Interaction Between Epithelial‐Mesenchymal Transition and Tumor Microenvironment Biomarkers and Their Impact on the Prognosis of Oral Tongue Squamous Cell Carcinoma

To investigate, through immunohistochemistry, the interaction between the epithelial-mesenchymal transition (EMT) status and the tumor microenvironment (TME) in oral tongue squamous cell carcinomas (OTSCCs). A total of 61 cases of OTSCC were selected. In all cases, the EMT status was determined through the analysis of E-cadherin and N-cadherin immunoexpression, while the TME was characterized using TGF-β and α-SMA for cancer-associated fibroblasts, CD163 for M2 macrophages, and Foxp3 for regulatory T cells. Associations between the expression patterns of these proteins and clinicopathological features, as well as overall survival (OS) and disease-free survival (DFS) parameters, were investigated. High α-SMA expression in OTSCC cases was significantly associated with a positive EMT status (p = 0.011). This marker also showed a significant positive correlation with TGF-β immunostaining (p = 0.028). Foxp3 and CD163 also demonstrated a significant positive correlation (p = 0.010). Multivariate analysis identified high Foxp3 (p = 0.011) and TGF-β (p = 0.002) expression as independent prognostic factors for OS, and high TGF-β expression (p = 0.031) as an independent prognostic factor for DFS. The results suggest an interaction among TME biomarkers, with implications for EMT development and progression, as well as for the prognosis of OTSCC.