Immunohistochemical evaluation of epithelial Mesenchymal transition proteins in oral Pre malignant and malignant lesions

Abstract

Background: newlineOral squamous cell carcinoma (OSCC) is the most frequent oral malignancy newlineassociated with chronic tobacco and areca nut use. They are preceded by potentially newlinemalignant lesions; particularly leukoplakia, erythroplakia and oral submucous fibrosis newline(OSMF). OSCC can also develop multi-focally in clinically normal appearing mucosa newlinedue to field cancerisation. Presently, it is impossible to predict which lesions will newlinetransform into OSCC. Identification of molecular characteristics can assist in defining the newlinebiologic aggressiveness and malignant potential. Epithelial Mesenchymal Transition newline(EMT) is a complex molecular process which results in loss of epithelial differentiation newlineand gain in mesenchymal characteristics implicated as a critical mechanism for the newlineacquisition of malignant phenotypes by epithelial cells. The present study evaluates the newlinerole of EMT in oral premalignancy and malignancy. newlinePrimary objectives: newlineand#61623; To study the immunohistochemical expression of EMT proteins and their newlineinterrelation in Oral premalignancy (Oral leukoplakia and OSMF) and OSCC. newlineSecondary Objectives: newlineand#61623; To compare the immunohistochemical expression of the EMT proteins with newlineNormal mucosa and Apparently Normal mucosa adjacent to OSCC newline(ANMAOSCC). newlineand#61623; To study the association of their expression with histopathologic grading of Oral newlinepremalignancy and OSCC and lymph node metastasis in OSCC. newline newlineMethodology: A total of 209 cases i.e oral leukoplakia/oral epithelial dysplasia (OED) newline(63), OSMF (43), OSCC (62) and 30 ANMAOSCC were included. newlineImmunohi st ochemi st r y was done using six proteins i.e. E-cadherin, and#946;-catenin, Ncadherin, newline newlineVimentin, Fibronectin and MMP-9. Statistical evaluation included Chi-square newlineanalysis, Correlation coefficient, Odds ratio and Discriminant function analysis. newline newlineXIII newlineResults: newlineReduction in the E-cadherin and and#946;-catenin expression and their altered newlinelocalization (membrane +cytoplasm) and neoexpression of N-cadherin, Vimentin, and newlineFibronectin, increased MMP-9 expression was evidenced in ANMAOSCC, OED an