INVERSE RELATION OF E-CADHERIN AND AUTOCRINE MOTILITY FACTOR-RECEPTOREXPRESSION AS A PROGNOSTIC FACTOR IN PATIENTS WITH BLADDER CARCINOMAS

Down-regulation of E-cadherin, an intercellular adhesion molecule, and up-regulation of autocrine motility factor receptor (gp78) expression s have been shown to play a role in tumor cell invasion and metastasis . Monoclonal antibodies against E-cadherin and gp78 were used to stain serial snap-frozen sections of 12 normal bladder and 83 bladder carci noma specimens (27 noninvasive, 53 invasive, and 3 metastases). In nor mal urothelium, E-cadherin is expressed while gp78 is not. Positive ex pression of E-cadherin and negative expression of gp78 were found to b e associated with a low risk of clinical progression in the superficia l bladder carcinoma patient group. While reduction in E-cadherin conco mitantly with an increase in gp78 expression was associated with poor prognosis, 71% of the patients (n = 30) underwent rapid cancer progres sion, and 32% of the patients died of cancer-related disease at a medi an of 2 years after initial diagnosis. Thus, it is suggested that redu ction of E-cadherin expression associated with an increase in the leve l of gp78 in bladder cancers may define a high risk group of patients. The dual use of these two antigens may improve early diagnosis of hig h risk bladder cancer patients and influence treatment decisions.