Twist and Snail/Slug Expression in Oropharyngeal Squamous Cell Carcinoma in Correlation With Lymph Node Metastasis

Abstract

Background/aim: Oropharyngeal squamous cell carcinoma (OPSCC) could be clinically undetectable despite the relatively large size of lymph node metastases. Here, we aimed to elucidate the correlation of p16 expression with epithelial-to-mesenchymal transition (EMT) markers.

Patients and methods: Radically resected 121 OPSCC and 270 non-OPSCC tissue samples were included in the analysis, and p16, Twist, and Snail/Slug immunohistochemistry was performed.

Results: Compared to non-OPSCCs, OPSCCs were significantly associated with lymphovascular invasion, lymph node metastasis, larger maximal diameter of metastatic foci in the lymph nodes, and p16 expression. In addition, p16 expression correlated with high Twist and Snail/Slug expression.

Conclusion: Expression of EMT markers, such as Twist and Snail/Slug, is related to p16 expression in OPSCC. This might indicate that HPV infection in OPSCCs alters the expression of EMT markers and results in metastases.

Keywords: Oropharyngeal squamous cell carcinoma; epithelial-to-mesenchymal transition; head and neck squamous cell carcinoma; lymph node metastasis; tumor budding.