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E-cadherin immunoexpression patterns in the characterisation of gastric carcinoma histotypes
  1. P R Almeida1,2,
  2. V A Ferreira2,
  3. C C Santos3,
  4. F D Rocha-Filho3,
  5. R R Feitosa1,
  6. E A A Falcão1,
  7. B K Cavada1,
  8. R A Ribeiro1,3
  1. 1Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
  2. 2Department of Pathology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
  3. 3Department of Surgical and Clinical Oncology, Cancer Institute of Ceará, Fortaleza, Brazil
  1. Correspondence to Professor Dr Paulo R C Almeida, Departamento de Patologia e Medicina Legal/FAMED/UFC, Rua Monsenhor Furtado S/N, Rodolfo Teófilo, 60 430-350 Fortaleza-CE, Brazil; paulo.almeida{at}


Aims E-cadherin, the main epithelial intercellular adhesion molecule, is abnormally expressed in many cancer types, including gastric carcinoma, which is the second leading cause of cancer death worldwide. The aim of this study was to contribute to the characterisation of gastric carcinoma histotypes based on a new approach to E-cadherin immunoexpression.

Methods 97 gastric tumour samples obtained from the files of the Hospital of Cancer/Cancer Institute of Ceará, Brazil, were histologically analysed and classified as intestinal (n=40), diffuse (n=34), mixed (n=16) or unclassified (n=7) carcinomas. Immunohistochemistry was performed on the tissue microarray sections. Scores were applied according to the system of Jawhari: 0, no staining; 1, cytoplasmic staining; 2, cytoplasmic and membranous staining in the same case; 3, normal membranous immunoexpression; abnormal patterns: scores 0, 1 and 2; normal pattern: score 3. Jawhari scores were then evaluated utilising another approach: the absence of membranous expression scores (0 and 1) versus the presence of membranous expression (scores 2 and 3).

Results A significant association between membranous expression of E-cadherin and the intestinal histotype (36/40 (90%), and 28/41 (68%) for other histotypes) was found, while diffuse carcinomas were related to the absence of membranous expression. A very strong and peculiar relationship was observed between cytoplasm-exclusive E-cadherin expression (score 1) and the diffuse component of mixed tumours (11/16 (69%)).

Conclusions E-cadherin immunoexpression patterns help us to characterise gastric carcinoma histotypes. The presence or absence of membranous staining is the most valuable criterion in evaluating E-cadherin expression. Mixed tumours show a characteristic E-cadherin cytoplasmic expression in gastric carcinomas.

  • Cell adhesion molecules
  • E-cadherin
  • gastric cancer
  • gastric carcinoma histotypes
  • immunohistochemistry

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  • Funding Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES-Brazil); Consenho Nacional de Desenvolvimento Científico e Tecnológico (CNPq-Brazil); Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP-Portugal).

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Ethics Committee of the Cancer Institute of Ceará, Brazil (Protocol No. 32/2004).

  • Provenance and peer review Not commissioned; externally peer reviewed.