Expression of e-cadherin and vimentin in lesions of oropharynx

Dhanya R. Thankam, Aria Jyothi A.


Background: Oral squamous cell carcinoma is the 6th most common malignancy in the world and ranks as first in males in Indian sub-continent. Vimentin is an intermediate filament found in mesenchymal cells and e-cadherin is an adhesion molecule found in epithelial cells. The objective of the study is to evaluate the expression of e-cadherin and vimentin in lesions of oropharynx and to assess the sensitivity, specificity and positive predictive value of e - cadherin and vimentin in oropharyngeal squamous cell carcinoma (OPSCC), against routine H and E stained histopathological diagnosis.

Methods: 100 oropharyngeal biopsy specimens taken and routine H and E stained histopathological slide diagnosis made. E-cadherin and vimentin expression studied in OPSCC, moderate to severe dysplasia, mild dysplasia and benign cases and its sensitivity, specificity, positive predictive value and negative predictive value analysed using appropriate statistical tools.

Results: Vimentin positivity was observed in 70 out of 79 OPSCC, 2 out of 3 cases of moderate - severe dysplasia, 0 out of 2 mild dysplasia and 2 out of 16 benign lesions. Out of 79 cases of OPSCC, 15 were e-cadherin negative, 27 showed low and 37 cases showed high membraneous positivity.

Conclusions: We observed a significant decrease in e-cadherin membrane expression from dysplasia to carcinoma insitu to invasive carcinoma and a significant increase in vimentin expression with progression of the tumor. E-cadherin is a good prognostic marker whereas vimentin expression indicates a poor prognosis.


E-cadherin, Vimentin, Oropharyngeal squamous cell carcinoma, Dysplasia

Full Text:



Carolina A, Vasconcellos O, Le Campion, Maria C, Ribeiro B, Luiz RR et al. Low Survival Rates of Oral and Oropharyngeal Squamous Cell Carcinoma. International Journal of Dentistry. 2017:7-15.

Narayan S. Oral cancer in India: An epidemiologic and clinical review. Oral Surg Oral Med Oral Pathol. 1990;69:325 3 .

Christopher DM, Fletcher. Diagnostic histopathology of tumors. 1:246-252.

Scully C, Bagan J. Oral squamous cell car¬cinoma: overview of current understanding of aetiopathogenesis and clinical implications. Oral Dis. 2009;15:388-99.

Barnes L, Eveson JW, Reichart P, Sidransky D. World Health Organization. Classification of tumors. Pathology and genetics of head and neck tumors. IARC Press: Lyon. 2005.

Danielle H Carpenter, Samir K El-Mofty and James S Lewis Jr. Undifferentiated carcinoma of the oropharynx: a human papillomavirus-associated tumor with a favorable prognosis. Modern Pathology. 2011;24:1306-312.

Lee JM, Dedhar S, Kalluri R, Thompson EW. The epithelial–mesenchymal transition: new insights in signaling, development, and disease. J Cell Biol. 2006;172(7):973-81.

Wong TS, Gao W, Chan JYW. Interactions between E-Cadherin and MicroRNA Deregulation in Head and Neck Cancers: The Potential Interplay. Hindawi Publishing Corporation BioMed Research International. 2014:126038.

Greenburg G, Hay ED. Epithelia suspended in collagen gels can lose polarity and express characteristics of migrating mesenchymal cells. J Cell Biol. 1982;95:333-9.

Krisanaprakornkit S and Iamaroon A. Epitheli¬al-mesenchymal transition in oral squamous cell carcinoma. ISRN Oncol. 2012;2012:681469.

Kaplanis K, Kiziridou A, Liberis V, Destouni C, Galazios G. E-cadherin expression during progression of squamous intraepithelial lesions in the uterine cervix. Eur J Gynaecol Oncol. 2005;26(6):608-10.

Zhoul J, Tao D, Xu1 Q, Gao Z, Tang D. Expression of E-cadherin and vimentin in oral squamous cell carcinoma. Int J clin Exp Pathol. 2015;8(3):3150-4.

M. G. H. Biazevic, R. A. Castellanos, J. L. F. Antunes, and E. Michel-Crosato,Trends in oral cancer mortality in the city of S˜ao Paulo, Brazil, 1980–2002, Cad Saude Publica. 2002;22(10):2105-114.

S. Warnakulasuriya.Global epidemiology of oral and oropharyngeal cancer. Oral Oncology. 2009;45(4-5):309-16.

Kerala cancer registery 2011-2012.

Papagerakis S, Pannone G. Epithelial-Mesenchymal Interactions in Oral Cancer Metastasis. InTech. 2012.

El-Mofty SK, Lu DW. Prevalence of high-risk human papillomavirus DNA in nonkeratinizing (cylindrical cell) carcinoma of the sinonasal tract: a distinct clinicopathologic and molecular disease entity. Am J Surg Pathol. 2005;29(10):1367-72.

Kimple AJ, Welch CM, Zevallos JP, Samip N. Oral Cavity Squamous Cell Carcinoma – An Overview. OHDM. 2014;13:3.

Akhtar K, Ara1 A, Siddiqui SA, Sherwani RK. Transition of Immunohistochemical Expression of E-Cadherin and Vimentin from Premalignant to Malignant Lesions of Oral Cavity and Oropharynx. Oman Med J. 2016;31(3):165-69.

Chandrashekar C, Natarajan J, Radhakrishnan R. Critical biomarkers of epithelial-mesenchymal transition in the head and neck Cancers: Journal of Cancer Research and Therapeutics. 2014;10(3):512-18.

Liu LK, Jiang XY, Zhou XX, Wang DM, Song1 XL, Jiang HB. Modern Pathology. 2010;23:213-24.

Kokkinos MI, Wafai R, Wong MK. Vimentin and epithelial-mesenchymal transition in human breast cancer—observations in vitro and in vivo. Cells Tissues Organs. 2007;185:191-203.

Conacci-Sorrell M, Zhurinsky J, Ben Ze’ev A. The cadherin-catenin adhesion system in signaling and cancer. J Clin Invest. 2002;109:987–991.

Woolgar JA. Histopathological prognosticators in oral and oropharyngeal squamous cell carcinoma. Oral Oncol. 2006;42:229-39.

Christiansen JJ, Rajasekaran AK. Reassessing epithelial to mesenchymal transition as a prerequisite for carcinoma invasion and metastasis. Cancer Res. 2006;66:8319-326.

Huber MA, Kraut N, Beug H. Molecular requirements for epithelial-mesenchymal transition during tumor progression. Curr Opin Cell Biol. 2005;17:548-58.

Fan HX, Wang S, Zhao H, Liu N, Chen D, Sun M, et al. Sonic hedgehog signaling may promote invasion and metastasis of oral squamous cell carcinoma by activating MMP-9 and E-cadherin expression. Med Oncol. 2014;31(7):41-44.

Hollier BG, Evans K, Mani SA. The epithelial-tomesenchymal transition and cancer stem cells: a coalition against cancer therapies. J Mammary Gland Biol Neoplasia. 2009;14(1):29-43.

Kaur G, Carnelio S, Rao N, Rao L. Expression of E-cadherin in primary oral squamous cell carcinoma and metastatic lymph nodes: an immunohistochemical study. Indian J Dent Res. 2009;20(1):71-76.

Myong NH. Loss of E-cadherin and Acquisition of Vimentin in Epithelial Mesenchymal transition are noble indicators of Uterine Cervix Cancer progression. Korean J Pathol. 2012;46(4):341-48.

Nijkamp MM, Span PN, Hoogsteen IJ, Kogel AJ, Kaanders JHAM, Bussink J. Expression of E-cadherin and vimentin correlates with metastasis formation in head and neck squamous cell carcinoma patients. 2004;31:35-41.

Kumar V. In: Pathologic basis of disease. 1st ed. Robins, Cortan (editors). Elsevier India. 2014;56-59.

Goldblum J, Lamps L, McKenney J, Myers J, Ackerman L, Rosai RJ et al. In: Surgical pathology. 10th ed. St Louis: Mosby. 2011.

Yilmaz M, Christofori G. EMT the cytoskeleton, and cancer cell invasion. Cancer Metastasis Rev. 2009;28:15-33.

Chen IC, Chiang WF, Huang HH, Chen PF, Shen YY, Chiang HC. Role of SIRT1 in regulation of epithelial-to-mesenchymal transition in oral squamous cell carcinoma metastasis. Molecular Cancer. 2014;13:254.