Abnormal expression of E-cadherin and β-catenin may be a molecular marker of submucosal invasion and lymph node metastasis in early gastric cancer

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Abstract
Background Impaired expression of E-cadherin and α- and β-catenin is frequently observed in several human cancers. The aim of this study was to examine immunohistochemical expression of these adhesion molecules, focusing on early gastric carcinomas, and to investigate differences between differentiated and undifferentiated gastric cancer at the early phase of carcinogenesis. Methods Immunohistochemical staining of E-cadherin and α- and β-catenin was performed using specimens from 143 patients with early gastric cancer. Results Abnormal E-cadherin and β-catenin staining correlated with depth of tumour invasion in differentiated-type tumours. In contrast, abnormal staining was frequently found even in intramucosal carcinoma of undifferentiated-type tumours, suggesting an apparent difference in the onset of E-cadherin–catenin complex abnormality between the two cancer types. Absent staining of β-catenin was associated with lymph node metastasis. Multivariate analysis revealed abnormal E-cadherin expression as an independent factor that correlated with submucosal invasion in early gastric cancer. Conclusion Abnormal E-cadherin expression is a possible marker of submucosal invasion in differentiated-type early gastric cancer and absent β-catenin staining could be used as a predictor of lymph node metastasis in both types.