The E-Cadherin expression vs. tumor cell proliferation paradox in endometrial cancer.
BACKGROUND
E-Cadherin is a putative marker of good prognosis in endometrial cancer. Paradoxically, in a previous study of endometrial carcinoma we found that E-Cadherin is significantly co-expressed with molecular markers of proliferation, usually associated with a worse prognosis in most tumor types.


METHODS
The expression of estrogen (ER) and progesterone receptors (PR), Ki67, Human Epidermal Growth Factor Receptor 2 (HER-2, c-ERB-B2), p53 and E-Cadherin was studied by means of immunohistochemistry in 126 endometrial carcinoma samples. The results were correlated with patient survival and included in a multivariate model, in order to identify factors independently associated with the patient outcome.


RESULTS
E-Cadherin overexpression was associated with a significantly better overall survival in the whole group of patients with endometrial carcinoma (p=0.012), as well as in the group of patients exclusively harboring endometrioid tumors (p=0.004). In a restricted multivariate model, only tumor stage and E-Cadherin expression retained their independent prognostic power, both for the whole group of tumors (p=0.04), as well as for the subgroup of endometrioid carcinomas (p=0.05).


CONCLUSIONS
E-Cadherin is an independent predictor of survival in endometrial carcinoma, regardless of histological variety. Proliferation, on the other hand, does not seem to play a prominent role in this same context. This may explain why E-Cadherin retains its prognostic power, despite being significantly co-expressed with all tested molecular proliferation markers.
Department of Obstetrics & Gynaecology, Marqués de Valdecilla University Hospital, Cantabria University, Avenida Herrera Oria S/N, 39011 Santander, Spain.Tel: +34 942203303, jschneider@humv.es.
Irene
I
González-Rodilla
Laura
L
Aller
Javier
J
Llorca
Ana-Belén
AB
Muñoz
Virginia
V
Verna
José
J
Estévez
José
J
Schneider
D018262:Adenocarcinoma, Clear Cell / Q000378:metabolism / Q000401:mortality / Q000473:pathology; D014408:Biomarkers, Tumor / Q000378:metabolism*; D015820:Cadherins / Q000378:metabolism*; D002291:Carcinoma, Papillary / Q000378:metabolism / Q000401:mortality / Q000473:pathology; D049109:Cell Proliferation; D018284:Cystadenocarcinoma, Serous / Q000378:metabolism / Q000401:mortality / Q000473:pathology; D016889:Endometrial Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D015996:Survival Rate; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
D014408:Biomarkers, Tumor; D015820:Cadherins; D019394:Ki-67 Antigen; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D016159:Tumor Suppressor Protein p53; C495901:TP53 protein, human; C508053:ERBB2 protein, human
E-cadherin; Endometrial carcinoma; proliferation