Abstract
BackgroundNumerous attempts have been made to establish and develop tumor markers that could determine the susceptibility of normal tissues to transform into cancerous ones. To determine whether altered expression patterns of E-cadherin could be an early event in the progression of potentially malignant disorders to oral squamous cell carcinoma, this study aimed to assess the relationship between the immunoexpression of E-cadherin and the different degrees of epithelial dysplasia in oral leukoplakia.MethodsSurgically excised specimens from patients with oral leukoplakia (n = 31), oral cavity squamous cell carcinoma with cervical lymph node metastasis (n = 12) and normal oral mucosa (n = 9) were immunostained for E-cadherin. Oral leukoplakia samples were distributed into low and high risk group according to a binary system for grading oral epithelial dysplasia. Comparative analyses between E-cadherin expression and microscopic features (WHO histological grading and epithelial dysplasia) were performed by Pearson Chi-square test (P < 0.05).ResultsDifferences in E-cadherin expression were observed between normal oral mucosa and low risk oral leukoplakia (P = 0.006), low and high risk oral leukoplakia (P = 0.019), and high risk oral leukoplakia and oral cavity squamous cell carcinoma with cervical lymph node metastasis (P = 0.0001). In addition, as epithelia undergo dysplastic changes, the risk of malignant transformation increases, and there is a reduction or loss of E-cadherin expression by keratinocytes. Reduced E-cadherin expression was an early phenomenon and it was observed in moderate-severe dysplasia, showing that the loss of epithelial cohesion may be an indicator of progression to oral cavity squamous cell carcinoma.ConclusionsE-cadherin could be used as a novel biomarker to identify lesions with potential risk for malignant transformation, which may provide opportunities for prophylactic interventions in high risk patient groups.
Highlights
Numerous attempts have been made to establish and develop tumor markers that could determine the susceptibility of normal tissues to transform into cancerous ones
To determine whether altered expression patterns of E-cadherin could be an early event in the progression of potentially malignant disorders to oral squamous cell carcinoma and invasiveness, this study aimed to assess the relationship between the immunoexpression of Ecadherin and the different degrees of epithelial dysplasia in oral leukoplakia (OL)
Patients with oral leukoplakia were monitored in a period, which ranged from 6–18 months, and during this period malignant transformation was not observed
Summary
Numerous attempts have been made to establish and develop tumor markers that could determine the susceptibility of normal tissues to transform into cancerous ones. There have been numerous attempts to establish or even develop tumor markers to determine the susceptibility of normal tissues to transform into cancer [8,9,10,11]. The expression of mesenchymal genes is often accompanied by loss of epithelial characteristics, including reduced inter-cellular adhesion, loss of epithelial cell polarity and increased motility. These EMT features are seen in oral epithelial dysplasia and in their progression to cancer [12,13]. There is a strong relationship between reduced expression of these adhesion molecules, decreased differentiation and increased invasiveness [8,10,14,15,16,17,18]
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