Abstract:
Background
Esophageal squamous cell carcinoma (SCC) remains a disease of poor prognosis. Early diagnosis is compromised by the delayed onset of symptoms. By the time of surgical intervention metastases and organ infiltration have already occurred this reduces the prognosis significantly and the 5-year survival rate of operative advanced esophageal SCC remains poor. In order to select an appropriate therapeutic regime and guard against both over- and under treatment, reproducible prognostic markers are needed at the time of diagnosis. The study evaluates the phenotypic expression of E-cadherin and β- catenin in SCC of the esophagus.
Methods: The expression patterns of both β-catenin and E-cadherin was determined using immunohistochemistry technique in patients with esophageal SCC with the application of the Broders and Brynes grading systems in assessing clinical outcome. Forty four cases were randomly selected, one case was esophagectomy, and 43 were endoscopic biopsies with one case of Broders Grade I, 37 Grade II and 6 Grade III and 9 cases had pattern 2 and 35 had pattern 3 with Brynes Grade.
Results: The reduced expression of E-cadherin and β-catenin was 45.5% and 47.7% respectively. No significant level was observed with E-cadherin (P= 0.20) and for β-catenin (P= 0.18) but the low protein level of both biomarkers was associated with tumor cell differentiation with Broders classification. The reduced expression of E-cadherin on invasive tumor front was 27% and 57% for reduced expression of β-catenin. The level of significance was found to be (P=1.00) for E-cadherin expression and (P=0.02) for β-catenin. E-cadherin and β-catenin showed reduced expression on invading tumor front and β-catenin was associated with tumor cell invasiveness.
Conclusion: The expression of E-cadherin and β-catenin with regard to Broders classification showed no significance on tumor cell differentiation and these expressions do not play a role in guiding nor predict the behavior or progression of the tumor. However, the assessment β-catenin on the tumor invasive front (Brynes) shows a high correlated with tumor behavior as it is involved in regulation E-cadherin function.
