The study of E-cadherin expression in glottic laryngeal squamous cell carcinoma

Abstract

Background: E-cadherin is a 120 kDa transmembrane protein that is thought to play an important role in malignant progression of tumours and in tumour differentiation. A reduced or absent expression of E-cadherin has been observed in several carcinomas, including squamous cell carcinoma of the head and neck. Objective: The aim of this study was to analyse the clinicopathologic significance of E-cadherin expression in squamous cell carcinomas with a primary location in the glottic region of the larynx. Materials and methods: E-cadherin expression was determined by immunohistochemistry in paraffin-embedded tissue specimens from 40 patients with squamous cell carcinoma of the glottic larynx. A staining score was given based on the percentage of cells stained (0-100%). All stained cells were considered positive regardless of the intensity of the staining. Using the mean expression of Ecadherin as a cut-off, 17 (42.5%) tumours were classified into the "high E-cadherin" group and 23 (57.5%) into the "low E-cadherin" group. Results: E-cadherin expression varied greatly among the tissue samples, with scores ranging from 2 to 72 (median 23). The mean expression score for E-cadherin was 27.35 (standard deviation [SD]=20.15). Decreased E-cadherin expression was significantly correlated with more aggressive tumours, including tumours staged as T3 or T4 (p = 0.038) and those with advanced clinical stage (TNM stage III and IV) (p = 0.010). The results of a stepwise logistic regression analysis showed that only the presence of lymph node metastasis was an independent predictor for tumour recurrence (p=0.019). A Cox proportional hazards model confirmed that the presence of cervical lymph node metastases (P=0.003) and age ≤ 59 years (P=0.006) were statistically significant independent predictors of a reduced disease-specific survival. Conclusion: Expression of E-cadherin may be useful to identify patients with aggressive disease, allowing more effective treatment strategies to be implemented. Larger studies are required to confirm the role of E-cadherin expression in predicting the behaviour of laryngeal squamous cell carcinomas.