Soluble E-cadherin as a diagnostic and prognostic marker in gastric carcinoma.
Modifications in E-cadherin (E-Cad) expression are associated with dedifferentiation, progression, metastases and poor prognosis in many types of tumors. The aim of the present study was to identify a potential association of the pre- and post-operative soluble E-Cad levels (sE-Cad) with the clinicopathological parameters of patients with gastric cancer.



Serum sE-Cad levels were determined in 99 gastric cancer patients and 78 healthy volunteers using ELISA.



Levels of sE-Cad were significantly increased in gastric cancer patients compared with these levels in healthy controls (p < 0.001). For the evaluation of the diagnostic significance of sE-Cad the area under the receiver operating characteristic (ROC) curve (AUC) was 0.835, while the optimal cut-off point of 9.9 microg/mL was determined to classify gastric cancer patients, which yielded sensitivity of 72.7%, specificity of 80.8% and accuracy of 76.3%. Poor differentiation (p = 0.009) and the presence of distant metastases (p < 0.001) were the two significant independent prognostic determinants for high sE-Cad levels in multivariate linear regression analysis. The preoperative levels of sE-Cad also proved helpful in classifying patients according to the choice treatment (curative versus palliative) (AUC, 0.656); when the optimal cut-off point was set at 17.60 microg/mL, the sensitivity was 57%, the specificity was 83% and accuracy was 75%. Survival was shorter in patients with increased sE-Cad (median, 7 months vs 39 months, p = 0.0002), although multivariate Cox regression analysis demonstrated a marginal prognostic significance of sE-Cad for survival (adjusted HR = 1.68, 95% CI = 0.93 to 3.02, p = 0.072).



Serum sE-Cad levels could be considered as a diagnostic and prognostic marker in gastric cancer patients as well as a tool to select a treatment approach. The prognostic value of sE-Cad on overall survival requires further study.
2nd Department of Surgery
Christos
C
Tsalikidis
Laboratory of Experimental Surgery and Surgical Research
Fotini
F
Papachristou
2nd Department of Surgery
Michael
M
Pitiakoudis
Department of Physiology
Byron
B
Asimakopoulos
Department of Medical Statistics, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
Grigorios
G
Trypsianis
2nd Department of Surgery
Eleni
E
Bolanaki
Oncology Unit GPP, Sotiria General Hospital, Athens School of Medicine, Athens, Greece
Konstantinos N
KN
Syrigos
2nd Department of Surgery
Constantinos
C
Simopoulos
D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D015820:Cadherins / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D013274:Stomach Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000401:mortality / Q000601:surgery
D014408:Biomarkers, Tumor; D015820:Cadherins