The Prognostic Value of Inositol Polyphosphate 5-Phosphatase in Cutaneous Squamous Cell Carcinoma

Publication date: Available online 22 October 2018

Source: Journal of the American Academy of Dermatology

Author(s): Helen JL. Cumksy, Collin M. Costello, Nan Zhang, Richard Butterfield, Matthew Buras, Jessica Schmidt, Kevin Drenner, Steven A. Nelson, Shari A. Ochoa, Christian Baum, Mark R. Pittelkow, David J. DiCaudo, Aleksandar Sekulic, Aaron R. Mangold

Abstract

Background

Inositol Phosphate 5-Phosphatase (INPP5A) has been shown to play a role in development and progression of cutaneous squamous cell carcinoma (cSCC). The goal of the current study is to explore the prognostic value of INPP5A expression in cSCC.

Methods

A total of 189 cases of actinic keratoses and SCCs from 174 patients were identified, clinical and outcome data abstracted, histopathology re-rereviewed, and immunohistochemical (IHC) staining and interpretation was performed for INPP5A.

Results

The majority of tumors (89.4%) had an INPP5A score of 2 or 3. No patients had complete loss of INPP5A. Tumors with INPP5A score of 1 were more likely to be intermediate to high risk (BWH stage T2a and above 85.0% vs 23.7%, p < 0.0001), have a larger diameter (2.4 cm vs. 1.3 cm, p = 0.0004), moderate to poor differentiation (86.7% vs. 17.6%, p < 0.0001), and perineural invasion (37.5% vs. 5.3%, p < 0.0001). INPP5A score of 1 has worse 3-year survival of 42.3% (HR = 2.81, p = 0.0006) and local metastatic rates of 48.0% (HR=4.71, p < 0.0001).

Conclusions

Low INPP5A scores are predictive of aggressive tumors and may be a useful adjunct to guide clinical management of cSCC.