Expression and Significance of Warburg Effect Key Factors GLUT-1 and HK-II in Vocal Cord Leukoplakia: The Role of GLUT-1 and HK-II in Vocal Cord Leukoplakia

Objective: We assessed the expression of glucose transporter (GLUT)-1 and hexokinase (HK)-Ⅱ in vocal cord leukoplakia (VCL) and investigated its clinical significance.

Methods: We collected 127 archival pathological specimens from patients with VCL, 29 from vocal cord polyps, and 31 with laryngeal carcinoma at our hospital between December 2018 and December 2022. GLUT-1 and HK-II expression was detected using immunohistochemistry.

Results: Significant differences were observed between the VCL and vocal cord polyp groups according to sex (P < 0.0001), smoking status (P = 0.001), and alcohol consumption (P = 0.007). GLUT-1 expression was observed in 36.2%, 20.7%, and 90.3% of patients with VCL, vocal cord polyps, and laryngeal carcinoma, respectively. GLUT-1 was highly expressed in severe dysplasia or carcinoma in situ (CIS) compared with vocal cord polyps (P < 0.001). GLUT-1 expression was lower in the VCL group than in the laryngeal carcinoma group (P < 0.001). HK-II expression was observed in 42.5%, 34.5%, and 80.6% of patients with VCL, vocal cord polyps, and laryngeal carcinoma, respectively. HK-II expression was significantly higher in severe dysplasia or CIS compared with vocal cord polyps (P = 0.004). HK-II expression was lower in the VCL group than in the laryngeal carcinoma group (P < 0.001). Both GLUT-1 expression (P < 0.001) and HK-II expression (P = 0.03) increased significantly with the degree of dysplasia. A significant correlation was observed between GLUT-1 and HK-II expression (r = 0.313, P < 0.001).

Conclusion: GLUT-1 and HK-II are significantly overexpressed in VCL patients. In VCL patients, GLUT-1 and HK-II expression levels increase proportionally with the degree of dysplasia.