Role of Twist and Vimentin as Epithelial-Mesenchymal Transition Biomarkers in Oral Squamous Cell Carcinoma: Relation to Cancer-Associated Fibroblasts.

Various molecular pathways regulate oral squamous cell carcinoma (OSCC) progression, including epithelial-mesenchymal transition (EMT), which involves loss of epithelial adhesion, acquisition of mesenchymal traits, and upregulation of markers like Twist and Vimentin. Cancer-associated fibroblasts (CAFs) promote EMT through crosstalk with cancer cells. This study aimed to evaluate Twist and Vimentin IHC expression in OSCC and their correlation with tumor grade and lymph node (LN) metastasis. In addition, Twist and Vimentin mRNA levels were investigated in OSCC cells with and without fibroblasts. The study included 30 OSCC specimens (7 well-differentiated, 14 moderately differentiated, 9 poorly differentiated), with 12 showing LN metastasis. IHC staining for Twist and Vimentin was performed and analyzed. Gene expression was assessed by qRT-PCR in SCC-25, WI-38, and coculture. A Transwell migration assay was also conducted. Twist and Vimentin IRS showed significant correlation with OSCC grades ( P <0.05). Twist IRS had a strong correlation with LN involvement ( P <0.001), and Vimentin was significantly linked to LN metastasis ( P ≤0.001). Twist and Vimentin IRS were highly correlated ( P <0.001). Coculture for 7 days increased Twist and Vimentin expression compared with individual cell cultures. In the migration assay, the SCC + fibroblast group had significantly higher migration (4667.50±1042.24) than SCC alone (1136.67±137.79), P <0.001. Twist and Vimentin expressions as an assessment of EMT might offer better prognostic factors in OSCC and could be helpful detectors of subtle LN metastasis in OSCC.