ERCC1, XPF and XPA—locoregional differences and prognostic value of DNA repair protein expression in patients with head and neck squamous cell carcinoma

  • Sebastian ProchnowEmail author
  • W. Wilczak
  • V. Bosch
  • T. S. Clauditz
  • A. Muenscher
Original Article



Nucleotide excision repair protein expression has been claimed to be responsible for platinum-based chemotherapy resistance. ERCC1, XPF and XPA, core proteins in DNA repair, were evaluated regarding their prognostic value in patients with head and neck squamous cell carcinoma by looking at overall survival and time to recurrence.

Materials and methods

Tissue microarrays were constructed from 453 cases of HNSCC, including 222 oral (49%), 126 oropharyngeal (27.8%) and 105 laryngeal (23.2%) tumours. There were 284 XPF, 293 XPA and 294 ERCC1 specimens evaluable for protein expression analysis after immunohistochemical workup. Expression levels were dichotomised into high- and low-expressing groups. Outcomes for overall survival (OS) and time to recurrence (TTR) were analysed using the Kaplan-Meier method.


No correlation between ERCC1, XPA and XPF expression and OS was found by looking at the overall patient cohort. However, subsite analysis revealed that high ERCC1 expression was associated with a significantly inferior OS in patients with SCC of the oral cavity (p = 0.028) and showed an independent predictive value in multivariate analysis (p = 0.0123). High XPA expression showed a significantly increased OS in patients with oropharyngeal SCC (p = 0.0386). Regarding XPF, no impact on OS in any subsite could be shown.


While high ERCC1 expression functions as a predictive marker with decreased OS in patients with squamous cell carcinoma of the oral cavity, high XPA expression shows an inverse effect in the subsite of the oropharynx, which has not been described previously.

Clinical relevance

ERCC1 and XPA might be candidates to overcome chemotherapy resistance in subtypes of HNSCC.


ERCC1 XPA XPF DNA repair Prognostic factors HNSCC 



This work was supported by the Hamburger Krebsgesellschaft e.V.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent



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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Otorhinolaryngology and Head and Neck SurgeryUniversity Medical Center Hamburg-EppendorfHamburgGermany
  2. 2.Department of PathologyUniversity of HamburgHamburgGermany

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