title: E-cadherin expression pattern in primary colorectal carcinomas and their metastases reflects disease outcome.
abstract: OBJECTIVE
  To investigate the changes that occur in E-cadherin expression during the process of metastasis in colorectal cancer.
  
  
  METHODS
  E-cadherin expression was detected by immunohistochemistry and two indices of expression were calculated which reflected the level of expression and the locations (membrane and cytoplasm). Univariate and multivariate survival analyses were used to assess the value of these two E-cadherin indices as predictors of both disease-free (DFS) and disease-specific (DSS) survival.
  
  
  RESULTS
  E-cadherin membrane index (MI), but not cytoplasmic index (CI), was significantly higher in primary tumors than their metastases (P = 0.0001). Furthermore, both primary tumor MI and CI were higher among the patients who developed subsequent metastasis (P = 0.022 and P = 0.007, respectively). Interestingly, both indices were higher in liver metastase compared to other anatomic sites (MI, P = 0.034 and CI, P = 0.022). The CI of the primary tumors was a significant predictor of DFS (P = 0.042, univariate analysis), with a strong inverse correlation between CI and DFS (P = 0.006, multivariate analysis). Finally, the MI of primary tumor proved to be a significant independent predictor of DSS, with higher indices being associated with a more favorable outcome (P = 0.016).
  
  
  CONCLUSIONS
  Examination of E-cadherin expression and distribution in colorectal tumors can be extremely valuable in predicting disease recurrence. The observation that aberrant cytoplasmic expression of E-cadherin can predict disease recurrence is obviously of great importance for both patients and clinicians, and significantly affects decisions concerning the therapy and management of the patients.
authors.affiliation: Department of Oncology and Radiotherapy, Turku University Hospital, Savitehtaankatu 1 PB 52, FIN-20520 Turku, Finland. adibel@utu.fi
authors.forename: Adam
authors.initials: A
authors.lastname: Elzagheid
authors.forename: Annika
authors.initials: A
authors.lastname: Algars
authors.forename: Riyad
authors.initials: R
authors.lastname: Bendardaf
authors.forename: Hanan
authors.initials: H
authors.lastname: Lamlum
authors.forename: Raija
authors.initials: R
authors.lastname: Ristamaki
authors.forename: Yrjo
authors.initials: Y
authors.lastname: Collan
authors.forename: Kari
authors.initials: K
authors.lastname: Syrjanen
authors.forename: Seppo
authors.initials: S
authors.lastname: Pyrhonen
mesh_terms: D015820:Cadherins / Q000235:genetics / Q000378:metabolism*; D002462:Cell Membrane / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000235:genetics / Q000378:metabolism* / Q000473:pathology*; D003593:Cytoplasm / Q000378:metabolism; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000378:metabolism* / Q000556:secondary*; D008297:Male; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D011237:Predictive Value of Tests; D011379:Prognosis
chemical_list: D015820:Cadherins