👤 Fábio Haach Téo

Oral squamous cell carcinoma (OSCC) remains a challenging malignancy with poor 5-year survival rates due to diagnosis at an advanced stage and a high likelihood of recurrence and metastasis. These aggressive traits may be influenced by cancer stem cells (CSC) and epithelial-mesenchymal transition (EMT). This study investigated the prognostic significance of the CSC marker CD44 and EMT-related proteins (Snail1, Snail2, E-cadherin, N-cadherin) in 132 OSCCs using immunohistochemistry. The comprehensive survival analysis included univariate and multivariate (stepwise method) Cox regression for disease-specific survival (DSS) and disease-free survival (DFS), Kaplan-Meier curves based on log-rank testing, and receiver operating characteristic (ROC) analysis to assess the predictive accuracy of the markers. High CD44 expression independently predicted worse DSS (HR = 2.74, 95% CI 1.44-5.23, p = 0.003) and DFS (HR = 2.22, 95% CI 1.16-4.23, p = 0.01), and Snail1 was significantly associated with poor DSS (HR = 2.62, 95% CI 1.37-5.03, p = 0.004). The combined expression of CD44 and Snail1 improved the discrimination of worse outcomes compared to markers individually. The presence of lymphovascular invasion (HR = 8.68, 95% CI 3.81-19.75, p < 0.0001) and a positive surgical margin (< 5 mm; HR = 4.45, 95% CI 1.99-9.96, p = 0.0003) were also independently associated with DSS. The results of this study highlight the prognostic significance of CD44 and Snail1 in OSCC, emphasizing their potential interplay in tumor aggressiveness. Show less

The aim of the present study was to investigate the role of SNAIL1, E-cadherin, and N-cadherin immunoexpression in oral tongue carcinogenesis. In addition, we evaluated in vitro the impact of silencing of the nuclear transcription factor SNAIL1 on the viability, apoptosis, proliferation, migration, and invasion of SCC-9 and HSC-3 cells. Immunohistochemical analysis of SNAIL1, E-cadherin, and N-cadherin was carried out in 47 samples representing oral epithelial dysplasia (OED) and 41 oral tongue squamous cell carcinoma (OTSCC). The suppression of SNAIL1 expression was performed using shRNA-expression vectors in HSC-3 and SCC-9 cells to investigate in vitro the impact of SNAIL1 on proliferation, apoptosis, viability, migration, and invasion of SCC-9 and HSC-3 cells. Significant differences were observed in the expression of SNAIL1, E-cadherin, and N-Cadherin between OTSCC and OED. A low membrane expression of E-cadherin was strongly associated with poor overall survival in patients with OTSCC (P < .05), but the association did not withstand the Cox multivariate survival analysis. SNAIL1 silencing played a key role in the suppression of epithelial-mesenchymal transition and inhibited migration and invasion of HSC-3 cells (P < .0001, P < .01, respectively). In SCC-9 cells, SNAIL1 silencing promoted a significant reduction in the proliferation (P < .0001) and invasion (P < .0001). The epithelial-mesenchymal transition is present in different stages of oral tongue carcinogenesis, and SNAIL1 plays a key role in this process, although the underlying mechanisms still need to be elucidated. Thus, SNAIL1 might be a promising therapeutic target in OTSCC. Show less