Results
Patients’ Demographic and Histopathological Features
The mean age of the 104 total cases in our study was determined as 56±8.1 years (33-82 years). There was no significant difference between the mean age of both genders (p: 0.775). 102 of the cases were male, and the male/female ratio was 8,5/1. Glottic cancers (75.4%) were more common than supraglottic cancers (22%), and three primary subglottic cancers were recorded (2.6%). The average macroscopic radius of the tumor was determined as 3.1±1.8 (0.8-6 cm) cm. In the histological grading of the cases, it was determined that 70 of the cases were moderately differentiated (G2). Primary Tumor (pT) distributions were observed as follows: 12 of them had pT1, 18 of them had pT2, 36 of them had pT3 and 48 of them had pT4. According to the TNM staging system (American Joint Committee on Cancer) [18], 12 cases were stage I, 16 cases were stage II, 26 cases were stage III, 60 cases were stage IV. Lymphovascular invasion was present in 66 cases but was not observed in 48 of the cases. When the peritumoral lymphocytic reaction distribution was examined, it was determined that 52 of the cases were of moderate intensity. When the lymph nodule metastasis distributions of the cases were examined, it was determined that 78 cases did not have lymph nodule metastasis, and 28 of them had pN1. 60 (52,6%) of the patients died within 5 years of observation. The survival rate ranged from 1 months to 52 months. Metastasis was seen in 24 (21%) patients, recurrence was seen in 8 (7%) patients within 5 years of observation. (Table 1). 
Expression of HSPA-2 in different areas of laryngeal tisues
A total of 114 cases of paraffin blocks of LSCC and adjacent non-cancerous tissues were analyzed by immunohistochemistry. In all of the cases, HSPA-2 positivity was determined in tumoral areas (%100). The positive expression rate of HSPA-2 in the adjacent non-cancerous tissues was 48/114 (%42). There was significant correlation between adjacent non-cancerous tissues and tumoral areas (p:0,002). There was no significant correlation between adjacent non-cancerous tissues and normal tissues (p: 0,225).
In well-differentiated tumors, a more distinct expression was observed predominately in the periphery of tumor solid islands. In areas where differentiation loss was pronounced, more widespread and severe expression was observed. Additionally, while positivity was observed only in 1/3 of the basal part of the epithelium in low-grade epithelial dysplasia areas, full coat staining was seen in high-grade epithelial dysplasia areas (Figure 2). 
Prognostic significance of HSPA-2 expression in LSCC
The statistical relationship of age and the HSPA-2 staining ratio, intensity, histoscore could not be determined (p: 0,527/ p: 0,722/ p: 0,518). The statistical relationship of gender and the HSPA-2 staining ratio, intensity, histoscore could not be determined either (p: 0,235/ p: 0,255/ p: 0,092).
When the interactions between prognostic parameters such as the tumoral macroscopic volume, peritumoral lymphocytic reaction, the presence of ulceration, perineural invasion, , lymphovascular invasion, histological grade, lymph nodule metastasis, primary tumor, the TNM stage, recurrence, metastasis and survival rate were examined, the following results were obtained. A significant positive correlation was observed between the presence of lymph nodule metastasis (pN) (p:0,0046 , p:0,0008, p:0,0014), lymphovascular invasion (p: 0,0003, p:0,0009, p:0,0001), primary tumor (pT) (p<0,0001, p<0,0001 p<0,0001), TNM stage (p<0,0001, p<0,0001 p<0,0001), recurrence (p:0,0020, p:0,0010, p:0,0009) , metastasis (pM) (p<0,0001, p<0,0001 p<0,0001), survival rate and HSPA-2 staining rate, staining intensity, histoscore (Table-2). A significant positive correlation was observed between the tumoral macroscopic volume (p: 0,015, p:0,014) and HSPA-2 staining rate and histoscore only. A statistically significant relationship was not found between histological grade (p:0,6896, p:0,2405, p:0,2434), peritumoral lymphocytic reaction (p:0,0975, p:0,2431, p:0,5526), ulceration (p:0,3696, p:0,4774, p:0,2143), perineural invasion (p:0,1543, p:0,1291, p:0,054) and HSPA-2 staining rate, intensity and histoscore (Table-2).