الفهرس 
AbstractOnly 14 pages are availabe for public view
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Abstract
Cancer stem cells have been proposed as the driving force of tumorigenesis and metastasis. Mesenchymal features have been described to invasive cells. EMT is regarded as an essential step for tumor invasion and metastasis in many cancers including HNSCC. Expression of ALDH1, HA and N-cadherin in tumor progression remains a controversial topic in HNSCC. The present study aimed to assess the prognostic significance of ALDH1, HA and N-cadherin expression in 58 selected HNSCC cases. Complete clinico-pathological and follow-up data were collected. The results were correlated with patient`s survival data. High ALDH1, HA and N-cadherin expressions were strongly correlated with adverse prognostic features. With respect to ALDH1, high expression was significantly related to large-sized tumors, presence of nodal metastasis, advanced TNM clinical stages, reduced periods of DFS and OS, higher histologic grades, non-conventional histologic type and presence of lymph-vascular invasion (p<0.05).Increased HA expression was significantly related to tumor site and size, nodal metastasis, TNM clinical stage, different histologic grades and types (p<0.05). Moreover, strong tumor and stromal HA expression intensities were demonstrated in more than two-thirds of cases with positive history of recurrence.The current research demonstrated significant high N-cadherin expression associated with large sized tumors (T3+T4), advanced TNM clinical stages (III & IV), increased incidence of tumor recurrence and patient`s death. Also, N-cadherin was differentially expressed in the three histologic grades of conventional SCC histologic type and its expression was significantly associated with presence of neural invasion (p<0.05).Follow up and survival analysis of the studied cases revealed significant lower rates of DFS and OS in patients with high ALDH1 and N-cadherin expression, diffuse HA immunoreactivity, strong stromal HA expression intensity, higher histologic grade, large sized tumors, presence of nodal and distant metastasis and advanced TNM clinical stages ( for DFS only).The univariate and multivariate analysis of various prognostic factors in relation to DFS and OS elucidated that N-cadherin expression (final score), distant metastasis and histologic grade (DFS only) remained as independent prognostic factors in the studied HNSCCs.