Clinicopathologic evaluation of immunohistochemical E-cadherin expression in human gastric carcinomas

BACKGROUND: E-cadherin plays a crucial role in cell-cell adhesion in epithelial tissues. Recent studies have shown a correlation between decreased E-cadherin expression and cancer cell detachment. METHODS: The expression of E-cadherin was immunohistochemically analyzed using antihuman E-cadherin antibody in 121 cases of human gastric carcinoma. RESULTS: In noncancerous areas, the epithelial cells, including those with intestinal metaplasia, were stained positively in the plasma membrane. In contrast, E-cadherin expression of the cancer cells varied from case to case in primary and secondary sites. Tumors with a decrease in E-cadherin occurred significantly more frequently in undifferentiated adenocarcinoma (P < 0.05) and scirrhous type (P < 0.01). The rate of E-cadherin-negative tumors was higher in patients with peritoneal metastasis (P < 0.01) or in those with distant lymph node metastasis (P < 0.01), though the tumors with liver metastasis had relatively positive E-cadherin expression. Patterns of initial recurrence had similar results. Reduction or loss of E-cadherin expression correlated with shorter survival in patients after curative operation regardless of stage of disease. CONCLUSIONS: The decreased E-cadherin expression correlates with dedifferentiation, infiltrative tumor growth, distant metastasis, and poor survival for patients with gastric carcinoma. Thus, immunohistochemical study of E-cadherin may have clinicopathologic value for patients with gastric carcinoma.