Correlation of E-cadherin expression with clinicopathological data in patients suffering from transitional cell carcinoma of the bladder

Epithelial cadherin (E-cadherin, E-cad) is a calcium-dependent cell-cell adhesion molecule that binds cells through homotypic fashion interactions. Its role is crucial in the induction and maintenance of cell polarity and differentiation. Downregulation or loss of its function is associated with an invasive and aggressive phenotype in many types of human cancers. 45 male patients (mean age 63 years, age range from 29 years to 87 years) with transitional cell carcinoma (TCC) of the bladder were included in the study. E-cad expression was estimated immunohistochemically in a semiquantitative fashion using light microscopy. An avidin-biotin immunoperoxidase technique was employed using anti E-cad murine monoclonal antibodies. Loss of the E-cad normal surface expression by the bladder cells was found in 32/45 (71%) of patients compared to normal bladder epithelia observed at the intercellular borders (p<0.001). A statistically significant difference between abnormal expression of E-cad and tumor grade and disease stage was also observed (p<0.001). Loss of the surface E-cadherin expression was most frequently detected in grade 3 bladder cancer patients (17/21, 80.95%) than in well differentiated tumors (grade 1) (3/7, 43.86%) (p<0.001). Surface E-cadherin expression was also most frequently lost in bladder cancer patients with lymph node and distant organs metastases (stage 4) (1/1,100%) compared to 13/25 (52%) of patients with lymph node-negative tumors (stage 1) (p<0.001). We conclude that E-cad adhesion molecule is a useful marker and the loss of its expression is associated with high grade and advanced stage in patients suffering from TCC of the bladder.