Open Access

ARTICLE

miR-449a: A Novel Biomarker for Diagnosis, Prognosis, and Treatment Response in Locally Advanced Laryngeal Squamous Cell Carcinoma

Amal F. Gharib¹, Ohud Alsalmi¹, Hayaa M. Alhuthali¹, Afaf Alharthi¹, Saud Ayed Alharthi², Shaimaa A. Alharthi³, Rasha L. Etewa⁴, Wael H. Elsawy^5,*

1 Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif, 21944, Saudi Arabia
2 Department of Otorhinolaryngology, King Abdulaziz Specialized Hospital, Taif, 26521, Saudi Arabia
3 Department of Medicine, Fakeeh College for Medical Sciences, P.O. Box 2537, Jeddah, 21461, Saudi Arabia
4 Pathology Department, College of Medicine, Jouf University, Sakaka, 72388, Saudi Arabia
5 Clinical Oncology Department, Faculty of Medicine, Zagazig University, Zagazig, 44519, Egypt

* Corresponding Authors: Wael H. Elsawy. Email: ,

(This article belongs to the Special Issue: Novel Biomarkers and Treatment Strategies in Solid Tumor Diagnosis, Progression, and Prognosis (Ⅱ))

Oncology Research 2026, 34(3), 21 https://doi.org/10.32604/or.2025.073051

Received 09 September 2025; Accepted 29 October 2025; Issue published 24 February 2026

Abstract

Background: Locally advanced laryngeal squamous cell carcinoma (LA-LSCC) presents clinical challenges due to the lack of reliable non-invasive biomarkers. This study aimed to evaluate miR-449a as a diagnostic and prognostic biomarker in LA-LSCC. Methods: miR-449a expression was analyzed in tumor tissues, adjacent normal tissues, and serum from 81 LA-LSCC patients and 50 controls using quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR). We assessed the diagnostic accuracy by Receiver Operating Characteristic curve (ROC curves), clinicopathological associations, survival outcomes (Kaplan-Meier), and treatment response dynamics. Results: miR-449a was significantly downregulated in LA-LSCC tissues (p < 0.0001) and serum (p < 0.0001), with a strong tissue-serum correlation (R² = 0.988). Tissue miR-449a demonstrated a diagnostic accuracy (Area Under the Curve, AUC = 0.857), while serum showed moderate accuracy (AUC = 0.734). High miR-449a expression correlated with favorable clinicopathological features and improved survival (median overall survival: 67.82 vs. 23.74 months; p = 0.0012). Multivariate analysis confirmed miR-449a as an independent prognostic factor (p < 0.001). miR-449a levels increased post-treatment, particularly in responders to chemotherapy/radiation (p < 0.0001). Conclusion: miR-449a serves as a non-invasive biomarker for LA-LSCC diagnosis, prognosis, and treatment monitoring. Its dynamic expression highlights potential for risk stratification and therapy response prediction, warranting further validation in larger cohorts.

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