Characterization of E-cadherin expression in normal mucosa, dysplasia and adenocarcinoma of gastric cardia and its influence on prognosis.

Autor:	Wang HL; State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China., Zhao XK; State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China., Zhou FY; Department of Thoracic Surgery and Tumor Prevention Treatment, Anyang Tumor Hospital, Anyang 455000, Henan Province, China., Song X; State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China., Li LY; State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China., Huang GR; Department of Geriatrics, Henan Provincial People's Hospital, Zhengzhou 450003, Henan Province, China., Bao QD; Department of Oncology, Anyang District Hospital, Anyang 455000, Henan Province, China., Lei LL; State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China., Yang HJ; Department of Pathology, Anyang Tumor Hospital, Anyang 455000, Henan Province, China., Li L; Department of Geriatrics, Henan Provincial People's Hospital, Zhengzhou 450003, Henan Province, China., Xu RH; State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China., Li AL; Department of Pathology, Linzhou Tumor Hospital, Linzhou 456500, Henan Province, China., Wang XZ; Department of Thoracic Surgery, Linzhou People's Hospital, Linzhou 456500, Henan Province, China., Han WL; State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China., Ren JL; Department of Pathology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China., Wang LD; State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China. ldwang2007@126.com.
Jazyk:	angličtina
Zdroj:	World journal of gastrointestinal oncology [World J Gastrointest Oncol] 2022 Jan 15; Vol. 14 (1), pp. 265-277.
DOI:	10.4251/wjgo.v14.i1.265
Abstrakt:	Background: Gastric cardia adenocarcinoma (GCA), which has been classified as type II adenocarcinoma of the esophagogastric junction in western countries, is of similar geographic distribution with esophageal squamous cell carcinoma in China, and even referred as "sister cancer" by Chinese oncologists. The molecular mechanism for GCA is largely unknown. Recent studies have shown that decreased expression of E-cadherin is associated with the invasion and metastasis of multiple cancers. However, the E-cadherin expression has not been well characterized in gastric cardia carcinogenesis and its effect on GCA prognosis. Aim: To characterize E-cadherin expression in normal gastric cardia mucosa, dysplasia and GCA tissues, and its influence on prognosis for GCA. Methods: A total of 4561 patients with GCA were enrolled from our previously established GCA and esophageal cancer databases. The enrollment criteria included radical surgery for GCA, but without any radio- or chemo-therapy before operation. The GCA tissue from 4561 patients and matched adjacent normal epithelial tissue ( n = 208) and dysplasia lesions ( n = 156) were collected, and processed as tissue microarray for immunohistochemistry. The clinicopathological characteristics were retrieved from the medical records in hospital and follow-up was carried out through letter, telephone or home interview. E-cadherin protein expression was determined by two step immunohistochemistry. Kaplan-Meier and Cox regression analyses were used to correlate E-cadherin protein expression with survival of GCA patients. Results: Of the 4561 GCA patients, there were 3607 males with a mean age of 61.6 ± 8.8 and 954 females with a mean age of 61.9 ± 8.6 years, respectively. With the lesions progressed from normal gastric cardia mucosa to dysplasia and GCA, the positive immunostaining rates for E-cadherin decreased significantly from 100% to 93.0% and 84.1%, respectively (R 2 = 0.9948). Furthermore, E-cadherin positive immunostaining rate was significantly higher in patients at early stage (0 and I) than in those at late stage (II and III) (92.7% vs 83.7%, P = 0.001). E-cadherin positive expression rate was significantly associated with degree of differentiation ( P = 0.001) and invasion depth ( P < 0.001). Multivariate analysis showed that the GCA patients with positive E-cadherin immunostaining had better survival than those with negative ( P = 0.026). It was noteworthy that E-cadherin positive expression rate was similar in patients with positive and negative lymph node metastasis. However, in patients with negative lymph node metastasis, those with positive expression of E-cadherin had better survival than those with negative expression ( P = 0.036). Similarly, in patients with late stage GCA, those with positive expression of E-cadherin had better survival than those with negative expression ( P = 0.011). Conclusion: E-cadherin expression may be involved in gastric cardia carcinogenesis and low expression of E-cadherin may be a promising early biomarker and overall survival predictor for GCA. Competing Interests: Conflict-of-interest statement: We have no potential conflicts of interest to disclose. (©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
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