The E-Cadherin expression vs. tumor cell proliferation paradox in endometrial cancer

Anticancer Res. 2013 Nov;33(11):5091-5.

Abstract

Background: E-Cadherin is a putative marker of good prognosis in endometrial cancer. Paradoxically, in a previous study of endometrial carcinoma we found that E-Cadherin is significantly co-expressed with molecular markers of proliferation, usually associated with a worse prognosis in most tumor types.

Patients and methods: The expression of estrogen (ER) and progesterone receptors (PR), Ki67, Human Epidermal Growth Factor Receptor 2 (HER-2, c-ERB-B2), p53 and E-Cadherin was studied by means of immunohistochemistry in 126 endometrial carcinoma samples. The results were correlated with patient survival and included in a multivariate model, in order to identify factors independently associated with the patient outcome.

Results: E-Cadherin overexpression was associated with a significantly better overall survival in the whole group of patients with endometrial carcinoma (p=0.012), as well as in the group of patients exclusively harboring endometrioid tumors (p=0.004). In a restricted multivariate model, only tumor stage and E-Cadherin expression retained their independent prognostic power, both for the whole group of tumors (p=0.04), as well as for the subgroup of endometrioid carcinomas (p=0.05).

Conclusion: E-Cadherin is an independent predictor of survival in endometrial carcinoma, regardless of histological variety. Proliferation, on the other hand, does not seem to play a prominent role in this same context. This may explain why E-Cadherin retains its prognostic power, despite being significantly co-expressed with all tested molecular proliferation markers.

Keywords: E-cadherin; Endometrial carcinoma; proliferation.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma, Clear Cell / metabolism
  • Adenocarcinoma, Clear Cell / mortality
  • Adenocarcinoma, Clear Cell / pathology
  • Biomarkers, Tumor / metabolism*
  • Cadherins / metabolism*
  • Carcinoma, Papillary / metabolism
  • Carcinoma, Papillary / mortality
  • Carcinoma, Papillary / pathology
  • Cell Proliferation*
  • Cystadenocarcinoma, Serous / metabolism
  • Cystadenocarcinoma, Serous / mortality
  • Cystadenocarcinoma, Serous / pathology
  • Endometrial Neoplasms / metabolism*
  • Endometrial Neoplasms / mortality
  • Endometrial Neoplasms / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Ki-67 Antigen / metabolism
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Staging
  • Prognosis
  • Receptor, ErbB-2 / metabolism
  • Receptors, Estrogen / metabolism
  • Receptors, Progesterone / metabolism
  • Survival Rate
  • Tumor Suppressor Protein p53 / metabolism

Substances

  • Biomarkers, Tumor
  • Cadherins
  • Ki-67 Antigen
  • Receptors, Estrogen
  • Receptors, Progesterone
  • TP53 protein, human
  • Tumor Suppressor Protein p53
  • ERBB2 protein, human
  • Receptor, ErbB-2