STUDY OF IMMUNOHISTOCHEMICAL EXPRESSION OF E-CADHERIN AND VIMENTIN IN PREMALIGNANT AND MALIGNANT SQUAMOUS LESIONS OF ORAL CAVITY AND OROPHARYNX AT A TERTIARY CARE CENTRE IN NORTH INDIA

Dr. Indira Sahu*, Dr. Kusum Mathur and Dr. Mukta Meel

ABSTRACT

Background: Oral squamous cell carcinoma accounts for high morbidity and mortality despite the improvement in surgical treatment and adjunctive therapy. This necessitates the use of molecular markers to identify the high risk cases for invasion and metastasis. Loss of epithelial morphology and acquisition of mesenchymal characteristics, termed epithelial-to-mesenchymal transition (EMT) are typical for dysplastic epithelium to become tumorigenic and correlate with local invasiveness and metastatic potential. Objectives: To study EMT by observing the expression of E-cadherin and vimentin in precancerous and cancerous lesions of the oral cavity and oropharynx and to know the specific pattern of expression and hence predict invasiveness. Methods: This cross-sectional study looked at 96 cases of oral and oropharyngeal lesions obtained between 2018 - 2019 & Immunohistochemical expression of epithelial marker E-cadherin and mesenchymal marker vimentin was evaluated. Results: There were 36 premalignant and 60 malignant cases in this study. Majority of malignant cases were seen in the fifth and sixth decades of life while most of the premalignant lesions were seen in a decade earlier. The majority of premalignant lesions showed strong E-cadherin expression and low expression of vimentin while dysplasias showed reduced E cadherin and gain in expression of vimentin intensifying with increase in grade. E-cadherin expression was significantly reduced in carcinomas compared to dysplasias and the difference in immunoreactivity was statistically significant (p < 0.003). Vimentin expression increased as the tumor progressed from dysplasias to carcinomas (p < 0.001). Conclusions: This study highlighted the role of expression of E-cadherin and vimentin where decreased or loss of E-cadherin and increased vimentin expression proved the predictor of high risk cases for invasion and distant metastasis in oral dysplasia and squamous cell carcinoma patients who can be picked by clinician for further follow up and targeted therapy.

Keywords: Premalignant, Malignant, Cadherin, Vimentin.