Publication: Transcription factor snail1 expression and poor
survival in pharyngeal squamous cell carcinoma
Authors
Jouppila-Mättö, Anna ; Tuhkanen, Hanna ; Soini, Ylermi ; Pukkila, Matti ; Närkiö-Mäkelä, Mervi ; Sironen, Reijo ; Virtanen, Ismo ; Mannermaa, Arto ; Kosma, Veli-Matti
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Publisher
Murcia: F. Hernández
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DOI
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info:eu-repo/semantics/article
Description
Abstract
Snail1, a key regulator of epithelialmesenchymal
transition (EMT), plays an important role
in tumour progression. Previous studies of snail1 have
mainly focused on the epithelial tumour cells. The
objective of this study was to evaluate the expression of
snail1 protein in endothelial cells, stromal
myofibroblasts and malignant epithelial cells of
pharyngeal squamous cell carcinomas (PSCC), as well
as its relation to clinicopathological features and
survival. One hundred and ten tissue microarray samples
were analyzed for snail1 expression using
immunohistochemistry. In endothelial cells snail1
expression was observed in 51 (48%) of 107 cases and it
predicted reduced disease specific survival (DSS)
(p=0.009). In 49 (46%) tumour samples snail1 immunostaining
was detected in stromal myofibroblasts and
there was a tendency to poorer DSS in that group
(p=0.067). Snail1 expression in endothelial cells and
stromal myofibroblasts is also associated with
hypopharyngeal tumours (p=0.01 and p=0.038
respectively), increasing T category (T3-4) (p=0.005,
p=0.037 respectively) and poorer general condition of
the patient (Karnofsky performance status score <70;
p=0.029, p=0.039 respectively). Moreover endothelial
expression correlated with advanced stage (III-IV)
(p=0.005) and poorer differentiation (grade 2-3;
p=0.012). In malignant epithelial cells snail1
immunostaining was detected in 75 of 110 cases (68%).
Expression of the protein was more common in
hypopharyngeal tumours (p=0.044). Snail1 positive tumours associated with a lower Karnofsky performance
status score (p=0.039) and regional failure (p=0.042).
Our findings indicate that snail1 protein expression in
endothelial cells and to some extent also in tumour
stromal myofibroblasts seems to be a predictor of poor
survival in PSCC. The presence of snail1 protein in
tumour microenvironment rather than in malignant
epithelial tumour cells may induce tissue remodelling
and tumour progression.
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