Abstract

We aimed to investigate the association of the expression levels of five epithelial–mesenchymal transition (EMT)-related proteins (Snail, Twist, E-cadherin, N-cadherin, and Vimentin) with tumorigenesis, pathologic parameters and prognosis in tongue squamous cell carcinoma (TSCC) patients by immunohistochemistry of tissue microarray. The expression levels of Snail, E-cadherin, N-cadherin and Vimentin were significantly different between the tumor adjacent normal and tumor tissues. In tumor tissues, lower E-cadherin and higher N-cadherin levels were associated with a higher grade of cell differentiation, advanced stage of disease, and lymph node metastasis. However, higher Vimentin expression was associated with poor cell differentiation and lymph node metastasis. Patients with low E-cadherin expression had poor disease-specific survival (DSS). Conversely, positive N-cadherin and higher Vimentin expression levels were associated with poor DSS and disease-free survival. Notably, our multivariate Cox regression model indicated that high Vimentin expression was an adverse prognostic factor for DSS in TSCC patients, even after the adjustment for cell differentiation, pathological stage, and expression levels of Snail, Twist, E-cadherin, and N-cadherin. Snail, E-cadherin, N-cadherin, and Vimentin were associated with tumorigenesis and pathological outcomes. Among the five EMT-related proteins, Vimentin was a potential prognostic factor for TSCC patients.

Highlights

  • Tongue squamous cell carcinoma (TSCC) is one of the most common cancers of the oral cavity

  • The results showed that higher expression levels of Snail (187 cases, p

  • The results showed that Vimentin was still a less favorable prognostic factor for disease-specific survival (DSS) in TSCC patients (AHR = 1.90; 95% confidence interval (CI) = 1.26–2.87; p = 0.002; Table 4) after adjustment for cell differentiation, pathological stage, and expression of Snail, Twist, E-cadherin, and N-cadherin

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Summary

Introduction

Tongue squamous cell carcinoma (TSCC) is one of the most common cancers of the oral cavity. Epithelial—mesenchymal transition (EMT), recently identified as a key process in carcinogenesis, invasion, and metastasis, is a predictor of TSCC progression [4]. It plays a critical role in promoting metastasis in epithelial carcinoma, accompanied by a decrease in the expression of epithelial markers, including cell-surface E-cadherin, and an increase in the expression of mesenchymal markers, such as transcription factors Snail and Twist, and cell-surface N-cadherin, as well as cytoskeletal Vimentin [5,6]. Vimentin is an intermediate filament protein that is ubiquitously expressed in normal mesenchymal cells to maintain the cellular architecture and tissue integrity, and it participates in tumorigenesis, EMT, and the metastatic spread of cancer [10]

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