PERINEURAL INVASION IN EPIDERMOID CARCINOMA OF THE HEAD AND NECK: IMPACT OF GENES RELATED TO CIRCADIAN RHYTHM
Proliferation; Schwann; Tumor progression; Metastasis.
During the processes of tumor formation and progression there is the involvement of the action of cells
that create a favorable microenvironment for cancer development. Among the mechanisms involved in
these events are circadian rhythm alterations and perineural invasion. Both events have been described,
separately, as active in tumor aggressiveness. It is important to identify events related to circadian
rhythm alterations that are associated with cancer that may directly impact the invasion of this tissue
into the peripheral nervous system. The aim of this study was to evaluate perineural invasion in head
and neck cancer, associating it with genes related to the peripheral nervous system and circadian rhythm.
The data showed that the circadian rhythm and axon guidance pathways were deregulated in head and
neck squamous cell carcinoma with positive perineural invasion. Differential expression analyses identified
that genes associated with Schwann cell response in injured nerves that are positively regulated
activate the circadian rhythm pathway. Negative correlation was identified between expression and
methylation of PER3 and RORC genes when analyzed separately in both tumor groups. Positive correlations
between expression of PER2 and RORC, as well as of RORC with MPZ, S100A8 and NUF2
genes were identified only in the groups of patients who did not present perineural invasion. Circadian
rhythm genes are dysregulated in neoplastic tissues, with increased expression of oncogenes and decreased
expression of tumor suppressors. Increased expression of mTOR protein was identified in patients
presenting with perineural invasion. The data suggest that dedifferentiation and proliferation of
Schwann cells may be associated with downregulation of circadian rhythm genes; consequently,
Schwann cells produce different factors that participate in various processes of tumor progression and
invasion of adjacent tissues, including activation of the mTOR pathway. These processes may also be
involved in tumor invasion into the perineural tissue in head and neck cancer.