Top

Published in:

01-11-2010 | Translational Research and Biomarkers

Prognostic Significance of E-cadherin Expression and Peripheral Blood Micrometastasis in Gastric Carcinoma Patients

Authors: Abeer A. Saad, MD, Nahla M. Awed, MD, Nashwa N. A. Abd Elkerim, MD, Dina EL-Shennawy, MD, Marian A. Alfons, MD, Mohamed E. Elserafy, MD, Yaser W. Darwish, MD, Eman M. F. Barakat, MD, Sahar S. Ezz-Elarab, MD

Published in: Annals of Surgical Oncology | Issue 11/2010

Abstract

Background

The primary objective is to evaluate the prognostic value of E-cadherin (E-cad) expression and peripheral blood micrometastasis (PBMM) in gastric carcinoma. Secondary objective is to study the association between these 2 markers and the clinicopathological features of the patients.

Materials and Methods

This study took place at Ain Shams University Hospitals. A total of 30 patients with histologically proven gastric adenocarcinoma after curative surgical resection were enrolled in this study. E-cad expression was assessed in tumor tissue samples. Before the start of adjuvant chemoradiotherapy, fresh blood samples were collected to detect PBMM as indicated by cytokeratin18 mRNA expression using real-time quantitative polymerase chain reaction (RQ-PCR).

Results

Both abnormal E-cad expression and PBMM were significantly associated with lymph node metastasis, TNM stage, and lymphatic invasion. Moreover, PBMM was significantly associated with poor tissue differentiation and vascular invasion (P < .05). We found strong agreement between E-cad expression and presence of PBMM (P = .001). Both cases with altered E-cad expression and cases with positive PPMM showed shorter relapse-free survival (RFS) (P = .003 and <.001, respectively). Cox regression analysis showed that positive PBMM was independent predictor factor for relapse (hazard ratio [HR] = 6.14; 95% confidence interval [95% CI] = 1.06–35.63; P = .04). Cases with positive PBMM showed shorter overall survival (OS) (P = .001).

Conclusions

In conclusion, loss of normal E-cad expression in gastric cancer showed a close correlation with the presence of PBMM. PBMM was associated with poor RFS independent of other clinicopathological features. Additionally, detection of PBMM was a significant indicator of OS, and intensive chemotherapy seems to be indicated for these patients.

Gamboa-Dominguez A, Seidl S, Reyes-Gutierrez E, Hermannstädter C, Quintanilla-Martinez L, Busch R, et al. Prognostic significance of p21WAF1/CIP1, P27Kip1, p53 and E-cadherin expression in gastric cancer. J Clin Pathol. 2007;60:756–61.CrossRefPubMed

Chan AOO. E-cadherin in gastric cancer. World J Gastroenterol. 2006;12:199–203.PubMed

Takeichi M. Cadherin cell adhesion receptors as a morphogenetic regulator. Science. 1991;251:1451–5.CrossRefPubMed

Xu W, Zhang MW, Huang J, Wang X, Xu SF, Li Y, et al. Correlation between CK18 gene and gastric carcinoma micrometastasis. World J Gastroenterol. 2005;11:6530–4.PubMed

Chen XM, Chen GY, Wang ZR, Zhu FS, Wang XL, Zhang X. Detection of micrometastasis of gastric carcinoma in peripheral blood circulation. World J Gastroenterol. 2004;10:804–8.PubMed

Gong YL and Zhou QH. Study progression of molecular diagnosis of lung carcinoma micrometastasis. Zhongguo Feiai Zazhi. 2002;3:75.

Macdonald JS, Smalley SR, Benedetti J, Hundahl SA, Estes NC, Stemmermann GN, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med. 2001;345:725–30.CrossRefPubMed

Zhou YN, Xu C-P, Han B, Li M, Qiao L, Fang DC, et al. Expression of E-cadherin and beta-catenin in gastric carcinoma and its correlation with the clinicopathological features and patient survival. World J Gastroenterol. 2002;8:987–93.PubMed

Kaplan EL and Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;53:457–81.CrossRef

10.

Shimoyama Y and Hirohashi S. Expression of E- and P-cadherin in gastric carcinomas. Cancer Res. 1991;51:2185–92.PubMed

11.

Mayer B, Johnson JP, Leitl F, Jauch KW, Heiss MM, Schildberg FW, et al. E-cadherin expression in primary and metastatic gastric cancer: down-regulation correlates with cellular differentiation and glandular disintegration. Cancer Res. 1993;53:1690–5.PubMed

12.

Wu ZY, Zhan WH, Li JH, He YL, Wang JP, Lan P, et al. Expression of E-cadherin in gastric carcinoma and its correlation with lymph node micrometastasis. World J Gastroenterol. 2005;11:3139–43.PubMed

13.

Kim JH, Park JM, Jung CW, Park SS, Kim SJ, Mok YJ, et al. The significances of lymph node micrometastasis and its correlation with E-cadherin expression in pT1-T3N0 gastric adenocarcinoma. J Surg Oncol. 2008;97:125–30.CrossRefPubMed

14.

Jung IM, Chung KJ, Kim YA, Kim JE, Heo SC, Ahn YJ, et al. Epstein-Barr virus, beta-catenin, and E-cadherin in gastric carcinomas. J Korean Med Sci. 2007;22:855–61.CrossRefPubMed

15.

Chen HC, Chu RY, Hsu PN, Hsu PI, Lu JY, Lai KH, et al. Loss of E-cadherin expression correlates with poor differentiation and invasion into adjacent organs in gastric adenocarcinomas. Cancer Lett. 2003;201:97–106.CrossRefPubMed

16.

Yonemura Y, Ninomiya I, Kaji M, Sugiyama K, Fujimura T, Tsuchihara K, et al. Decreased E-cadherin expression correlates with poor survival in patients with gastric cancer. Anal Cell Pathol. 1995;8:177–90.PubMed

17.

Matsunami K, Nakamura T, Oguma H, Kitamura Y, Takasaki K. Detection of bone marrow micrometastasis in gastric cancer patients by immunomagnetic separation. Ann Surg Oncol. 2003;10:171–5.CrossRefPubMed

18.

Jawhari A, Jordan S, Poole S, Browne P, Pignatelli M, Farthing MJ. Abnormal immunoreactivity of the E-cadherin-catenin complex in gastric carcinoma: relationship with patient survival. Gastroenterology. 1997;112:46–54.CrossRefPubMed

19.

Gabbert HE, Mueller W, Schneiders A, Meier S, Moll R, Birchmeier W, et al. Prognostic value of E-cadherin expression in 413 gastric carcinomas. Int J Cancer. 1996;69:184–9.CrossRefPubMed

Title: Prognostic Significance of E-cadherin Expression and Peripheral Blood Micrometastasis in Gastric Carcinoma Patients
Authors: Abeer A. Saad, MD
Nahla M. Awed, MD
Nashwa N. A. Abd Elkerim, MD
Dina EL-Shennawy, MD
Marian A. Alfons, MD
Mohamed E. Elserafy, MD
Yaser W. Darwish, MD
Eman M. F. Barakat, MD
Sahar S. Ezz-Elarab, MD
Publication date: 01-11-2010
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 11/2010
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-010-1151-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prognostic Significance of E-cadherin Expression and Peripheral Blood Micrometastasis in Gastric Carcinoma Patients

Abstract

Background

Materials and Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Materials and Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 11/2010

Role of Systematic Lymphadenectomy and Adjuvant Radiation in Early-Stage Endometrioid Uterine Cancer

The Prognostic Value of Tumor Mitotic Rate and Other Clinicopathologic Factors in Patients with Locoregional Recurrences of Melanoma

Robotic Right Colon Resection: Evaluation of First 50 Consecutive Cases for Malignant Disease

Clinical Significance of Human Kallikrein7 Gene Expression in Colorectal Cancer

Sentinel Lymph Node Intraoperative Imprint Cytology in Patients with Breast Cancer—Costly or Cost Effective?

New Predictors of Response to Neoadjuvant Chemotherapy and Survival for Invasive Thymoma: a Retrospective Analysis