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

Summary 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.