Decreased E-Cadherin Immunoreactivity Correlates with Poor Survival in Patients with Bladder Thmors

Pierre Paul Bringuier, H. Rainy Umbas, H. Ewout Schaafsma, Herbert F.M. Karthaus, Frans M.J. Debruyne, Jack A. Schalken

Research output: Contribution to journalArticlepeer-review

343 Citations (Scopus)


E-cadherin, an intercellular adhesion molecule, has been shown to behave like an invasion suppressor gene in vitro. This may explain the inverse relation between expression of E-cadherin and tumor grade that was found in certain cancers. We therefore examined E-cadherin expression in bladder cancer samples from patients with known clinical follow-up. Forty-nine snap-frozen specimens (24 superficial and 25 invasive tumors) and 4 samples of normal urothelium were retrospectively analyzed with anti-E-cadherin monoclonal antibodies. In normal urothelium E-cadherin is expressed homogeneously with a typical membranous staining at cell-cell borders. Decreased expression is found in 5 of 24 superficial tumors and in 19 of 25 invasive cancers. Completely negative tumors are infrequent (4 cases). Most of the time a heterogeneous staining, which may correspond to an unstable E-cadherin expression during tumor development, is seen. Decreased E-cadherin expression correlates with both increased grade and stage (x2 = 9.5, P < 0.01, and x2 = 14.9, P < 0.005, respectively). More importantly, abnormal E-cadherin expression correlates with shorter survival (tog rank test: x2 = 16.5, P < 0.001). In keeping with its in vitro invasion suppressor function, decreased E-cadherin expression correlates with the clinical aggressiveness of bladder tumors. This is the first report of E-cadherin as a marker with prognostic value. This parameter must now be tested in a large prospective study to assess its precise clinical relevance.

Original languageEnglish
Pages (from-to)3241-3245
Number of pages5
JournalCancer Research
Issue number14
Publication statusPublished - Aug 1993


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