Altered Distribution and Expression Pattern of E-cadherin in Hepatocellular Carcinomas: Correlations with Prognosis and Clinical Features

Objective: E-cadherin has been identified as a tumor suppressor in many types of carcinoma. However, somestudies recently suggested that the role and expression of E-cadherin might be more complex and diverse. In thepresent study, we evaluated the prognostic value of E-cadherin expression with reference to levels in membranesand cytoplasm, and the membrane/cytoplasm ratio, in hepatocellular carcinomas (HCCs) after curativehepatectomy.
Methods: The expression of E-cadherin was assessed by immunohistochemistry in HCC tissuemicroarrays from 125 patients, and its prognostic values and other clinicopathlogical data were retrospectivelyanalyzed. Patients were followed for a median period of 43.7 months (range 1 to 126 months).
Results: Univariateanalysis demonstrated that a high membrane/cytoplasm (M/C) ratio of E-cadherin expression was associatedwith poor overall survival (OS) (P =0.001) and shorter time to recurrence (TTR) (P =0.038), as well as tumorsize, intrahepatic metastasis, and TNM stage. In contrast, neither membrane nor cytoplasmic expression ofE-cadherin was related with OS and TTR. Furthermore, multivariate analysis confirmed the M/C ratio to be anindependent predictor of OS (P =0.031). χ2 tests additionally showed that the M/C ratio of E-cadherin expressionwas related with early stage recurrence (P =0.012), rather than later stage recurrence.
Conclusion: The M/Cratio of E-cadherin expression is a strong predictor of postoperative survival and is associated with early stagerecurrence in patients with HCC.