Immunohistochemical expression of epithelial mesenchymal transition proteins ZEB1 and E-cadherin in oral leukoplakia and oral squamous cell carcinoma

BACKGROUND: Oral squamous cell carcinoma (OSCC) is a frequent cancer affecting the oral cavity. OSCC is usually preceded by occurrence of precursor lesions, which demonstrate a varying degree of malignant transformation potential. Epithelial-mesenchymal transition is a significant biological phenomenon that facilitates tumor growth and metastasis through the involvement of diverse epithelial and mesenchymal proteins. E-cadherin down regulation and over-expression of zinc-finger E-box-binding homeobox 1 (ZEB1) has been reported in several cancers. AIM: To evaluate the role of E-cadherin and ZEB1 in oral leukoplakia and OSCC. METHODS: test was employed to compare individual markers across the study groups. Spearman's correlation was done followed by discriminant function analysis. RESULTS: Reduction in the expression E-cadherin and altered localization were noted from OED to OSCC. Overexpression of ZEB1 along with cytoplasmic accumulation was noted in OED, with marked expression in OSCC. ZEB1 epithelium intensity and ZEB1 connective tissue percentage contributed to the discriminant function with an accuracy of 85% for the classification of OED from OSCC. CONCLUSION: Loss of E-cadherin and up-regulation of ZEB1 from OED to OSCC, predisposes to induction of epithelial-mesenchymal transition. Discriminant formulas are developed to classify cases of OED and OSCC with 85% accuracy.