Epithelial–Mesenchymal Transition Predicts Survival in Oral Squamous Cell Carcinoma

Abstract

Synergistic loss of E-cadherin and acquisition of vimentin are characteristic feature of epithelial–mesenchymal transition (EMT) which confers an invasive phenotype of epithelial cancer cells. The aim of the study was to evaluate the prognostic significance of E-cadherin and vimentin expression individually and in combination as a measure of epithelial–mesenchymal transition (EMT) in oral squamous cell carcinoma (OSCC). Expression of E-cadherin and vimentin through immunohistochemical analysis was examined in 200 patients with surgically resected OSCC. Combined E-cadherin and vimentin expression was evaluated to determine the EMT status. Kaplan–Meier curves and log-rank test were used to compare differences in survival. Cox regression analysis was performed to identify independent prognostic factors. E-cadherin expression was negative in 28 (14%) tumors, and vimentin expression was positive in 87 (43.5%) tumors. Moreover, 99 (49.5%), 87 (43.5%), and 14 (7.5%) tumors exhibited no, partial, and complete EMT, respectively. Both individual protein expression were significant prognostic factors [Negative E-cadherin, hazard ratio (HR) = 1.74, 95% confidence interval (CI) = 1.04–2.93; positive vimentin, HR = 1.64, 95% CI = 1.12–2.41]. For EMT status, the HR increased with EMT progression [partial EMT, HR = 1.64, 95% CI = 1.09–2.49; complete EMT, HR = 2.88, 95% CI = 1.44–5.79], of which, the complete EMT had higher HR than was individual protein expression. Combined E-cadherin and vimentin expression as a measure of EMT showed a superior prognostic significance compared with individual protein expression.

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Abbreviations

ASR:

Age-standardized incidence rate

CI:

Confidence interval

CMT:

chemotherapy

EMT:

Epithelial–mesenchymal transition

HR:

Hazard ratio

LVSI:

lymphovasular invasion

OSCC:

Oral squamous cell carcinoma

PNI:

perineural invasion

RT:

radiotherapy

TMA:

Tissue microarray

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Acknowledgments

This work was supported by funding from the Faculty of Medicine, Prince of Songkla University, Thailand. We would like to thank the cancer registry unit for the use of their registry data.

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Correspondence to Paramee Thongsuksai.

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Wangmo, C., Charoen, N., Jantharapattana, K. et al. Epithelial–Mesenchymal Transition Predicts Survival in Oral Squamous Cell Carcinoma. Pathol. Oncol. Res. 26, 1511–1518 (2020). https://doi.org/10.1007/s12253-019-00731-z

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Keywords

  • Epithelial–mesenchymal transition
  • E-cadherin
  • Vimentin
  • p16
  • Oral squamous cell carcinoma
  • Prognosis
  • Immunohistochemistry