This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mell, L. K. Articles by Mundt, A. J. Search for Related Content PubMed PubMed Citation Articles by Mell, L. K. Articles by Mundt, A. J.

Prognostic Significance of E-Cadherin Protein Expression in Pathological Stage I-III Endometrial Cancer

Departments of ¹ Radiation and Cellular Oncology, ² Pathology and ³ Obstetrics and Gynecology, University of Chicago, and ⁴ Department of Radiation Oncology, University of Illinois at Chicago, Chicago, Illinois

Purpose: Decreased expression of E-cadherin in endometrial cancer cells is associated with adverse prognostic features. This study aimed to evaluate the prognostic significance of decreased E-cadherin expression in patients with endometrial cancer.

Experimental Design: Between 1992 and 1999, 102 endometrial cancer patients with stage I-III disease underwent primary surgery at the University of Chicago. Representative tissue specimens were immunostained with a monoclonal antibody to E-cadherin. A semiquantitative evaluation scale was developed based on the percentage of endometrial cancer cells with membranous E-cadherin staining. Tissue sections were scored as "3" if >75%, "2" if 25–75%, "1" if 5–25%, and "0" if <5% of cells stained. E-Cadherin staining was correlated with overall survival (OS), cause-specific survival (CSS), progression-free survival (PFS), and extrapelvic progression. Multivariate Cox proportional hazards modeling was used to estimate hazard ratios, controlling for clinicopathological characteristics and adjuvant treatment. Median follow-up for the study group was 58.5 months.

Results: E-Cadherin staining was scored as 0, 1, 2, and 3 in 29.4%, 18.6%, 26.5%, 25.5% of cases, respectively. E-Cadherin expression was positively correlated with myometrial invasion (Kendall : 0.30, P < 0.01), and negatively correlated with grade (Kendall : –0.13, P = 0.15) and papillary serous or clear cell histology (Kendall : –0.14, P = 0.12). Five-year actuarial OS, CSS, PFS, and extrapelvic recurrence rates for negative (score = 0), heterogeneous (score = 1–2), and positive (score = 3) staining were as follows: OS, 69.2 versus 75.7 versus 81.0% (P = 0.64); CSS, 78.8 versus 91.2 versus 95.5% (P = 0.19); PFS, 69.1 versus 88.6 versus 92.2% (P = 0.079), and extrapelvic progression, 20.8 versus 7.3 versus 4.0% (P = 0.17). On multivariate Cox regression, a higher E-cadherin expression score was associated with decreased overall mortality [hazard ratio (HR), 0.59; 95% confidence interval (CI), 0.34–1.03; P = 0.066), and statistically significant decreases in endometrial cancer mortality (HR, 0.23; 95% CI, 0.055–0.94; P = 0.040), disease progression (HR, 0.28; 95% CI, 0.10–0.77; P = 0.014), and extrapelvic recurrence (HR, 0.24; 95% CI, 0.062–0.97; P = 0.045).

Conclusions: Decreased E-cadherin expression is an independent prognostic factor for disease progression and mortality in pathological stage I-III endometrial cancer. Evaluation of E-cadherin expression may aid in the selection of patients for more aggressive adjuvant therapy.

This article has been cited by other articles:

				K. Sawada, A. K. Mitra, A. R. Radjabi, V. Bhaskar, E. O. Kistner, M. Tretiakova, S. Jagadeeswaran, A. Montag, A. Becker, H. A. Kenny, et al. Loss of E-Cadherin Promotes Ovarian Cancer Metastasis via {alpha}5-Integrin, which Is a Therapeutic Target Cancer Res., April 1, 2008; 68(7): 2329 - 2339. [Abstract] [Full Text] [PDF]