The middle and outer skin layers are susceptible to squamous cell carcinoma (cSCC). The red lesions and scaly bumps can metastasize to lymph nodes and other organs. A large scale protein study or proteomics can give insights into the biological processes behind metastasis. This study attempts to identify proteins responsible for cSCC metastasis.

The researchers conducted a proteomic approach on 105 completely excised primary cSCCs. A total of 52 metastasized (P-M), while 53 did not metastasize at 5 year post-surgery (P-NM). The researchers microdissected the formalin-fixed, paraffin-embedded squamous cells. The analysis continued with one dimensional (1D), separate 2D, and liquid chromatography fractionation. Finally, the cSSCs underwent proteomic profiling process.

The discovery set had 24 P-Ms and 24 P-NMs. They identified 144 protein expressions with significant differentiation. They included 33 proteins identified using both 1D and 2D separation between P-Ms and P-NMs. Several protein expressions had a high association with SCC survival in other organs. The 2 proteins Annexin A5 (ANXA5) and Dolichyl‐diphosphooligosaccharide‐protein glycosyltransferase non‐catalytic subunit (DDOST) got verified and validated. Their increased expression reduced cSCC metastasis time. They also decreased survival chances in cervical, mouth, and throat cancers. 

The prediction model with the 2 proteins had 91.18% accuracy, higher sensitivity, and specificity. These prognostic biomarkers are more efficient than current cSCC staging systems.