Epithelial-mesenchymal transition related to bone invasion in oral squamous cell carcinoma

Jaqueline Vaz Vanini; Leonardo Kenji Sakaue Koyama; Leandro Luongo de Matos; José Martins Figueredo Junior; Claudio Roberto Cernea; Cibele Pidorodeski Nagano; Cláudia Malheiros Coutinho-Camillo; Ricardo Hsieh; Silvia Vanessa Lourenço

doi:10.1016/j.jbo.2022.100418

Epithelial-mesenchymal transition related to bone invasion in oral squamous cell carcinoma

J Bone Oncol. 2022 Feb 18:33:100418. doi: 10.1016/j.jbo.2022.100418. eCollection 2022 Apr.

Affiliations

¹ Department of Stomatology, Dental School, University of São Paulo, São Paulo, Brazil.
² Head and Neck Surgery Discipline, Medical School, University of São Paulo, São Paulo, Brazil.
³ Instituto do Câncer do Estado de São Paulo, ICESP/HCFMUSP (São Paulo Cancer Institute), São Paulo, Brazil.
⁴ AC Camargo Cancer Center, São Paulo, Brazil.
⁵ Tropical Medicine Institute, University of São Paulo, São Paulo, Brazil.

Abstract

Introduction: Bone invasion is an important prognostic factor in oral squamous cell carcinoma, leading to a lower survival rate and the use of aggressive treatment approaches. Epithelial-mesenchymal transition (EMT) is possibly involved in this process, because it is often related to mechanisms of cell motility and invasiveness. This study examined whether a panel of epithelial-mesenchymal markers are present in cases of oral squamous cell carcinoma with bone invasion and whether these proteins have any relationship with patients' clinical-pathological parameters and prognostic factors.

Methods: Immunohistochemical analysis of E-cadherin, twist, vimentin, TGFβ1, and periostin was performed in paraffin-embedded samples of 62 oral squamous cell carcinoma cases.

Results: The analysis revealed that most cases (66%) presented with a dominant tumor infiltrative pattern in bone tissue, associated with lower survival rates, when compared with cases with a dominant erosive invasion pattern (P = 0.048). Twenty-seven cases (43%) expressed markers that were compatible with total or partial EMT at the tumor-bone interface. There was no association between evidence of total or partial EMT and other demographic or prognostic features. E-cadherin-positive cases were associated with tobacco smoking (P = 0.022); vimentin-positive cases correlated with tumors under 4 cm (P = 0.043). Twistexpression was observed in tumors with a dominant infiltrative pattern (P = 0.041) and was associated with the absence of periostin (P = 0.031).

Conclusion: We observed evidence of total or partial EMT in oral squamous cell carcinoma bone invasion. The transcription factor twist appears to be involved in bone invasion and disease progression.

Keywords: EMT, epithelial-mesenchymal transition; Epithelial-mesenchymal transition; Neoplasm invasion; OSCC, oral squamous cell carcinoma; Squamous cell carcinoma.