Publication:

Evaluation of epithelial mesenchymal transition markers snail and slug as predictor of nodal metastasis in oral squamous cell carcinoma

Background Presence of regional neck node metastasis in head and neck cancer is a major determinant of overall survival. In patients presenting with neck node metastasis, there is a fifty percent decrease in overall survival, irrespective of the treatment modality. Tumor, nodes, metastases staging system, based on the anatomical extent of disease is used to predict patient prognosis and need for adjuvant treatment. Advent of immune based therapy has led to development of new molecular markers which can predict the disease aggressiveness by predicting lymph node and distal metastasis. Epithelial mesenchymal transition (EMT) in cancer is thought to convert the stable epithelial cells to mesenchymal cells that acquire properties of invasion with regional and distal metastasis.

Methods In the current study we evaluated the expression of EMT markers snail and slug in oral squamous cell carcinoma with and without neck node metastasis in 86 patients.

Results In this study, snail positivity was observed in 72 cases (83.72%), slug positivity was observed in 52 cases (60.46%) and either of the two expressions was observed in 77 cases (89.53%). Found that snail was significantly associated with clinical nodal status (p=0.037) and post-op histopathological nodal status (p=0.003). Also found that slug was significantly associated with clinical nodal status (p<0.001), post-op histopathological nodal status (p=0.001) and perineural invasion (p=0.003).

Conclusions Snail and slug positivity correlates with clinical and post-op histopathological nodal status and thus can be used as a predictor of nodal metastasis in oral squamous cell carcinoma.