Prognostic value of the expression of E-cadherin and beta-catenin in bladder cancer

The purpose of this study was to assess the prognostic effect of the expres sion of E-cadherin. beta-catenin and CD44 adhesion molecules in bladder car cinoma. 22 superficial and 18 invasive bladder tumour samples were studied by immunohistochemistry. The median follow-up was 24 months (range: 1-50 mo nths). Loss of E-cadherin and beta-catenin immunoreactivity was found in 14 (35%) and 17 (43%) tumours, respectively, and was significantly associated with invasiveness, high grade and p53 overexpression. There was no correla tion between CD44 variant expression and clinicopathological findings. Loss of E-cadherin expression was an independent predictor of poor survival in a multivariate analysis. when assessed with age, grade, stage and p53 statu s (hazards ratio adjusted (HRa) = 4.45 [95% confidence interval (CI). 1.06- 18.63]). This effect was particularly augmented in patients with invasive b ladder cancer. When expression of E-cadherin and beta-catenin were evaluate d simultaneously, loss of immunoreactivity of both proteins was a strong pr edictor of poor survival (HRa = 13.06 [95% CI, 0.95-175.55]). The same patt ern was found when progression-free survival in relation to these variables was assessed. In conclusion. assessment of E-cadherin and beta-catenin imm unoreactivity may he a useful prognostic marker in bladder cancer complemen tary to established prognostic factors. (C) 2000 Elsevier Science Ltd. All rights reserved.