E‐cadherin expression in bladder cancer using formalin‐fixed, paraffin‐embedded tissues: Correlation with histopathological grade, tumour stage and survival

To determine the potential prognostic value of epithelial cadherin (E‐cadherin), a Ca2+‐dependent cell‐cell adhesion molecule, we have analysed its immunoreactivity and cellular localisation in 67 transitional cell carcinomas (TCC) using an avidin‐biotin immunoperoxidase technique on formalin‐fixed, paraffin‐embedded tissues. These results were correlated with histopathological grade, tumour stage, presence of metastases and survival. In addition, 10 cystitis and 11 normal bladder biopsies were evaluated as controls. E‐cadherin was expressed in a normal membranous pattern in all normal and 7 of 10 cystitis biopsies. Loss of normal surface E‐cadherin was expression was found in 3 of 15 superficial tumours and in 48 of 52 invasive cancers. Abnormal immunoreactivity was strictly related to tumour differentiation and stage. Fifteen of 20 well‐differentiated (grade 1) tumours showed preserved membranous E‐cadherin immunoreactivity, while 46 of 47 moderate and poorly differentiated tumours (grades II and III) demonstrated abnormal staining patterns. Loss of membranous E‐cadherin immuno‐reactivity was also associated with advanced tumour stage. There was a significantly higher 5‐year survival rate for patients with preserved membranous staining compared with patients with abnormal staining. © 1995 Wiley‐Liss, Inc.