Nuclear E-cadherin expression is associated with the loss of membranous E-cadherin, plasmacytoid differentiation and reduced overall survival in urothelial carcinoma of the bladder
Keck B, Wach S, Kunath F, Bertz S, Taubert H, Lehmann J, Stöckle M, Wullich B, Hartmann A (2013)
Publication Type: Journal article
Publication year: 2013
Journal
Book Volume: 20
Pages Range: 2440-2445
Journal Issue: 7
DOI: 10.1245/s10434-012-2709-4
Abstract
Background: Loss of E-cadherin represents a hallmark of plasmacytoid differentiation. We analyzed the effect of membranous E-cadherin loss and its nuclear accumulation in patients with locally advanced conventional urothelial carcinoma (UC) who were treated with radical cystectomy and adjuvant chemotherapy. Methods: A total of 247 formalin-fixed, paraffin-embedded tumor samples were reviewed to detect histological variants of UC. Immunohistochemical staining of E-cadherin was performed and analyzed for membranous and nuclear expression. The correlation between E-cadherin expression and histology was assessed, and overall survival (OS) was analyzed with univariate and multivariate Cox regression and Kaplan-Meier analyses. Correlation of nuclear E-cadherin to tumor stage (pT), lymph node metastasis (pN), histologic subtype, and chemotherapy was performed by Fisher's exact test. Results: Membranous and nuclear E-cadherin expression was strongly correlated to plasmacytoid urothelial carcinoma (PUC) (p < 0.001). Complete loss of membranous E-cadherin expression was observed in 76.2 % of PUCs, 11.1 % of conventional UCs, and 0 % of micropapillary urothelial carcinoma (MPCs). Nuclear accumulation was found in 47.6 % of PUCs, 10 % of MPCs, and 1.8 % of UCs. Sixty-two percent of all tumors with negative membranous E-cadherin expression and nuclear accumulation were PUCs (p = 0.035). In a Kaplan-Meier analysis, mean survival with nuclear E-cadherin expression was 31.9 months [95 % confidence interval (CI) 16.1-47.6] of patients without nuclear staining 61 months (95 % CI 53.5-67.7; p = 0.045). A univariate Cox regression analysis showed that nuclear E-cadherin accumulation was associated with a 2-fold increase in risk of death (95 % CI 1.03-4.06; p = 0.04). In multivariate Cox regression analysis adjusted to type of chemotherapy, tumor stage, and tumor grade, the hazard ratio for patients with nuclear E-cadherin was 2.03 (95 % CI 1.00-4.121; p = 0.050). Conclusions: Nuclear E-cadherin is associated with PUCs and is suggested to be an independent prognostic factor in advanced UC. © 2012 Society of Surgical Oncology.
Authors with CRIS profile
Bastian Keck
Medizinische Fakultät
Sven Wach
Medizinische Fakultät
Frank Kunath
Urologische Klinik
Simone Bertz
Institute of Pathology
Helge Taubert
Professur für Molekulare Urologie
Bernd Wullich
Lehrstuhl für Urologie
Arndt Hartmann
Lehrstuhl für Allgemeine Pathologie und Pathologische Anatomie
Involved external institutions
Germany (DE)How to cite
APA:
Keck, B., Wach, S., Kunath, F., Bertz, S., Taubert, H., Lehmann, J.,... Hartmann, A. (2013). Nuclear E-cadherin expression is associated with the loss of membranous E-cadherin, plasmacytoid differentiation and reduced overall survival in urothelial carcinoma of the bladder. Annals of Surgical Oncology, 20(7), 2440-2445. https://doi.org/10.1245/s10434-012-2709-4
MLA:
Keck, Bastian, et al. "Nuclear E-cadherin expression is associated with the loss of membranous E-cadherin, plasmacytoid differentiation and reduced overall survival in urothelial carcinoma of the bladder." Annals of Surgical Oncology 20.7 (2013): 2440-2445.
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