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.