Study on Diagnostic and Prognostic Significance of E-Cadherin and Vimentin in Oral Cancer Metastasis

Background: To investigate the role of E-cadherin and vimentin expression in epithelial-to-mesenchymal transition in precancerous and cancerous lesions of the oral cavity and oropharynx, as well as to predict invasiveness based on the unique pattern of E-cadherin and vimentin expression.

Material and Methods: Biopsies/samples from the oral cavity and oropharynx were examined for all premalignant lesions and invasive epithelial squamous lesions using haematoxylin and eosin sections, as well as immunohistochemistry expression of E-cadherin and vimentin, when needed. During the study, patients' follow-up and therapy-related changes were also investigated.

Results: There were 64 premalignant and 23 malignant cases in our study with 65 (71.0%) males and 22 (29.0%) females. Majority of the malignant cases, 15 (64.2%) were seen in the 5th and 6th decades of life while most of the premalignant lesions, 36 (56.4%) were seen in the 4th and 5th decade. Amongst the 64 premalignant oral lesions, leukoplakia comprised of 14 cases (21.9%), out of which 3 cases had associated mild to moderate dysplasia. Majority of the premalignant lesions showed strong 4+/3+ E-cadherin expression and decreased expression of vimentin with negative and weak expression in both dysplasias and carcinoma-in-situ(p=0.013). E-cadherin staining showed 4+ degree of expression in 6/10 (60%) cases of well differentiated carcinoma while 0/10 case of poorly differentiated carcinoma showed 4+ and only a single case showed 3+ degree of expression. 6/10(60%) cases of well differentiated oral squamous cell carcinoma showed 1+ degree of expression of vimentin while 6/10(60%) cases of poorly differentiated carcinoma showed 4+ degree of expression of vimentin . 1(1.6%) case of positive lymph node metastasis showed strong positive staining for E-cadherin and 4 (66.6%) cases showed absent staining pattern of E-cadherin. The differences in the immunoreactivities were statistically significant between CIS and microinvasive or invasive carcinomas (p<0.001) in our study. E-cadherin expression was significantly reduced in invasive carcinomas as compared to dysplasias and carcinoma-in-situ and the difference in immunoreactivity was statistically significant (p value <0.05).Vimentin expression was increased as the tumor progressed from dysplasias to carcinoma-in-situ to invasive carcinomas, which was statistically significant (p value <0.05).

Conclusions: Invasiveness and recurrence can be assessed using immunohistochemistry E-cadherin and vimentin stains, which can aid in the prediction of tumor behavior, prognosis, survival, and patient treatment. These compounds can also be employed as biomarkers in future study on tumor microinvasion for early diagnosis and patient survival.