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Exploring and validating innovative methods for detection and localization of head and neck squamous cell carcinoma primary tumors and lymph node metastases

placental cadherin (P-cadherin), monocarboxylate transporter 1 (MCT-1), and neural/glial antigen 2 (NG2). These findings on mRNA level were validated on protein level by immunohistochemistry (IHC) in biopsies of HNSCC, adjacent suspicious tissue, and of normal mucosa. The targets showing the highest expression were GLUT-1 and P-cadherin, both expressed in all tumors and with the highest median percentage of expression in tumor cells (100%). GLUT-1 is the main glucose transporter that is overexpressed to meet the higher glucose demand in cancer cells, 26 and our results are in line with the literature describing expression in 96-100% of oral cavity tumors. 27,28 P-cadherin is a cell-cell adhesion glycoprotein that had higher expression than healthy mucosa in a laryngeal SCC cell line microarray. 29,30 We found the percentage of expression in tumor cells to be significantly higher for GLUT-1 and P-cadherin compared with the percentage of EGFR. Based on these findings by IHC, GLUT-1 and P-cadherin are promising targets for fluorescence imaging in HNSCC as an alternative to EGFR. However, GLUT-1 expression was also seen in erythrocytes, and P-cadherin expression was seen in the basal layer of the mucosa, which could reduce the TBR during fluorescence imaging. There are no clinically approved antibodies available for these targets yet.