Positive association of glucose-regulated protein 78 during oral cancer progression and the prognostic value in oral precancerous lesions

Background. Our aim was to examine the potential role of glucose-regulated protein (GRP)78 during oral cancer progression and the prognostic value in oral precancerous lesions. Methods. A total of 204 patients with oral cancer and 86 with precancerous lesions were investigated. GRP78 expression was determined in the lesion tissues by Western blot analysis. Association of GRP78 with clinicopathology or disease prognosis was examined using Fisher's exact, Kaplan-Meier, or Cox regression method. Results. Hyperexpression of GRP78 was found to be correlated with increasing malignant potential of oral lesions, with 14% in leukoplakia, 27% in erythroplakia, 50% in verrucous lesion, and 74% in oral cancer (p < .0001), suggesting this molecule plays a crucial role in the early steps of oral oncogenesis. In patients with precancerous lesions of the oral cavity, GRP78 expression predicts poorer same-site premalignancy-free survival (p = .002) and malignancy-free survival rates (p = .002). Conclusion. Determination of GRP78 expression levels might enable a better risk stratification for patients with oral premalignant lesions.