title: Soluble E-cadherin is a valid prognostic marker in gastric carcinoma.
abstract: BACKGROUND
  Gastric cancer remains a major cause of cancer mortality globally but no good prognostic tumour marker is available. Soluble fragment of E-cadherin protein has been reported to increase in the sera of patients with cancer and recently was found to be elevated in 67% of patients with gastric cancer.
  
  
  OBJECTIVE
  To investigate if serum soluble E-cadherin is a valid prognostic marker in gastric cancer.
  
  
  METHODS
  Concentrations of soluble E-cadherin from 116 patients with histologically confirmed gastric adenocarcinoma and 40 healthy subjects were measured using an immunoenzymometric method with a commercially available sandwich ELISA kit based on monoclonal antibodies.
  
  
  RESULTS
  The logarithm of the means of soluble E-cadherin concentration was significantly higher in patients with gastric cancers (mean 3.85 (SD 0.28)) than in healthy subjects (3.71 (0.18)) (p=0.001), and in palliative/conservatively treated cancers (3.91 (0.35)) than in operable cancers (3.78 (0.19)) (p=0.015). The logarithm of the concentrations correlated with tumour size (p=0.032) and carcinoembryonic antigen concentrations (p=0.001). The cut off value calculated from discriminant analysis on operability and inoperability/palliative treatment was 7025 ng/ml. Soluble E-cadherin concentrations higher than this cut off value predicted tumour (T4) depth invasion (p=0.020, confidence interval (CI) 1.008-1.668) and palliative/conservative treatment (p=0.023, CI 1.038-2.514). In contrast, the relative risks for lymph node (N2) metastasis, distant metastasis, and stage III/IV disease were 1.41, 1.33, and 1.55 respectively, despite not reaching statistical significance.
  
  
  CONCLUSIONS
  Serum soluble E-cadherin is a potential valid prognostic marker for gastric cancer. A high concentration predicts palliative/conservative treatment and T4 invasion.
authors.affiliation: Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong.
authors.forename: A O
authors.initials: AO
authors.lastname: Chan
authors.forename: S K
authors.initials: SK
authors.lastname: Lam
authors.forename: K M
authors.initials: KM
authors.lastname: Chu
authors.forename: C M
authors.initials: CM
authors.lastname: Lam
authors.forename: E
authors.initials: E
authors.lastname: Kwok
authors.forename: S Y
authors.initials: SY
authors.lastname: Leung
authors.forename: S T
authors.initials: ST
authors.lastname: Yuen
authors.forename: S Y
authors.initials: SY
authors.lastname: Law
authors.forename: W M
authors.initials: WM
authors.lastname: Hui
authors.forename: K C
authors.initials: KC
authors.lastname: Lai
authors.forename: C Y
authors.initials: CY
authors.lastname: Wong
authors.forename: H C
authors.initials: HC
authors.lastname: Hu
authors.forename: C L
authors.initials: CL
authors.lastname: Lai
authors.forename: J
authors.initials: J
authors.lastname: Wong
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000175:diagnosis; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D015820:Cadherins / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood; D016022:Case-Control Studies; D016001:Confidence Intervals; D016002:Discriminant Analysis; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D016011:Normal Distribution; D011237:Predictive Value of Tests; D011379:Prognosis; D013274:Stomach Neoplasms / Q000097:blood* / Q000175:diagnosis
chemical_list: D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor; D015820:Cadherins; D002272:Carcinoembryonic Antigen