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01.11.2010 | Translational Research and Biomarkers | Ausgabe 11/2010

Annals of Surgical Oncology 11/2010

Prognostic Significance of E-cadherin Expression and Peripheral Blood Micrometastasis in Gastric Carcinoma Patients

Annals of Surgical Oncology > Ausgabe 11/2010
MD Abeer A. Saad, MD Nahla M. Awed, MD Nashwa N. A. Abd Elkerim, MD Dina EL-Shennawy, MD Marian A. Alfons, MD Mohamed E. Elserafy, MD Yaser W. Darwish, MD Eman M. F. Barakat, MD Sahar S. Ezz-Elarab
Wichtige Hinweise
None of the participating authors has conflicting interests, was supported or funded by any company.



The primary objective is to evaluate the prognostic value of E-cadherin (E-cad) expression and peripheral blood micrometastasis (PBMM) in gastric carcinoma. Secondary objective is to study the association between these 2 markers and the clinicopathological features of the patients.

Materials and Methods

This study took place at Ain Shams University Hospitals. A total of 30 patients with histologically proven gastric adenocarcinoma after curative surgical resection were enrolled in this study. E-cad expression was assessed in tumor tissue samples. Before the start of adjuvant chemoradiotherapy, fresh blood samples were collected to detect PBMM as indicated by cytokeratin18 mRNA expression using real-time quantitative polymerase chain reaction (RQ-PCR).


Both abnormal E-cad expression and PBMM were significantly associated with lymph node metastasis, TNM stage, and lymphatic invasion. Moreover, PBMM was significantly associated with poor tissue differentiation and vascular invasion (P < .05). We found strong agreement between E-cad expression and presence of PBMM (P = .001). Both cases with altered E-cad expression and cases with positive PPMM showed shorter relapse-free survival (RFS) (P = .003 and <.001, respectively). Cox regression analysis showed that positive PBMM was independent predictor factor for relapse (hazard ratio [HR] = 6.14; 95% confidence interval [95% CI] = 1.06–35.63; P = .04). Cases with positive PBMM showed shorter overall survival (OS) (P = .001).


In conclusion, loss of normal E-cad expression in gastric cancer showed a close correlation with the presence of PBMM. PBMM was associated with poor RFS independent of other clinicopathological features. Additionally, detection of PBMM was a significant indicator of OS, and intensive chemotherapy seems to be indicated for these patients.

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