EXPRESSION OF E-CADHERIN IN ESOPHAGEAL CARCINOMAS FROM THE UK AND CHINA - DISPARITIES IN PROGNOSTIC-SIGNIFICANCE

Aims-To study the expression and prognostic significance of the cell a dhesion molecule E-cadherin in oesophageal tumours from the UK (low ri sk area) and China (high risk area). Methods-E-cadherin expression was measured immunohistochemically in resected tumours from 17 patients i n the UK with adenocarcinoma, 23 patients from the UK with squamous ca rcinoma, and 30 patients from China with squamous carcinomas who survi ved for five years postoperatively and compared with similar tumours f rom patients in the same regions who did not survive (140 tumours in a ll). Results-Normal squamous epithelial cells and well differentiated areas of tumours showed membranous staining for E-cadherin expression. Cytoplasmic staining, heterogeneous staining, or an absence of staini ng was seen in dysplastic epithelium and in less well. differentiated areas of tumours. Only one of 140 primary tumours had homogeneous memb ranous expression. In tumours from UK patients with adenocarcinoma (p = 1.00) and from Chinese patients with squamous carcinomas (p = 0.06) there was no correlation between E-cadherin absence and nonsurvival. I n tumours from UK patients with squamous carcinomas there was a signif icant correlation between absence of E-cadherin and non-survival (p = 0.009). Tumours from UK patients with squamous carcinoma who survived were significantly less Likely to be E-cadherin absent than those from Chinese patients with squamous carcinomas who survived (p =.0.007). M ultivariate analysis (n = 37 UK, paired data) showed that absence of E -cadherin in the primary tumour was a weak independent prognostic fact or for non-survival (30% significance level; p = 0.26; odds ratio = 3. 56). In UK nodal metastases there was no correlation between E-cadheri n expression and survival. Conclusions-Squamous carcinomas from UK pat ients differed from both adenocarcinomas from UK patients and carcinom as from Chinese patients with respect to E-cadherin expression and pro gnostic significance. In tumours from UK patients, E-cadherin absence in the primary carcinoma (a weak independent prognostic factor) but no t metastases correlated with non-survival.