Correlation of N-Cadherin and MMP-9 Expression with Regional Nodal Metastasis in Laryngeal Squamous Cell Carcinoma

Abstract

Background: In laryngeal carcinoma, regional nodal metastasis serves as a significant prognostic factor. A special biomarker is needed to predict the status of nodal metastases. N-cadherin, a binding protein, aids in cell migration and enabling tumor cells to spread to new locations. The involvement of matrix metalloproteinase-9 (MMP-9) in metastasis includes fostering the dissemination of tumor cells from the primary tumor and enhancing tumor cell motility. Objective: This study seeks to explore the distinctions and relationships in N-cadherin and MMP-9 expression among patients with laryngeal squamous cell carcinoma at various N stages. Methods: Employing a cross-sectional approach, this study conducted an analytic observational investigation on formalin-fixed paraffin-embedded patients whose histopathological diagnosis is laryngeal squamous cell carcinoma in the Pathology Laboratory of Dr. Soetomo Regional Public Hospital in 2018–2021. The samples were divided into N stages based on radiological imaging from the CT scan. Immunohistochemistry examinations were performed using N-cadherin and MMP-9 antibodies and scored using the immunoreactive score (IRS), based on percentage and intensity. The differences in expression and correlation between N-cadherin and MMP-9 were analyzed using statistical tests. Results: Statistical insignificance was observed in N-cadherin expression at various N stages (p = 0.099). There were significant differences in MMP-9 expressions at various N stages (p = 0.0006338). There was no correlation between N-cadherin and MMP-9 expression at various N stages in laryngeal squamous cell carcinoma (p = 0.0638, rs = 0.27). Conclusion: In laryngeal squamous cell carcinoma, MMP-9 serves as a predictor for lymph node metastasis, which, if present, deteriorates the patient's prognosis. Keywords: Laryngeal cancer, N-cadherin, MMP-9, N stages, Metastasis