Expression of e-cadherin and beta-catenin in human esophageal squamous cell carcinoma: relationships with prognosis

Abstract

Aim: To elucidate the expression of E-cadherin and beta-catenin correlating with its clinical outcome in patients with esophageal squamous cell carcinoma (ESCC), by analyzing their interrelationship with clinicopathological variables and their effects on progress and prognosis.

Methods: Expression of E-cadherin and beta-catenin was determined by SP immunohistochemical technique in patients with ESCC consecutively, their correlation with clinical characteristics was evaluated and analyzed by multivariate analysis.

Results: The rate of expression of E-cadherin decreased to 66.03 % (70/106) in ESCC and the protein level was negative correlated with histologic grade, tumor size, clinical staging, lymph node metastasis and venous invasion. Whereas the expression rate of beta-catenin was reduced to 69.8 % (74/106) and the level of protein expression correlated only with histologic grade. There obviously existed inverse correlation between level of E-cadherin protein and survival, especially in stage I, IIa, IIb (P=0.0033), Patients with low-expressing tumors for beta-catenin and non-expressing tumors for E-cadherin/beta-catenin had lower survival period than those with normal-expressing ones (P=0.0501 and P=0.0080, respectively). Patients with diminished expression of E-cadherin as grade II or III had shorter survival period than those with normally expressing and grade I, no significance existed between grade I and grade II or III with respect to different status of E-cadherin expression. Furthermore, Correlation analysis showed level of E-cadherin correlated with that of beta-catenin (P=0.005). Cox proportional hazards model analysis suggested downregulation of E-cadherin was an important factor indicating poor prognosis.

Conclusion: As a probable independent prognostic factor, it correlates with overall and disease free survival period, expression of E-cadherin but not beta-catenin may predict prognosis in patients with ESCC.

Figure 1

Expression of E-cadherin in esophageal squamous carcinoma tissue, brownish membrane and cytoplasm were shown in part of the tumor cells (A, B positive, C heterogeneous, D negative expression Original magnification × 200; B, Original magnification × 400).

Figure 2

Expression of β-catenin in esophageal squamous carcinoma tissue ,brownish membrane and cytoplasm were shown in part of the tumor cells in the centers showing zonal differentiation (E, F positive, G heterogeneous, H negative expression Original magnification; H, Original magnification × 400)

Figure 3

Kaplan-Meier survival curves for patients with stage I, II according to E-cadherin expression.

Figure 4

Kaplan-Meier survival curves for patients with stage III, IV according to E-cadherin expression.

Figure 5

Kaplan-Meier survival curves for patients with ESCC stratified for histologic grade according to E-cadherin expression