Clinicopathological Significance of Epithelial-Mesenchymal Transition in Oral Squamous Cell Carcinoma.

Epithelial-mesenchymal transition (EMT) contributes to oral squamous cell carcinoma (OSCC) progression, although the clinical relevance of EMT-related markers remains controversial. This study evaluated the expression of EMT markers and transcription factors and their associations with clinicopathological features and survival in OSCC. Immunohistochemical expression of E-cadherin, N-cadherin, vimentin, and EMT-associated transcription factors (Snail1, Slug, Twist, ZEB1, ZEB2, and E47) was assessed in OSCC samples. Associations with clinicopathological variables were analyzed using χ2 or Fisher's exact test, while survival outcomes were evaluated using Kaplan-Meier and Cox regression analyses. E-cadherin, vimentin, and N-cadherin were expressed in 54.5%, 39.6%, and 2.5% of cases, respectively. Loss of E-cadherin and vimentin expression was associated with adverse clinicopathological features, including advanced stage, lymph node metastasis, and poor differentiation. Vimentin expression was significantly associated with reduced disease-specific and overall survival in univariate analysis. Based on combined E-cadherin and vimentin expression, tumors were classified as non-EMT, partial EMT, or complete EMT. Complete EMT was associated with significantly poorer survival, whereas partial EMT showed no prognostic impact. Vimentin independently predicted disease-specific survival, while EMT-related alterations overall appeared strongly influenced by established clinicopathological factors, particularly tumor stage.