Aruga Naohiro, Kijima Hiroshi, Masuda Ryota, Onozawa Hiroto, Yoshizawa Tadashi, Tanaka Makiko, Inokuchi Sadaki, Iwazaki Masayuki
Department of Pathology and Bioscience, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan.
Tokai J Exp Clin Med. 2018 Apr 20;43(1):5-13.
Epithelial-mesenchymal transition (EMT) is an important step leading to invasion and migration of various cancer cells, and are characterized by decreased E-cadherin as an epithelial marker, and increased vimentin as a mesenchymal marker. The present study focused on the clinicopathological significance of E-cadherin and vimentin expression in lung squamous cell carcinoma (SqCC). Immunohistochemically, E-cadherin expression patterns were classified into two types: preserved or reduced; and vimentin expression patterns were also divided into two types: positive or negative. The univariate analyses showed six factors associated with increased mortality: tumor size (P = 0.031), lymph node metastasis (P < 0.001), lymphatic invasion (P < 0.001), histological differentiation (P = 0.036), E-cadherin reduced expression (P < 0.001), and vimentin positive expression (P = 0.004). Multivariate analysis demonstrated that E-cadherin reduced expression (P < 0.001), vimentin positive expression (P = 0.028), lymph node metastasis (P < 0.001), and age (P = 0.020) were independent predictors of patient mortality. There may be some correlation between E-cadherin and vimentin expression (P = 0.017), but the correlation coefficient was 0.235. The complete EMT and the incomplete EMT type were associated with a poor prognosis (p < 0.001 and p=0.036, respectively). The overall survival rate after curative resection was significantly lower in patients with the complete EMT type (reduced E-cadherin / positive vimentin). In conclusion, both E-cadherin and vimentin are independent predictors of mortality, and the EMT phenotype is a significant indicator of poor prognosis in lung SqCC.
上皮-间质转化（EMT）是导致各种癌细胞侵袭和迁移的重要步骤，其特征是作为上皮标志物的E-钙黏蛋白减少，作为间质标志物的波形蛋白增加。本研究聚焦于E-钙黏蛋白和波形蛋白表达在肺鳞状细胞癌（SqCC）中的临床病理意义。免疫组织化学分析显示，E-钙黏蛋白表达模式分为两种类型：保留或减少；波形蛋白表达模式也分为两种类型：阳性或阴性。单因素分析显示，有六个因素与死亡率增加相关：肿瘤大小（P = 0.031）、淋巴结转移（P < 0.001）、淋巴管浸润（P < 0.001）、组织学分化（P = 0.036）、E-钙黏蛋白表达减少（P < 0.001）和波形蛋白阳性表达（P = 0.004）。多因素分析表明，E-钙黏蛋白表达减少（P < 0.001）、波形蛋白阳性表达（P = 0.028）、淋巴结转移（P < 0.001）和年龄（P = 0.020）是患者死亡率的独立预测因素。E-钙黏蛋白和波形蛋白表达之间可能存在一定相关性（P = 0.017），但相关系数为0.235。完全EMT型和不完全EMT型均与预后不良相关（分别为p < 0.001和p = 0.036）。完全EMT型（E-钙黏蛋白减少/波形蛋白阳性）患者根治性切除后的总生存率显著较低。总之，E-钙黏蛋白和波形蛋白均为死亡率的独立预测因素，EMT表型是肺SqCC预后不良的重要指标。
