Combined evaluation of mucin antigen and E-cadherin expression may help select patients with gastric cancer suitable for minimally invasive therapy.

Abstract

MUC1 mucin is known to be highly expressed in carcinomas that show invasive growth and poor prognosis. Impairment of adhesion molecule E-cadherin expression has been widely accepted as a critical event for cancer invasion and metastasis. The present study evaluated the combination of mucin and E-cadherin status as a possible predictor of patients suitable for minimally invasive therapy for gastric cancer. Two hundred and nine paraffin-embedded specimens of gastric carcinoma (141 early, 68 advanced) were examined by immunohistochemical staining using monoclonal antibodies against MUC1 mucin (MUC-1-CORE, DF3), MUC2 mucin (Ccp58) and E-cadherin (anti-E-cad). Gastric carcinoma with MUC1-positive expression demonstrated malignant characteristics. Normal E-cadherin expression showed an inverse correlation with MUC1 expression. Patients with early gastric carcinoma who had a combination of normal E-cadherin and MUC1-negative expression had no recurrence and a favourable prognosis. Moreover, cancers with normal E-cadherin/MUC1-negative expression were not found at an advanced stage in differentiated-type carcinoma. A normal E-cadherin/MUC1-negative expression pattern in gastric cancer is a favourable marker. Preoperative estimation of the E-cadherin and MUC1 status of an endoscopic biopsy specimen may help select appropriate patients for minimally invasive treatment of gastric cancer.