Clinicopathological Significance of Epithelial–Mesenchymal Transition in Oral Squamous Cell Carcinoma

This study investigated the expression of E-cadherin, N-cadherin, vimentin, Snail1, Slug (Snail2), Twist, ZEB1, ZEB2, and E47 in oral squamous cell carcinoma (OSCC) and assessed their association with clinicopathological parameters and patient survival. Immunohistochemical analysis was performed in OSCC samples, and correlations with clinicopathological variables and survival outcomes were evaluated. E-cadherin expression was detected in 54.5% of cases, vimentin in 39.6%, N-cadherin in 2.5%, Snail in 59.4%, Slug in 82.4%, ZEB1 in 3%, Twist in 94.5%, and E47 in 4.2% of tumors. Loss of E-cadherin was significantly associated with advanced clinical stage. N-cadherin expression was linked to moderate or poor differentiation, while vimentin expression correlated with lymph node metastasis, advanced stage, poor differentiation, recurrence, and disease-related death. Snail1 and Slug were associated with tobacco use, and Slug also with alcohol consumption. Complete epithelial–mesenchymal transition (EMT), defined by loss of E-cadherin and vimentin expression, was associated with poorer survival. Co-expression of vimentin and N-cadherin was linked to worse disease-specific and overall survival. However, only clinical stage remained independently associated with survival in multivariate analysis. In conclusion, vimentin expression is associated with aggressive tumor behavior, and EMT-related transcription factors are linked to tobacco exposure.