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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jan 15, 2022; 14(1): 265-277
Published online Jan 15, 2022. doi: 10.4251/wjgo.v14.i1.265
Characterization of E-cadherin expression in normal mucosa, dysplasia and adenocarcinoma of gastric cardia and its influence on prognosis
Hai-Ling Wang, Xue-Ke Zhao, Fu-You Zhou, Xin Song, Liu-Yu Li, Gai-Rong Huang, Qi-De Bao, Ling-Ling Lei, Hai-Jun Yang, Li Li, Rui-Hua Xu, Ai-Li Li, Xian-Zeng Wang, Wen-Li Han, Jing-Li Ren, Li-Dong Wang
Hai-Ling Wang, Xue-Ke Zhao, Xin Song, Liu-Yu Li, Ling-Ling Lei, Rui-Hua Xu, Wen-Li Han, Li-Dong Wang, State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
Fu-You Zhou, Department of Thoracic Surgery and Tumor Prevention Treatment, Anyang Tumor Hospital, Anyang 455000, Henan Province, China
Gai-Rong Huang, Li Li, Department of Geriatrics, Henan Provincial People’s Hospital, Zhengzhou 450003, Henan Province, China
Qi-De Bao, Department of Oncology, Anyang District Hospital, Anyang 455000, Henan Province, China
Hai-Jun Yang, Department of Pathology, Anyang Tumor Hospital, Anyang 455000, Henan Province, China
Ai-Li Li, Department of Pathology, Linzhou Tumor Hospital, Linzhou 456500, Henan Province, China
Xian-Zeng Wang, Department of Thoracic Surgery, Linzhou People's Hospital, Linzhou 456500, Henan Province, China
Jing-Li Ren, Department of Pathology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
Author contributions: Wang LD and Wang HL designed the study and wrote the paper; Zhao XK, Song X and Huang GR performed data collection; Bao QD, Lei LL and Yang HJ conducted follow-up of the patients; Li LY, Li L and Xu RH performed the tissue microarray; Zhou FY and Li AL performed the immunohistochemical analysis; Wang XZ, Han WL and Ren JL contributed to data analysis; Wang LD revised the manuscript.
Supported by National Natural Science Foundation of China, No. 81872032, and No. U1804262; and National Key R&D Program of China, No. 2016YFC0901403.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Zhengzhou University.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no potential conflicts of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Li-Dong Wang, MD, PhD, Professor, State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research, The First Affiliated Hospital of Zhengzhou University, No. 40 Daxue Road, Zhengzhou 450052, Henan Province, China. ldwang2007@126.com
Received: September 6, 2021
Peer-review started: September 6, 2021
First decision: November 8, 2021
Revised: November 18, 2021
Accepted: December 8, 2021
Article in press: December 8, 2021
Published online: January 15, 2022
ARTICLE HIGHLIGHTS
Research background
Gastric cardia adenocarcinoma (GCA), which has been classified as type II adenocarcinoma of the esophagogastric junction in western countries, is of similar geographic distribution with esophageal squamous cell carcinoma in China, and even referred as "sister cancer" by Chinese oncologists. The molecular mechanism for GCA is largely unknown. Recent studies have shown that decreased expression of E-cadherin is associated with the invasion and metastasis of multiple cancers. However, the E-cadherin expression has not been well characterized in gastric cardia carcinogenesis and its effect on GCA prognosis.
Research motivation
In previous reports, there is no consistent conclusion on the association between E-cadherin expression and gastric cardia carcinogenesis and its effect on prognosis with GCA.
Research objectives
This study aimed to characterize E-cadherin expression in normal gastric cardia epithelium, dysplasia lesions and GCA tissues, and its influence on prognosis for GCA.
Research methods
Immunochemistry stating of E-cadherin was performed on GCA and matched adjacent normal epithelial tissue and dysplasia. The correlation on E-cadherin protein expression and prognosis of patients with GCA were analyzed using Kaplan–Meier and Cox regression test.
Research results
With the lesions progressed from normal gastric cardia mucosa to dysplasia and GCA, the positive immunostaining rates for E-cadherin decreased significantly from 100% to 93.0% and 84.1%, respectively (R2 = 0.9948). E-cadherin had better survival than those with negative expression (P = 0.026). In the group with negative lymph node metastasis, survival was better in patients with positive E-cadherin expression than negative expression (P = 0.036). Similarly, in patients with late stage GCA, those with positive expression of E-cadherin had better survival than those with negative expression (P = 0.011).
Research conclusions
E-cadherin expression may be involved in gastric cardia carcinogenesis and low expression of E-cadherin may be a promising early biomarker and overall survival predictor for GCA.
Research perspectives
E-cadherin protein expression is expected to be a molecular marker for early detection and prognosis prediction for GCA.
