Relationship of E-cadherin, Beta-catenin, N-cadherin, ZEB1 and αSMA as Epithelial Mesenchymal Transition markers with prognostic factors in early and advanced stage laryngeal squamous cell carcinomas
1.IntroductionLaryngeal cancer (LC) is the most frequently observed malignant tumor of the larynx, and laryngeal squamous cell carcinoma (LSCC) accounts for approximately 90% of the cases [19]. LSCC is a tumor with a high risk of metastasis and a dismal prognosis. Despite advances in diagnosis and treatment methods, 5-year survival rates for LSCC are still not at the desired level [1,2]. The reason for the inadequacy in treatment may be related to complex molecular changes that may cause treatment resistance and difficulties in detecting molecular markers that will enable predetermination of tumor aggressiveness [3]. Therefore, studies on genetic regulatory networks involved in progression of LSCC have gained momentum in order to develop individualized treatment methods and to determine more appropriate treatment methods for the patient [1,2]
Epithelial mesenchymal transformation (EMT); is defined as the loss of typical properties of epithelial cells such as adhesion and apical-basal polarity (ie. E-cadherin, alpha and beta-catenin), and gaining a mesenchymal- like phenotype (ie. N-cadherin, vimentin, αSMA) [2,4,5]. Signal activation of EMT in the tumor is thought to be associated with invasion, metastasis, recurrence and the development of resistance to treatment [6]
There are studies in the literature on EMT in squamous cell carcinomas of head and neck (HNSCC). However, it has been reported that it would be more appropriate to evaluate LSCCs separately from HNSCCs because of the different embryonic origin of the larynx and different clinical and biological behaviors they demonstrate [7]. In this study, we aimed to investigate the relationship between E-cadherin, Beta-catenin, N-cadherin, ZEB1 and markers of αSMA in LSCC with tumor stage, lymph node metastasis (LNM) and overall survival (OS).
2.Material and method :
A total of 100 patients with complete clinical follow-up data who underwent partial / total laryngectomy with a diagnosis of LSCC in our hospital between 2013-2020 were included in the study. Age, gender, tumor location, tumor stage, and survival information of the patients were obtained from the departments of Otorhinolaryngology and Radiology. Hematoxylin - eosin stained slides of the cases in our archive were re-evaluated by two pathologists (ÜK, SE). Data about lymphovascular invasion (LVI), perineural invasion (PNI), necrosis and lymph node metastasis (LNM) associated with the tumor were recorded.