Expression of E‐cadherin (E‐CD) as related to other prognostic factors and survival in breast cancer

Abstract

A series of 208 breast cancer biopsies were analysed immunohistochemically for expression of E-cadherin (E-CD). Altogether, 72 per cent of the tumours showed E-CD positivity in over 50 per cent of cells, the staining being heterogeneous in nearly all tumours. In only 16 per cent of ductal carcinomas was positive staining seen in less than 1 per cent of cells. Expression of E-CD was not related to tumour diameter, nodal status, metastasis at diagnosis, histological grade, DNA ploidy, S-phase fraction, nuclear area, mitotic frequency, or PR content. There was a significant relationship between expression of E-CD, histological type (P = 0.01), the proportion of intraductal growth (P = 0.008), the density of tumour-infiltrating lymphocytes (P = 0.0007), ER content (P = 0.012), and morphometric nuclear factors (P < 0.02). Expression of E-CD showed a weak association with a high survival probability (P = 0.02), while the relation to recurrence-free survival was not significant (P = 0.1). In axillary lymph node-negative tumours, E-CD expression was not related significantly to survival (P = 0.11) or to recurrence-free survival (P = 0.06). In multivariate analysis, E-CD expression had no independent prognostic value, while the axillary lymph node status, tumour diameter, patient age, and mitotic frequency were independent prognostic factors. The results indicate that E-CD expression is related to several histological features in breast cancer, but has no independent prognostic value over standard prognostic factors.

E-cadherin as a prognostic indicator in primary breast cancer

“…Charpin's study (Charpin et al, 1997), also on frozen sections, noted that tumours with weaker E-CD expression were heterogeneous. Studies on paraffinembedded tumours, as in this study, have also observed distinct intratumoural variation in staining intensity (Lipponen et al, 1994).…”

“…Some (Gamallo et al, 1993;Lipponen et al, 1994;Gonzalez et al, 1999) have observed a relationship with histological grade and tumour type, but no other features. Maguire et al (1997), detecting E-CD by ELISA found no relationship with tumour size, node status or ER, but did associate early recurrence with lower E-CD levels.…”

“…E-CD expression in ductal carcinoma in situ (DCIS) is similar to that of normal tissue, while invasive ductal carcinomas may have reduced or heterogeneous expression. In contrast, infiltrating lobular carcinoma (ILC) has significantly reduced or absent expression (Gamallo et al, 1993;Oka et al, 1993;Rasbridge et al, 1993;Birchmeier and Behrens, 1994;Lipponen et al, 1994;Siitonen et al, 1996;Charpin et al, 1997;Gonzalez et al, 1999). The reduced expression seen in ILC is assumed to be reflected in the different pattern of invasion compared to ductal and special types of breast cancer.…”

Expression of E-Cadherin in breast carcinomas and its association with other biological markers — a prospective study

“…This direct association was found to be 51% after accounting for chance agreement. While, Lipponen et al 39 demonstrated a similar direct association of E-CD expression with ER protein expression, other workers 30,40 did not observe any significant association between the two. It has been postulated that reversible down regulation of E-CD may occur by hypermethylation of the promoter region of E-CD expression.…”

E-cadherin mediates the aggregation of breast cancer cells induced by tamoxifen and epidermal growth factor

“…Several studies indicate that reduced E-cadherin expression is an independent indicator of poor survival, particularly in node-negative patients [58][59][60][61]. However, other studies have found E-cadherin to be of little use in predicting clinical behavior of breast cancer patients [62]. Indeed, one study even noted that strong E-cadherin immunostaining correlated with poor survival [63].…”