Expression of E-cadherin and alpha-catenin in patients with colorectal carcinoma. Correlation with cancer invasion and metastasis.

Cadherins form complexes with groups of cytoplasmic proteins, such as alpha-, beta-, and gamma-catenins, that link the cadherin molecule to the cytoskeleton. In this study, we conducted an immunohistochemical investigation of E-cadherin and alpha-catenin expression in 100 tissue samples obtained from colorectal cancer patients undergoing surgical treatment. Reduced expression of alpha-catenin was observed in 56 (56%) of the cases and found to be significantly correlated with the depth of invasion of the patients' colorectal cancer and its metastasis to lymph nodes and liver. In contrast, E-cadherin expression was reduced in 29 (29%) of the cases and was not significantly correlated with either depth of invasion or metastasis. Although the levels of expression of these proteins were positively correlated, coexpression pattern analysis showed that invasion and metastasis were correlated with a reduction of alpha-catenin expression regardless of the status of E-cadherin staining. Thus, to predict tumor invasion and metastasis in colorectal adenocarcinoma, it is useful to investigate not just the expression of E-cadherin but also the expression of alpha-catenin.

Characterization of soluble E-cadherin as a disease marker in gastric cancer patients.

The soluble fragment of E-cadherin protein (S-ECD) is reported to be increased in the peripheral blood of cancer patients. In this study, we investigated the clinical significance of serum S-ECD in 81 patients with gastric cancer. The amount of serum S-ECD was significantly higher in the gastric cancer patients (4735 +/- 2310 ng ml(-1)) than in healthy volunteers (2515 +/- 744 ng ml(-1)). With the normal range cut-off at average +2 s.d., 67% patients showed abnormally high serum S-ECD levels. This frequency was significantly higher than that of other tumour markers, such as CEA (4.4%) or CA19-9 (13.3%). However, there was no significant correlation between the amount of S-ECD and clinicopathological factors. Serum S-ECD might be derived from cancer tissue, as removal of cancers by surgical treatment results in quick decline of the serum S-ECD and S-ECD can be detected by immunoblot in cancer tissues but not in normal epithelium. The serum S-ECD amount was compared with the E-cadherin expression in cancer tissues, which were classified into those showing preserved (+), partially reduced (+/-) or lost (-) expression. Interestingly, E-cadherin (+/-) tumours showed higher serum S-ECD levels than the other types, and a higher amount of S-ECD in the immunoblot analysis. Thus, the serum level of S-ECD may serve as an excellent tumour marker with high sensitivity. Furthermore, analysis of S-ECD in serum and cancer tissue can offer clues for elucidating the mechanism of reduction of E-cadherin expression in cancer cells.

Expression of autocrine motility factor receptor in human esophageal squamous cell carcinoma.

Autocrine motility factor and its receptor (gp78) have been shown to play an important role in tumor cell migration, invasion and metastasis. We have detected gp78 expression in buffered-formalin-fixed, paraffin-embedded sections of esophageal squamous cell carcinomas using an anti-gp78 monoclonal antibody (MAb), 3F3A, and examined the relationship between gp78 expression and clinicopathological and prognostic factors. In 55 of 101 (54%) patients, gp78 was detected in the tumor cells. The frequency of gp78-positive expression was significantly associated with tumor size, infiltrative growth, depth of invasion and lymph node metastasis. The cumulative survival rate of patients with gp78 was significantly lower than that of patients without gp78. Our results suggest that autocrine motility factor receptor (gp78) expression could be a useful biomarker for malignancy grading and prognosis in patients with esophageal squamous cell carcinoma.

[Correlation between the intercellular adhesion molecule (E-cadherin) and its associated protein (alpha-catenin) expression and metastasis in human digestive cancers].

The immunostaining (ABC method) of E-cadherin and alpha-catenin were performed on 46 esophageal cancers, 67 gastric cancers, 100 colon cancers. E-cadherin and alpha-catenin expression was evaluated as preserved and reduced according to the proportion of positive cells, respectively. The reduction of alpha-catenin expression was more significantly related to lymph node metastasis than that of E-cadherin. Furthermore, the frequency of hematogenous liver metastasis in preserved E-cadherin expression and reduced alpha-catenin expression was significantly higher than that in another combination of E-cadherin and alpha-catenin expression, in gastric and colon cancer. The reduction of alpha-catenin expression was associated with declined intercellular adhesiveness, which occasionally was not accompanied by reduction of E-cadherin. Therefore, the expression of alpha-catenin might more sensitively indicated cell-cell adhesion, predicting tumor metastasis.

Immunohistochemical detection of alpha-catenin expression in human cancers.

The function of E-cadherin is thought to be regulated by its associated cytoplasmic proteins including alpha-catenin. To determine whether possible downregulation of alpha-catenin expression may play a role in tumor invasion and metastasis through the dysfunction of E-cadherin, we investigated the expression of alpha-catenin in human carcinoma samples (esophagus, stomach, and colon) by immunohistochemistry using our monoclonal antibody against alpha-catenin (alpha-18). Normal epithelium expressed alpha-catenin strongly without exception. However, alpha-catenin expression was frequently reduced in primary tumors of esophagus (12 of 15:80%), stomach (14 of 20: 70%), and colon (8 of 10: 80%). Of the tumors with reduced alpha-catenin expression, alpha-catenin expression was completely negative in 70.6% of them (9 of 12 in esophagus, 9 of 14 in stomach, and 6 of 8 in colon). These results also suggested that some human cancer cells may have impaired E-cadherin-mediated cell adhesiveness through the downregulation of alpha-catenin expression.

[A case of inflammatory breast cancer successfully treated with intra-arterial infusion of high-dose epirubicin].

A 56-year-old female with extensive inflammatory breast cancer was treated with intra-arterial infusion chemotherapy using a high dose of epirubicin. One cycle consisted of epirubicin; 150 mg (day 1, 4, 7) and daily administration of tamoxifen; 40 mg. After completion of 2 cycles of the regimen, both the main tumor and the extensive inflammatory skin lesion completely disappeared (CR). Hair loss, gastrointestinal disorders and leukopenia (nadir; 1,600) were the side effects encountered, but all of them were reversible. These findings suggested that dose-escalation of epirubicin was effective, and that cases with extensive skin involvement were also candidates for this modality.