Clinico-pathological correlation of E-cadherin expression at the invasive tumor front of Indian oral squamous cell carcinomas: An immunohistochemical study

E-Cadherin is a diagnostic biomarker in the progression of oral epithelial dysplasia to squamous cell carcinoma

Background

Oral squamous cell carcinoma is a common cancer of head and neck region with poor prognosis and may sometimes show a premalignant stage. Cell-cell adhesion molecules play an important role in the process of malignant transformation. E-cadherin, a cell-to-cell adhesion molecule, plays a crucial role in maintaining cell polarity and adhesion of epithelial cells.

Aims

To assess the expression of E-cadherin in various grades of oral epithelial dysplasia and oral squamous cells carcinoma and compare it to unremarkable oral mucosa.

Materials and methods

The study comprised a total sample size of 80 with 10 cases of unremarkable oral mucosa which is the control group, 40 cases of oral epithelial dysplasia and 30 cases of oral squamous cell carcinoma. One section was stained with haematoxylin and eosin to confirm the histopathological diagnosis and other section was stained immunohistochemically with E-cadherin.

Results

The study found that E-cadherin expression was strongly positive in unremarkable mucosal epithelium, reduced in oral epithelial dysplasia, and gradually decreased as it progressed to oral squamous cell carcinoma. These findings were found to be statistically significant.

Conclusion

The study found a correlation between E-cadherin expression loss and oral squamous cell carcinoma progression, suggesting that E-cadherin can serve as a diagnostic biomarker for malignant transformation of oral epithelial dysplasia and predict disease prognosis in oral squamous cell carcinoma.

Quantification of CD44, Epidermal Growth Factor Receptor, E-cadherin, and Vimentin in Oral Squamous Cell Carcinoma as an Indicator for Disease Progression and Survival

BACKGROUND

Oral squamous cell carcinoma (OSCC) is commonly associated with early recurrence due to loco-regional spread. Changes at the cellular levels can be studied and are often an early indicator of disease progression, much before clinical symptoms become visible. Identifying parameters indicating an impending recurrence could help the clinician plan for early treatment and thus improve survival. Hence, this study aimed to determine if quantifiable parameters could be established for CD44, epidermal growth factor receptor (EGFR), E-cadherin, and vimentin and if these values could be used as indicators of disease progression on follow-up.

METHOD

A total of 150 cases of OSCC were included in the study and followed up linearly for 36 months. Paraffin-embedded tissues of these cases were subjected to immunohistochemical analysis for reactivity to CD44, EGFR, E-cadherin, and vimentin. The immunohistochemical staining correlated with the tumor's clinical and histological grade. Statistical analysis was done using SPSS Statistics version 17 (IBM Corp., Armonk, NY, USA). The receiver operating characteristics (ROC) were deployed for determining the correlation of recurrence with the immunohistochemistry (IHC) markers, while the Kaplan-Meier curve was employed for survival analysis.

RESULTS

A recurrence rate of 70.0% and a survival rate of 66.6% were noted after a follow-up period of three years. It was found that both CD44 and E-cadherin decreased with the grade of tumor, while EGFR and vimentin increased with tumor de-differentiation. The E-cadherin was found to be the best predictor of recurrence and survival among all the four markers.

CONCLUSION

The cut-off values could be identified for all four biomarkers, which on follow-up proved to be a valuable tool with a high sensitivity and specificity for predicting recurrence and three-year survival in patients with OSCC.

Alcohol consumption modulates Candida albicans-induced oral carcinogenesis and progression

OBJECTIVES

This study aimed to determine the impact of low levels of alcohol consumption on the interaction of the oral cavity with Candida albicans, a species that is commonly found at higher levels in the oral cavities of regular alcohol consumers, patients with pre-malignant diseases, and patients with existing oral cancer (OC).

METHODS

The gingival squamous cell carcinoma cell line, Ca9-22, was subjected to low-level ethanol exposure before co-culture with heat-inactivated C. albicans (HICA). We performed cell viability assays, measured reactive oxygen species, and used Western blot analysis for cell death markers to examine the effect of ethanol and HICA on cells. Scratch assays and anchorage-independent growth assays were used to determine cell behavioral changes.

RESULTS

The results showed that ethanol in combination with HICA exacerbated cell death and cell cycle disruption, delayed NF-κB signaling, increased TIMP-2 secretion, and subsequently decreased MMP-2 secretion when compared to exposure to HICA alone. Conversely, both ethanol and HICA independently increased proliferation of Ca9-22 cells in scratch assays, and in combination, increased their capacity for anchorage-independent growth.

CONCLUSION

Low levels of ethanol may provide protective effects against Candida-induced inflammatory oral carcinogenesis or OC progression.

Cadherin switching in oral squamous cell carcinoma: A clinicopathological study

Background and aim

Oral squamous cell carcinoma (OSCC) is one of the most common malignancies worldwide as it represents the sixth most common cancer. Numerous molecular mechanisms have been explained to regulate OSCC progression, including epithelial-mesenchymal transition (EMT). Cadherin switching is the pivotal process that controls EMT in which E-cadherin reduces while N-cadherin elevates. This work aimed to clarify the role of cadherin switching in OSCC.

Material and methods

Thirty paraffin-embedded tissue blocks of OSCC including six cases with lymph node metastasis were subjected to immunohistochemical staining using antibodies against E&N-cadherins. Cell cultures were performed using OSCC cell lines (SCC-15/SCC-25) from the human tongue. F-12K medium (Kaighn's Modification of Ham's F12 Medium) was added as EMT inducing media. E&N-cadherin mRNA gene expression levels were detected by real time-polymerase chain reaction (RT-PCR).

Results

Cadherin switching through N-cadherin elevation and E-cadherin reduction was evaluated at the histopathologic level in primary and metastatic OSCC as well as at the genetic level within OSCC cell culture. Cadherin switching showed a significant correlation between E&N-cadherins at different histopathological grades of OSCC and in metastatic OSCC. Moreover, the level of mRNA gene expression of E&N-cadherins in human 15 SCC and 25 SCC cell lines with EMT-inducing media exhibited a significant correlation.

Conclusions

Cadherin switching is a crucial event in the EMT process. It may be used as a significant tool in the study of OSCC progression. Cadherin switching plays a significant role in the invasion and metastasis of OSCC.

Immunohistochemical Expression of the Epithelial to Mesenchymal Transition Proteins E-cadherin and ß-catenin in Grades of Oral Squamous Cell Carcinoma

Background

E-Cadherin/β-Catenin protein complexes play a major role in epithelial to mesenchymal transition (EMT) and vice versa. Such types of EMT are implicated physiologically during embryonic development and pathologically in tissue fibrosis and tumorigenesis.

Aims

The aim was the evaluation of E-Cadherin and β-Catenin immunoreactivity in various grades of oral squamous cell carcinoma (OSCC) and to correlate their pattern of expression.

Materials and Methods

Immunohistochemical expression of E-Cadherin/β-Catenin was evaluated in a total n = 30 tissue samples comprising of n = 10 well-differentiated squamous cell carcinoma (WDSCC), n = 10 moderately differentiated squamous cell carcinoma (MDSCC), and n = 10 poorly differentiated squamous cell carcinoma (PDSCC). Based on the intensity of staining, an immunoreactivity scoring was calculated.

Statistical Analysis

The scorings obtained were subjected to independent t-test, paired t-test, Chi-square test, and ANOVA test using SPSS version 20.0 statistical analysis software. P < 0.05 was considered statistically significant.

Results

A significant difference was observed in the expression of β-Catenin between normal mucosa and WDSCC; normal mucosa and MDSCC. A gradual decrease in the immunoreactivity score of E-Cadherin is seen in WDSCC, MDSCC, and PDSCC.

Conclusion

Therefore, dysregulation of these proteins can lead to tumor progression, invasion, and metastasis. Further studies are warranted to specify the role of these EMT proteins as prognostic/therapeutic markers in patients suffering from OSCC.

A study of epithelial-mesenchymal transition immunohistochemical markers in primary oral squamous cell carcinoma

OBJECTIVE

To analyze markers of epithelial-mesenchymal transition (EMT) in oral squamous cell carcinoma (SCC) using E-cadherin, epithelial membrane antigen (EMA), vimentin, and smooth muscle actin (SMA), and their association with tumor metastasis and grade.

STUDY DESIGN

This was a retrospective study, which included 45 diagnosed cases of primary oral SCC with known lymph node status, taken from the archives of the Department of Pathology along with their clinical profile. Histomorphologic evaluation and immunohistochemical (IHC) analysis for E-cadherin, EMA, vimentin, and SMA were performed. IHC expression of these markers was compared with tumor differentiation as well as lymph node metastasis.

RESULTS

We observed that reduced E-cadherin expression and positive expression of SMA were significantly higher in tumors having lymph node metastasis and loss of tumor differentiation, respectively. Reduced EMA expression was associated with the presence of lymph node metastasis but not with the histologic differentiation. Vimentin positivity did not show any correlation with lymph node metastasis or histologic differentiation.

CONCLUSIONS

This study emphasizes the importance of EMT in the pathogenesis of oral SCC. The use of biomarkers like E-cadherin, EMA, and SMA might be a valuable tool for predicting patient outcomes and therapy.

Prediction of metastasis in oral squamous cell carcinoma through phenotypic evaluation and gene expression of E-cadherin, β-catenin, matrix metalloproteinase-2, and matrix metalloproteinase-9 biomarkers with clinical correlation

CONTEXT:

Controversies prevail regarding the true predictive role of epithelial–mesenchymal transition (EMT) biomarkers in metastasis of oral squamous cell carcinoma (OSCC). There is also limited research carried on till date wherein the protein and gene expression of EMT biomarkers have been investigated simultaneously in the Indian population.

AIM:

The aim of this study was to assess the gene expression and quantitative protein expression of EMT biomarkers using conventional method and MATLAB software and to determine if there is any difference in the expression between metastatic and nonmetastatic OSCCs with clinicopathologic correlation.

SETTINGS AND DESIGN:

Twenty metastatic and nonmetastatic OSCC tissue sections each were obtained from department archives. Gene expression and quantified protein expression of EMT markers were done and correlated with clinical parameters.

SUBJECTS AND METHODS:

Sections immunostained for EMT biomarkers were evaluated using semi-quantitative and quantitative (MATLAB) methods. Gene expression using semi-quantitative reverse transcriptase–polymerase chain reaction was done. These findings were correlated with clinical parameters.

STATISTICAL ANALYSIS USED:

Pearson's Chi-square test, Student's t-test, and univariate logistic regression analysis were performed using SPSS software.

RESULTS:

The low immunoexpression of E-cadherin and β-catenin and the high expression of matrix metalloproteinase (MMP)-2 and MMP-9 correlate with Stages III and IV showing high metastatic risk. Furthermore, the upregulated MMP-2 and MMP-9 gene expressions in advanced clinical stages of OSCC have high metastatic potential.

CONCLUSIONS:

This study is the first of its kind to employ texture and color segmentation in MATLAB to objectively assess the protein expression of EMT biomarkers. This research is instrumental in studying the protein and gene expressions of EMT markers with clinical correlation.

COMPARISON OF EXPRESSION OF E-CADHERIN IN ORAL PSEUDOEPITHELIOMATOUS HYPERPLASIA AND ORAL SQUAMOUS CELL CARCINOMA

Background: Pseudo-epitheliomatous Hyperplasia (PEH) is a benign proliferation of epithelium occurring in response to various neoplastic lesions, infections and inflammatory processes. It can be mistaken especially in small biopsies for an invasive oral squamous cell carcinoma (OSCC). The objective of this study was to determine the expression and comparison of immunohistochemical marker E-cadherin in OSCC and PEH lesions. Materials & Methods: This cross-sectional study was conducted in Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan from January 2013 to March 2016. 60 paraffin embedded cases, 30 each of PEH and OSCC were retrieved and stained with haematoxylin and eosin. They were then immune-stained with E-cadherin and expression evaluated and compared in two lesions by histopathologist. Age, sex, site of lesion and E-cadherin expression were variables. Age was described by mean and SD and other variables as frequency and percentages. Results: Mean age of OSCC group was 60.1±17.3 years and PEH group 52.7±16.6 years. OSCC group included 16 (53.33%) men and 14 (46.67%) women. PEH group included 18 (60%) men and 12 (40%) women. In OSCC group, site of lesion was buccal mucosa 12 (40%) cases, gingiva 10 (33.3%), tongue 7 (23.3%) and floor of mouth 1 (3.4%) case. In PEH group, site of lesion was buccal mucosa 12 (40%) cases, tongue 11 (36.67%), gingiva 6 (20%) and palate 1 (3.3%) case. The expression of E-cadherin was negative in all 30 cases of OSCC and positive in 29/30 (96.67%) cases in PEH. Conclusion: E-cadherin can be used as an ancillary marker in the differentiation of oral squamous cell carcinoma and pseudo-epitheliomatous hyperplasia.

Expression of E- Cadherin and Levels of Dysplasia in Oral Leukoplakia - A Prospective Cohort Study

AIM

Enormous attempts have been made to develop and establish markers that determines the susceptibility of potentially malignant tissues to transform to oral cancer. E - cadherin encoded by CDH1 gene is a protein which plays an important role in cellular adhesion. This study aimed to assess the relationship between the expression of E- cadherin and different grades of epithelial dysplasia in oral leukoplakia.

MATERIALS AND METHODS

Tumour biopsies from fifty leukoplakia patients was collected. Half of the tissue was sent for histopathological examination and other half was subjected to see E - cadherin expression by real time PCR.

RESULTS

On assessing, the expression of E - cadherin was found to be high in samples with mild dysplasia followed by samples with moderate dysplasia. Samples with severe dysplastic feature showed least expression of E - cadherin. All statistical analyses were performed using Statistical Package for Social science (SPSS) and was proven that there is significant decrease in the expression of E - cadherin as the degree of dysplasia increases with a p value 0.001 and confidence interval 95%.

CONCLUSION

We conclude that loss of E - cadherin can be used as a tumour marker that could determine the susceptibility of normal and potentially malignant tissues to transform into oral cancers. To generalise our results, further prospective studies with a large sample size using quantitative real time PCR to read the gene expression should be carried out at multi centre levels.
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WISP-1 Promotes Epithelial-Mesenchymal Transition in Oral Squamous Cell Carcinoma Cells Via the miR-153-3p/Snail Axis

Around half of all patients with oral squamous cell carcinoma (OSCC) present with lymphatic metastasis, a strong predictor of poor survival. Improving survival rates depends on preventing the first step in the “invasion-metastasis cascade,” epithelial-to-mesenchymal transition (EMT), and developing antilymphangiogenesis therapies that antagonize lymphatic metastasis. The extracellular matrix-related protein WISP-1 (WNT1-inducible signaling pathway protein-1) stimulates bone remodeling and tumor progression. We have previously reported that WISP-1 promotes OSCC cell migration and lymphangiogenesis induced by vascular endothelial growth factor C (VEGF-C). This investigation sought to determine the role of WISP-1 in regulating EMT in OSCC. Our analysis of oral cancer data from The Cancer Genome Atlas (TCGA) database revealed significant and positive associations between levels of WISP-1 expression and clinical disease stage, as well as regional lymph node metastasis. We also found higher levels of WISP-1 expression in serum samples obtained from patients with OSCC compared with samples from healthy controls. In a series of in vitro investigations, WISP-1 activated EMT signaling via the FAK/ILK/Akt and Snail signaling transduction pathways and downregulated miR-153-3p expression in OSCC cells. Our findings detail how WISP-1 promotes EMT via the miR-153-3p/Snail axis in OSCC cells.

Role of E-cadherin and cyclin D1 as predictive markers of aggression and clonal expansion in head and neck squamous cell carcinoma

Objectives

Head and neck squamous cell carcinoma (HNSCC) is the sixth most common malignancy worldwide. Inconsistency in various histopathologic features for predicting nodal metastasis and overall prognosis and a better understanding of molecular mechanisms of tumourigenesis have shifted the focus to a search for more definitive predictive markers. To identify the role of two immunohistochemical (IHC) markers, E-cadherin and cyclin D1, as predictive markers of aggressiveness in HNSCC and to assess clonal expansion of tumour cells.

Materials and Methods

A total of 66 cases of HNSCC with neck node dissection were studied. IHC was performed on primary tumour sections and lymph nodes showing metastatic deposits. Histopathological parameters such as tumour grade and TNM stage together with nodal status were compared according to expression of the two markers. Fischer's chi-square test was used to assess the correlation between the two markers and histopathological parameters.

Results

Out of 66 cases studied, 37 showed LN metastasis. Most of the patients were male, and the most common tumour site was buccal mucosa. We found a significant association between loss of E-cadherin and node metastasis (P<0.001) and higher TNM stage (P<0.001). Cyclin D1 overexpression was significantly associated with only nodal metastasis (P=0.007). No significant association with tumour grade was found for either marker. The subgroup of E-cadherin loss with cyclin D1 overexpression was associated with the maximum incidence of nodal metastasis and higher TNM stage, highlighting the importance of using a combination of these two markers. A significant association was noted between the expression of markers at the primary site and at nodal deposits, indicating clonal expansion.

Conclusion

A combination of the two markers E-cadherin and cyclin D1 can predict prognosis in HNSCC, although tumour heterogeneity may affect this association in some cases.

Podoplanin emerges as a functionally relevant oral cancer biomarker and therapeutic target

Oral cancer has become one of the most aggressive types of cancer, killing 140,000 people worldwide every year. Current treatments for oral cancer include surgery and radiation therapies. These procedures can be very effective; however, they can also drastically decrease the quality of life for survivors. New chemotherapeutic treatments are needed to more effectively combat oral cancer. The transmembrane receptor podoplanin (PDPN) has emerged as a functionally relevant oral cancer biomarker and chemotherapeutic target. PDPN expression promotes tumor cell migration leading to oral cancer invasion and metastasis. Here, we describe the role of PDPN in oral squamous cell carcinoma progression, and how it may be exploited to prevent and treat oral cancer.

Prognostic significance of the epithelial-mesenchymal transition factor zinc finger E-box-binding homeobox 2 in esophageal squamous cell carcinoma

Zinc finger E-box-binding homeobox 2 (ZEB2) has been reported to mediate epithelial-mesenchymal transition (EMT) and disease progression in several cancer types. However, the expression of ZEB2 in esophageal squamous cell carcinoma (OSCC) and its association with prognosis remains unclear. In the present study, a tissue microarray and immunohistochemistry were used to investigate ZEB2 and epithelial (E-)cadherin expression in OSCC tissues (n=218) and peritumoral esophageal tissues (POT; n=60). There was a significantly increased incidence of positive ZEB2 expression in OSCC tissues compared with the expression in POTs (P<0.012). By contrast, the incidence of positive E-cadherin expression in OSCC tissues was significantly decreased compared with the expression in POTs (P<0.004). ZEB2 expression in OSCC was associated with a number of clinicopathological factors, and it was also an independent predictive factor for shorter overall survival time (P<0.001). Overall, ZEB2 may promote OSCC metastasis and is a potential prognostic marker for malignancy.

Clinicopathological significance of ZEB-1 and E-cadherin proteins in patients with oral cavity squamous cell carcinoma

Background

Zinc-finger E-box binding homeobox 1 (ZEB-1), a member of the ZFH family, plays a key role in epithelial–mesenchymal transition during tumor progression in various cancers. However, little information is available on ZEB-1 expression in oral cavity squamous cell carcinoma (OSCC).

Methods

The expression levels of ZEB-1 and E-cadherin were assessed by immunohistochemistry in a cohort of 120 patients with OSCC treated by curative operation, and then the correlations between ZEB-1 and E-cadherin expression and clinical factors were evaluated, including patient prognosis. Quantitative real-time polymerase chain reaction (qRT-PCR) assays were performed to assess mRNA levels of ZEB-1 and E-cadherin in 20 matched OSCC specimens.

Results

Patients were followed up for a median period of 66 months (range 8−116 months), and 5-year overall survival was 68.3%. Positive ZEB-1 and E-cadherin immunostaining reactivity was detected in 64 (53.3%) and 53 (44.2%) patients, respectively. There was a negative correlation between ZEB-1 expression and E-cadherin expression. In addition, overexpression of ZEB-1 was significantly associated with recurrence, lymph node metastasis, and pathologic grading of patients, loss of E-cadherin was significantly associated with lymph node metastasis and pathologic grading of patients. Univariate analysis showed that increased ZEB-1 expression, loss of E-cadherin expression, lymph node metastasis, recurrence, and pathology grade were prognostic factors. In multivariate analysis, increased ZEB-1 expression and recurrence remained independent prognostic factors. In particular, patients with both ZEB-1 positivity and loss of E-cadherin expression had a poorer prognosis. qRT-PCR showed that ZEB-1 mRNA expression was higher in OSCC compared to the adjacent nontumorous tissues, while E-cadherin mRNA expression was lower in tumor tissues.

Conclusion

This study shows that overexpression of ZEB-1 and loss of E-cadherin expression are significantly correlated with poor survival in OSCC patients, and ZEB-1 expression might serve as an independent prognostic biomarker of OSCC.

A Study on the Mechanism of Low-Expressed Cancer Stem Cell Marker Lgr5 in Inhibition of the Proliferation and Invasion of Colorectal Carcinoma

The present study intends to explore the influence of Lgr5 as a marker of tumor stem cells after siRNA interference on the proliferation and invasion of colorectal carcinoma (CRC) and its mechanism. The tissue samples were taken for biopsy from 32 cases of patients and 32 cases of normal subjects by colonoscopy. Real-time quantitative PCR was used to detect the differential expression of Lgr5. After siRNA interference of Lgr5 in CRC cell line CT-26 cells, RT-PCR method was used to detect the mRNA expression level of Lgr5 after interference of CT-26 cells. CCK8 method was used to observe the influence of Lgr5 interference on the proliferation, colony formation, and invasion of CT-26 cells. RT-PCR and Western blot were used to detect the E-cadherin mRNA and protein levels in CT-26 cells. Lgr5 expression level in CRC tissue was significantly higher than that in the corresponding para-carcinoma tissue and the control group, and the differences were statistically significant (P < 0.05). Lgr5 mRNA expression level in tissue with lymph node metastasis was significantly higher than that in the tissue without lymph node metastasis, and the difference was statistically significant (P < 0.05). Compared with the control group, CT-26 cell proliferation, colony formation, and migration capability after Lgr5 siRNA transfection were all significantly reduced, and the differences were statistically significant (P < 0.05). CT-26 cells after Lgr5 interference were found with significantly reduced E-cadherin mRNA and protein levels. Lgr5 facilitates the cell proliferation, colony formation, and migration of colorectal carcinoma, which may be closely related to the expression level of E-cadherin.

Downregulated Expression of E-cadherin and TP53 in Patients with Gastric Diseases: the Involvement of H. pylori Infection and Its Virulence Markers

PURPOSE

Gastritis caused by infection with Helicobacter pylori is characterized by chronic inflammation and damage in gastric tissue, which is a main risk factor for gastric cancer. Associated with H. pylori, the TP53 gene tumor suppressor and the cell adhesion glycoprotein epithelial cadherin develop a relevant role in the integrity and carcinogenesis of the epithelium. We aimed to detection of H. pylori and its main virulence markers and measured the messenger RNA (mRNA) expression levels of E-cadherin and TP53 genes.

METHODS

The detection of H. pylori and its virulence markers, as well as the mRNA expression levels of E-cadherin and TP53 genes, were obtained for 161 samples of gastric biopsies including 37 with normal gastric tissue, 70 with gastritis, 24 from neoplastic tissue, and 27 from adjacent non-neoplastic by means of a quantitative real-time polymerase chain reaction.

RESULTS

The mRNA expression levels of E-cadherin and TP53 were found to be decreased in patients with gastritis, independently of H. pylori infection. In samples from gastric patients, the neoplastic tissue showed an accentuated decrease of expression; on the other hand, the expression of E-cadherin was normal in adjacent non-neoplastic.

CONCLUSIONS

No evidence was found of the involvement of the cagA and vacA genes in the decreased expression of E-cadherin and TP53. The process of carcinogenesis is complex, and the decrease of the E-cadherin gene expression and TP53 gene expression appears to contribute significantly.

Overexpression of Bcl-2, SOCS 1, 3 and Cdh 1, 2 are associated with the early neoplasic changes in modified 4-nitroquinoline 1-oxide-induced murine oral cancer model

BACKGROUND

The objective was to assess histopathological changes and the expression of proliferating cell nuclear antigen (PCNA), Bcl-2, suppressor of cytokine signaling (SOCS) 1 and 3, Vimentin, TWIST1, and Cdh 1 and 2 in early stages of experimental oral carcinogenesis process using a shorter period of exposure to 4-nitroquinoline oxide (4-NQO) model.

METHODS

In this study, 20 rats were divided into control group (n = 10), sacrificed on the first day of the experiment, and experimental group (n = 10) treated with 50 ppm of 4-NQO solution dissolved in drinking water for 8 and 12 weeks. The histological sections were stained with H&E or subjected to immunohistochemistry for detecting PCNA, Bcl-2, SOCS 1 and 3, and STAT 3. Some specimens were used for verification of Vimentin expression, Cdh 1, Cdh 2, and TWIST1 by RT-qPCR.

RESULTS

At both 8 and 12 weeks, morphological changes occurred mainly in the posterior portion of the tongue and were limited to the epithelial tissue, including moderate to severe dysplasia at 8 weeks, and severe dysplasia with exacerbation of atypical cells at 12 weeks. Expression of SOCS 1 and 3 increased from 8 to 12 weeks (P < 0.05), whereas STAT 3 expression was reduced mainly at 12 weeks (P < 0.05) in comparison with the control group. The expression of all epithelial-mesenchymal transition markers (EMT) was increased after 12 weeks, reaching statistical significance (P < 0.05) for Cdh 1 and 2.

CONCLUSIONS

Together, the results suggested that overexpression of Bcl-2, SOCS 1 and 3, and Cdh 1 and 2 is associated with the early neoplasic changes in modified 4-nitroquinoline 1-oxide-induced murine oral cancer model.

Prognostic Significance of Invasive Tumor Front in Oral Squamous Cell Carcinoma

How to cite this article

Patil S, Augustine D, Rao RS. Prognostic Significance of Invasive Tumor Front in Oral Squamous Cell Carcinoma. J Contemp Dent Pract 2016;17(1):1-2.

Co-Expression of TWIST1 and ZEB2 in Oral Squamous Cell Carcinoma Is Associated with Poor Survival

Oral squamous cell carcinoma (OSCC) is an aggressive disease accounting for more than 260,000 cancer cases diagnosed and 128,000 deaths worldwide. A large majority of cancer deaths result from cancers that have metastasized beyond the primary tumor. The relationship between genetic changes and clinical outcome can reflect the biological events that promote cancer's aggressive behavior, and these can serve as molecular markers for improved patient management and survival. To this end, epithelial-mesenchymal transition (EMT) is a major process that promotes tumor invasion and metastasis, making EMT-related proteins attractive diagnostic biomarkers and therapeutic targets. In this study, we used immunohistochemistry to study the expression of a panel of transcription factors (TWIST1, SNAI1/2, ZEB1 and ZEB2) and other genes intimately related to EMT (CDH1 and LAMC2) at the invasive tumor front of OSCC tissues. The association between the expression of these proteins and clinico-pathological parameters were examined with Pearson Chi-square and correlation with survival was analyzed using Kaplan Meier analysis. Our results demonstrate that there was a significant differential expression of CDH1, LAMC2, SNAI1/2 and TWIST1 between OSCC and normal oral mucosa (NOM). Specifically, CDH1 loss was significantly associated with Broder's grading, while diffused LAMC2 was similarly associated with non-cohesive pattern of invasion. Notably, co-expression of TWIST1 and ZEB2 in OSCC was significantly associated with poorer overall survival, particularly in patients without detectable lymph node metastasis. This study demonstrates that EMT-related proteins are differentially expressed in OSCC and that the co-expression of TWIST1 and ZEB2 could be of clinical value in identifying patients with poor survival for appropriate patient management.

Expression of E-cadherin and vimentin in oral squamous cell carcinoma

The aim of the study is to determine the levels of E-cadherin, vimentin expression in tumor tissues from patients with oral squamous cell carcinoma (OSCC), and the relationship between the expression of E-cadherin, vimentin and epithelial-mesenchymal transition, in order to explore its values for predicting the invasion and metastasis of oral squamous cell carcinoma, short survival of patients in many types of cancer. E-cadherin and vimentin expression of 10 benign and 42 OSCC tumor tissues was examined by immunohistochemical staining. E-cadherin is positively expressed in normal oral mucosa epithelium, but vimentin expression is not found in normal oral mucosa epithelia; the E-cadherin and vimentin were expressed in 26 of 42 (61.9%) and 16 of 42 (38.1%), respectively. No statistically difference was found for E-cadherin and vimentin expression in patients with different age, gender and tumor location, E-cadherin and vimentin expression was significantly associated with lymph node metastasis and tissue location (P<0.05); E-cadherin expression was also significantly associated with tumor stage (P<0.05); there are significantly difference between infiltrative margin and central area in patients with oral squamous cell carcinoma for E-cadherin and vimentin positive expression (P<0.05). E-cadherin and vimentin positive expression was associated with tumor metastasis of oral squamous cell carcinoma. Our study preliminarily confirmed that EMT phenomenon is existed during the development of oral squamous cell carcinoma. Co-evaluation of E-cadherin and vimentin might be a valuable tool for predicting OSCC patient outcome.