Prediction of prognosis in oral squamous cell carcinoma using infrared microspectroscopy

Abstract

Background: Estimation of prognosis of oral squamous cell carcinoma (OSCC) is inaccurate prior to surgery, only being effected following subsequent pathological analysis of the primary tumour and excised lymph nodes. Consequently, a proportion of patients are overtreated, with an increase in morbidity, or undertreated, with inadequate margins and risk of recurrence. We hypothesise that it is possible to accurately characterise clinical outcomes from infrared spectra arising from diagnostic biopsies. In this first step, we correlate survival with IR spectra derived from the primary tumour.

Methods: Infrared spectra were collected from tumour tissue from 29 patients with OSCC and subject to classification modelling.

Results: The model had a median AUROC of 0.89 with regard to prognosis, a median specificity of 0.83, and a hazard ratio of 6.29 in univariate Cox proportional hazard modelling.

Conclusion: The data suggest that FTIR spectra may be a useful early biomarker of prognosis in OSCC.

Keywords: FTIR; OSCC; biomarker; infrared microspectroscopy; prognosis.

FIGURE 1

Stratification of patients into low‐ and high‐risk groups. (A) Whisker box plots of survival duration in months for low‐ (left) and high (right)‐risk groups. Horizontal dotted line indicates the survival time that separates the two groups; (B) Kaplan–Meier survival curves of each risk group. The log‐rank statistic and corresponding p‐value are also shown.

FIGURE 2

Prediction of risk of death within 11 months using patient prediction scores. Median AUROC curve for the FTIR‐based model. The dashed black lines represent baselines scores associated with random chance.

FIGURE 3

Kaplan–Meier survival curves for each risk group. Blue line: low‐risk patient group defined by the model; red line: high‐risk patient group defined by the model. Shading indicates confidence intervals.