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

  • Kafil Akhtar
  • Anjum Ara
  • Shahid Siddiqui
  • Rana Sherwani
Keywords: Oral squamous cell carcinoma, Immunohistochemistry, E-cadherin, Vimentin

Abstract

Background: To study the role of epithelial-to-mesenchymal transition by E- cadherin and vimentin expression in precancerous and cancerous lesions of oral cavity and oropharynx and to predict invasiveness by the specific pattern of E-cadherin and vimentin expression.Methods: Biopsies/ specimens of oral cavity and oropharynx were evaluated for all premalignant lesions and invasive epithelial squamous lesions, by haematoxylin and eosin sections and by immunohistochemical expression of E-cadherin and vimentin, wherever. Patients follow up and therapy related changes were also studied during the period of study.Results: E-cadherin staining showed 6/10 (60%) cases of  well differentiated carcinoma with 4+ degree of expression while 0/10 case of poorly differentiated carcinoma showed 4+ and only a single case showed 3+ degree of expression with 8/10 (80%) cases of well differentiated carcinoma depicting strong staining intensity of E-cadherin.  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. 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 mi-croinvasive or invasive carcinomas (p<0.001) in our study.Conclusions:Invasiveness and recurrence can be analysed by the use of immunohistochemical stains of E-cadherin and vimentin, which can help in predicting the tumor behaviour, prognosis, survival and management of the patient. Also, these biomolecules can be used as biomarkers for further research on the micro-invasion of the tumor for early diagnosis and survival of the patients. 

References

1. National Cancer Registry Programme - Biennial Report (2008-2009) of the National Cancer Registry Programme. New Delhi: Indian Council of Medical Research; 2012.
2. Khandekar SP, Bagdey PS, Tiwari RR. Oral cancer and some epidemiological factors: a hospital based study. Ind J Community Med 2006; 31 (3): 157-159.
3. Hollier BG, Evans K, Mani SA. The epithelial-to-mesenchymal transition and cancer stem cells: a coalition against cancer therapies. J Mammary Gland Biol 2009; 14: 29-43.
4. Thiery JP. Epithelial-mesenchymal transitions in tumour progression. Nat Rev Cancer 2002; 2: 442-454.
5. Grille SJ, Bellacosa A, Upson J, Klein-Szanto AJ, Van Roy F, Lee-Kwon W et al. The protein kinase Akt induces epithelial mesenchymal transition and promotes enhanced motility and invasiveness of squamous cell carcinoma lines. Cancer Res 2003; 63: 2172-2178.
6. Kaur G, Carnelio S, Rao N, Rao L. Expression of E-cadherin in primary oral squamous cell carcinoma and metastatic lymph nodes: an immunohistochemical study. Ind J Dent Res 2009; 20: 71-76.
7. Na-Hye Myong. Loss of E-cadherin and Acquisition of vimentin in Epithelial-Mesenchymal transition are noble indicators of Uterine Cervix Cancer progression. Korean J Pathol 2012; 46: 341-348.
8. Huber GF, Zullig L, Soltermann A, Roessle M, Graf N, Haerle SK et al. Down regulation of E-Cadherin (ECAD)-a predictor for occult metastatic disease in sentinel node biopsy of early squamous cell carcinomas of the oral cavity and oropharynx. BMC Cancer 2011; 11: 217-218
9. Mehendirrata M, Solomon MC, Boaz K, Guddattu V, Mohindra A. Clinico-pathological correlation of E-cadherin expression at the invasive tumor front of indian oral squamous cell carcinomas: an immunohistochemical study. J Oral Maxillofacial Surg 2014; 18 (2): 217-222.
10. Araujo VC, Pinto DS Jr, Nunes FD, Araujo NS. Vimentin in oral squamous cell carcinoma. Eur Arch Otorhinolaryngol 1993; 250: 105-109.
11. Cavallaro U and Christofori G. Cell adhesion and signalling by cadherins and Ig-CAMs in cancer. Nat Rev Cancer 2004; 4: 118-123.
12. Willipinski-Stapelfeldt B, Riethdorf S, Assmann V, Woelfle U, Rau T, Sauter G, Heukeshoven J, Pantel K. Changes in cytoskeletal protein composition indicative of an epithelial-mesenchymal transition in human micrometastatic and primary breast carcinoma cells. Clin Cancer Res 2005; 11: 8006-8014.
13. Ramaekers FS, Puts JJG, Kant A, Moesker O, Jap PK, Vooijs GP. Differential diagnosis of human carcinomas, sarcomas and their metastasis using antibodies to intermediate- sized filaments. Eur J Cancer Clin Oncol 1982; 18: 1251-1252.
14. Guzinska-Ustymowicz K, Chetnik A, Kemona A. Effects of changes at the site of E-cadherin expression as an indicator of colon cancer aggressiveness. J Med Oncol 2004; 49 (1): 70-72.
15. Yasuto U, Natsugoe S, Okumura H. Slug expression in the E-cadherin preserved tumors is related to prognosis in patients with eosophageal sqamous cell carcinoma. Clin Cancer Res 2005; 11: 1174-1180.
16. Yong MH, Chang SY, Chiou SH. Overexpression of NBSI induces epithelial –mesenchymal transition and co-expression of NBSI and Snail predicts metastasis of head and neck cancer. Oncogene 2006; 32: 24-28.
17. Hou F, Yuan W, Huang J, Qian L, Chen Z, Wang J et al. Overexpression of EphA2 correlates with epithelial-mesenchymal transition-related proteins in gastric cancer and their prognostic importance for postoperative patients. Med Oncol 2012; 29 (4): 2691-2700.
18. Fan HX, Wong S, Zhou H, Liu N, Chen D, Sun M, Zeng JH. Sonic hedgehog signaling may promote invasion and metastasis of oral squamous cell carcinoma by activating MMP-9 and E-cadherin expression. Med Oncol 2014; 31: 41-43.
19. Liu LK, Jiang XY, Zhou XX, Wang DM, Song XL, Jiang HB. Up regulation of vimentin and aberrant expression of E-cadherin/beta-catenin complex in oral squamous cell carcinomas: correlation with the clinic-pathological features and patient outcome. Mod Pathol 2010; 23: 213-224.
Published
2016-02-07
Section
Original Article