Association between epithelial-mesenchymal transition markers, proliferative index, and oral epithelial dysplasia: an immunohistochemical study

Objective: To correlate the immunoexpression of epithelial-mesenchymal transition markers, vimentin and E-cadherin (E-CAD), and putative markers, podoplanin (PDPN) and osteopontin (OTPN), with the expression of interleukin (IL-6), P53, and Ki-67, and with clinical and histological parameters of oral epithelial dysplasia (ED). Study design: Immunohistochemical reactions were performed in 61 cases of leukoplakia with ED, graded as low-risk (LRED=38) and high-risk (HRED=23) for malignant transformation. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression analysis. Results: HRED was more frequently observed in non-homogeneous leukoplakia (OR:7.66; CI:1.43–41.04), lesions on the tongue/floor of the mouth (OR:3.37; 95% CI:1.14–9.94), and intense PDPN expression (OR:9.17; CI:1.0–83.77). HRED exhibited higher Ki-67 expression than LRED (P=0.013). Non-continuous PDPN was more likely to exhibit extensive loss of E-CAD than continuous PDPN expression (OR:5.81; CI:1.18–28.55). Intense OTPN was more likely to exhibit intense IL-6 than mild/moderate OTPN expression (OR: 8.06, 95% CI: 1.33–48.85). P53 expression was higher in the intense IL-6 group than in the mild/moderate expression group (P=0.021). Conclusions: Our data support the potential of PDPN as a biomarker for malignant transformation owing to its association with HRED and loss of E-CAD expression. Additionally, we demonstrated a possible shared regulatory mechanism between IL-6 and OTPN expression.