Epithelial-mesenchymal transition: clinical implications for nodal metastasis and prognosis of tongue cancer.
OBJECTIVE
The development of biomarkers for the prediction of lymph node metastasis and prognosis is critical for deciding the treatment modality of tongue cancer. The purpose of our study is to investigate the clinical implications of epithelial-mesenchymal transition (EMT) expression in tongue cancer.


METHODS
Historical cohort study


METHODS
Tertiary-care hospital.


METHODS
The study included 95 subjects with tongue cancer who underwent wide excision and neck dissection. According to characteristics of immunohistochemical staining for E-cadherin and vimentin, we classified the tumors as complete EMT phenotype, incomplete EMT phenotype, or epithelial phenotype. The correlation between risk factors and nodal metastasis was assessed, and disease-free survival (DFS) was analyzed.


RESULTS
Positive lymph nodes were detected in 46 (48.4%) patients and was found to correlate significantly with depth of invasion ≥ 4 mm and EMT expression on multivariate analysis (P = .030, P = .022, respectively). The mean follow-up period of all patients was 96.3 months (range, 6-149 months). Overall 5-year DFS was 61.7%. On multivariate analysis, the only factors affecting DFS were nodal stage and EMT expression (P = .033, P = .021, respectively).


CONCLUSIONS
Our study reveals that EMT expression is a significant biomarker for predicting lymph node metastasis and tumor recurrence in tongue cancer. Evaluation of EMT expression in tongue cancer can allow therapy to be offered accordingly.
Department of Otolaryngology, Ulsan University Hospital, Ulsan, Republic of Korea.
Myung Woul
MW
Han
Department of Otolaryngology, Ulsan University Hospital, Ulsan, Republic of Korea.
Jong Cheol
JC
Lee
Department of Pathology, Ulsan University Hospital, Ulsan, Republic of Korea.
Young Min
YM
Kim
Department of Pathology, Ulsan University Hospital, Ulsan, Republic of Korea.
Hee Jeong
HJ
Cha
Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Jong-Lyel
JL
Roh
Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Seung-Ho
SH
Choi
Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Soon Yuhl
SY
Nam
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Kyung-Ja
KJ
Cho
Department of Biochemistry and Molecular Biology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Seong Who
SW
Kim
Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea Biomedical Research Institute, Korea Institute of Science and Technology, Seoul, Republic of Korea sykim2@amc.seoul.kr.
Sang Yoon
SY
Kim
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D058750:Epithelial-Mesenchymal Transition; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary; D011379:Prognosis; D014062:Tongue Neoplasms / Q000473:pathology*; D055815:Young Adult
E-cadherin; epithelial-mesenchymal transition; lymph node metastasis; prognosis; tongue cancer; vimentin