods: Immunohistochemistry of HMGA2 was analyzed on resection samples from 148 patients with OSCC. The expression level of HMGA2 was determined by ImmunoRatio. Results: High expression of HMGA2 in OSCC was found to be associated with tumor recurrence (p=0.026). Cox model analysis revealed that high expression of HMGA2 was significantly associated with poor survival in patients with OSCC. The Kaplan-Meier analysis also showed decreased survival in patients with high HMGA2 expression. By combining HMGA2 immunostaining and clinicopathological characteristics as analyzing factors, high HMGA2 expression was specifically correlated with poor survival in patients with perineural invasion and lymph node metastasis of OSCC. Additionally, high expression of HMGA2 was found to be a tumor-stage independent prognostic factor associated with high incidence of tumor recurrence and shortened recurrence-free survival. Conclusion: HMGA2 is not only a biomarker for predicting patients with tumor recurrence and poor survival, but when combined with clinicopathological factors, can categorize patients into different risk groups for better clinical management of OSCC.