Expression of E-cadherin in gastric carcinoma and its correlation with lymph node micrometastasis.
OBJECTIVE
To examine the expression of E-cadherin in the primary tumor and to evaluate its relationship with lymph node micrometastasis (LNM).


METHODS
The authors studied 850 lymph nodes resected from 30 patients with gastric carcinoma who underwent gastrectomy with lymphadenectomy using reverse transcription polymerase chain reaction (RT-PCR) assay in addition to H and E staining. Cytokeratin-20 (CK-20) gene marker was used in this assay. The level of E-cadherin expression in the primary tumor was examined by immunochemical technique (EliVision plus).


RESULTS
LNM was detected in 77 (12.5%) lymph nodes of 14 patients (46.7%) with gastric carcinoma. The incidence of LNM was significantly higher in the diffuse type (12 of 19 cases, 63.2%) than in the intestinal type of gastric carcinoma (2 of 11 cases, 18.2%, P = 0.026). The incidence of LNM also increased in accordance with the depth of tumor invasion. The loss of expression of E-cadherin in primary tumors was found in 14 (46.7) of 30 tumors. The absence of E-cadherin expression was significantly associated with the Lauren classification (P = 0.026), lymph node metastasis (P = 0.011), the grade of differentiation (P = 0.004) and the lymphatic invasion (P = 0.001). Expression of E-cadherin was negative in 10 (71.4%) of the 14 patients with LNM, and in 4 (25%) of the 16 patients without LNM (P = 0.026).


CONCLUSIONS
The current results indicate that the RT-PCR assay is useful for the detection of LNM and can significantly increase the detection rate of lymph node metastasis in patients with gastric carcinoma. The Lauren classification and depth of tumor invasion are significantly associated with lymph node micrometastases. Our findings also indicate that E-cadherin may play an important role in determining the growth type and differentiation of gastric carcinoma. The loss of E-cadherin expression may contribute to LNM.
Wu
Ze-Yu
ZY
Department of Gastrointestinal and Pancreatic Surgery, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China.
Zhan
Wen-Hua
WH
Li
Jing-Hua
JH
He
Yu-Long
YL
Wang
Jian-Ping
JP
Lan
Ping
P
Peng
Jun-Sheng
JS
Cai
Shi-Rong
SR
D015820:Cadherins / Q000032:analysis* / Q000096:biosynthesis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013274:Stomach Neoplasms / Q000378:metabolism / Q000473:pathology*
D015820:Cadherins