Head and Neck Surgery Discipline, Clinics Hospital of Faculty of Medicine, University of São Paulo (HCFMUSP), São Paulo, Brazil.
Department of General Pathology, Dental School, University of São Paulo, São Paulo, Brazil.
ORL J Otorhinolaryngol Relat Spec. 2021;83(5):354-361. doi: 10.1159/000514229. Epub 2021 May 25.
Squamous cell carcinoma is the most common cancer of the oral cavity. When the tumor invades the bone tissue, the prognostic and survival rates decrease a lot, and the treatment becomes more aggressive, with several damages to the patient and health system. Many of the molecular mechanisms of bone invasion process are not understood yet, but it is already known that one of central processes of tumor evolution - adjacent tissues invasion and metastasis - is a large spectrum of phenotypic changes in epithelial cells to mesenchymal, in a process named as epithelial-mesenchymal transition (EMT). Loss of E-cadherin, an important epithelial cell adhesion protein, is a hallmark of this phenomenon. The objective of this retrospective study is to evaluate the expression of E-cadherin protein, comparing its distribution with clinical characteristics of the patients and possibly relation to EMT.
Sixty-two cases with respective clinical data were analyzed by comparing immunohistochemical, H and E staining, and clinical data, observing the tumor-bone interface (TBI) and the surrounding tumor that had no direct contact with the bone surface (ST).
Forty cases were positive for E-cadherin (64%) with a heterogeneous pattern. Statistical analysis showed a significant difference between the presence of E-cadherin expression and tobacco smokers. Also, the equal or weaker protein expression in the ST than TBI is related to a worse overall survival. No statistically significant difference in other prognostic factors was observed.
Our results suggest that the tumor cells that interact with the bone tissue could gain molecular changes, like partial EMT and osteoclastogenesis induction, which facilitate their migration and increase the bone resorption, resulting in a worse patient's prognosis.
鳞状细胞癌是口腔最常见的癌症。当肿瘤侵犯骨组织时，预后和生存率会大大降低，治疗也会变得更加激进，给患者和医疗系统带来多方面的损害。虽然骨侵袭过程的许多分子机制尚未得到充分理解，但已知肿瘤进化的一个核心过程——邻近组织侵袭和转移——是上皮细胞向间充质的大范围表型变化，这一过程被称为上皮-间充质转化（EMT）。上皮细胞黏附蛋白 E-钙黏蛋白的丢失是这种现象的一个标志。本回顾性研究的目的是评估 E-钙黏蛋白蛋白的表达，比较其与患者临床特征的分布，并可能与 EMT 相关。
通过比较免疫组织化学、H&E 染色和临床数据，观察肿瘤-骨界面（TBI）和与骨表面无直接接触的周围肿瘤（ST），对 62 例具有各自临床数据的病例进行分析。
40 例 E-钙黏蛋白阳性（64%），呈异质性模式。统计分析显示，E-钙黏蛋白表达的存在与吸烟者之间存在显著差异。此外，ST 中 E-钙黏蛋白表达的强度与 TBI 相等或较弱与总体生存率较差相关。未观察到其他预后因素的统计学显著差异。
我们的结果表明，与骨组织相互作用的肿瘤细胞可能获得分子变化，如部分 EMT 和破骨细胞诱导，从而促进其迁移并增加骨吸收，导致患者预后更差。
