Published online Jan 15, 2022. doi: 10.4251/wjgo.v14.i1.265
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
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.
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.
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.
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.
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).
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.
E-cadherin protein expression is expected to be a molecular marker for early detection and prognosis prediction for GCA.