Abnormal E-cadherin expression and prostate cell blood dissemination as markers of biological recurrence in cancer

Until now, no molecular parameter has been available for predicting the met astatic potential of prostate tumours, which leaves their outcome uncertain despite an apparent benign histology or early stage. Abnormal expression o f adhesion molecules, such as E-cadherin, can be contributing factors for i ncreased invasiveness and metastatic potential. Histological analysis for E -cadherin expression was carried out on paraffin-embedded tumour tissues. T umour metastatic potential was indirectly evaluated by detecting circulatin g prostate cells (CPC), using reverse transciptase-polymerase chain reactio n (RT-PCR) and prostate-specific membrane antigen (PSMA) as a target. Patie nts were followed-up for a median of 14 months (range 10-19 months) after s urgery with serum prostate-specific antigen (PSA) level measurement. Intere stingly, 23 of 44 localised tumours exhibited aberrant E-cadherin expressio n. Prior to primary surgery, PSMA RT-PCR detected the spread of prostate ce lls to the blood in 24 patients. Statistical analysis showed that abnormal E-cadherin expression in the tumours was the only variable that was indepen dently correlated with prostate cell dissemination in the blood (P < 0.0001 ). In logistic regression analysis, abnormal E-cadherin expression was a si gnificant independent predictor for a later biological relapse. This impair ed adhesion status was clearly correlated with a haematogenous spread of th e primary tumour cells. It could therefore be an objective way to restrict the indications for radical surgery to patients not presenting with this fe ature. (C) 2001 Elsevier Science Ltd. All rights reserved.