Korean J Otorhinolaryngol-Head Neck Surg.  2021 May;64(5):336-343. 10.3342/kjorl-hns.2020.00374.

Prognostic Significance of the Expression of Claudin-1 in Head and Neck Squamous Cell Carcinoma

  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 2Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea


Background and Objectives
Claudin-1 (CLDN-1) is the major component of tight junctions and functions in controlling cell to cell adhesion. Certain claudins were expressed aberrantly and proved to have prognostic significance in various human cancers. However, its clinical significance has been poorly understood in head and neck squamous cell carcinoma (HNSCC). The aim of this study was to investigate the relationship between CLDN-1 expression and clinicopathologic parameters in HNSCC.
Subjects and Method
The surgical specimens of primary HNSCCs from a consecutive cohort of 91 patients were retrospectively collected. Immunohistochemical staining for CLDN-1 was performed blindly by two pathologists. CLDN-1 staining intensity was scored semi-quantitatively on a scale of 0 to 3 (0: negative; 1: weak; 2: moderate; 3: strong). For the statistical analysis, the expression levels were classified as low (negative and weak) and high (moderate and strong). Next, the association between CLDN-1 expression and clinicopathological features & clinical outcomes was analyzed.
The increased CLDN-1 expression was significantly associated with lymphatic invasion (p=0.019). The expression level of CLDN-1 was not associated with pathological T stage, lymph node metastasis or recurrence. Kaplan-Meier analysis found that 3-year overall survival (OS) rate was 53% in patients with high level CLDN-1 expression and 74% in patients with low level CLDN-1 expression. It also found that 5-year OS rate was 49% in patients with high level CLDN-1 expression and 68% in patients with low level CLDN-1 expression. A significantly poor OS rate was recorded in patients with high level of CLDN-1 expression compared to patients with low level CLDN-1 expression (p=0.022).
CLDN-1 may serve as useful prognostic marker in patients with HNSCCs.


Claudin-1; Immunohistochemistry; Prognosis; Squamous cell carcinoma of head and neck; Tight junctions
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