Clinicopathologic Associations of Partial-EMT in Sinonasal Squamous Cell Carcinoma

Objectives: This study aims to quantify by immunohistochemistry (IHC), a partial epithelial-to-mesenchymal transition (p-EMT) population in sinonasal squamous cell carcinoma (SCC) and determine its associations with adverse clinicopathologic features.

Methods: All patients treated surgically for sinonasal SCC between January 2006 and December 2013 at our tertiary care institution were identified. IHC staining was performed for each of three p-EMT markers and one marker of anticorrelated well-differentiated epithelial cells. Staining was quantified as 1+, 2+, or 3+ in a blinded manner. A simple average of p-EMT markers was taken as the p-EMT score and used to quantify the p-EMT population. Clinical and pathologic data for these patients were also collected retrospectively from patient charts.

Results: Forty-eight patients were identified. Thirty patients (63%) had advanced T4 disease, and four patients (8.3%) had nodal disease at presentation. Twenty-five patients (52%) had positive margins, 24 (50%) had high grade tumors, 18 (38%) had PNI, and 15 (31%) had LVI. Associations of p-EMT scores with adverse pathologic features were determined by ANOVA and chi-squared analyses. Kaplan–Meier curves and multivariate Cox-proportional hazards models were used to determine the association of p-EMT and adverse pathologic features on overall survival (OS) and disease free survival (DFS).

Conclusion: In our single-institution experience of 48 sinonasal SCC patients, we determine the clinicopathologic associations of p-EMT, a program previously demonstrated to be associated with adverse pathologic features such as perineural invasion and high grade in oral cavity SCC.