Dual Role of Serum Soluble E-cadherin as a Biological Marker of Metastatic Development in Gastric Cancer

Abstract

Background: Soluble E-cadherin serum levels as a potential biological marker for gastric cancer were analysed with special consideration to clinical and pathological features. Methods: Seventy-one healthy control subjects and 166 patients with gastric cancer were enrolled. Gastric cancer patients were classified into intestinal-type (51%) and diffuse-type (49%), according to Laurén. Soluble E-cadherin serum levels were measured with enzyme-linked immunosorbent assay. Results: The mean logarithmic concentrations of soluble E-cadherin in gastric cancer patients were significantly higher than those of control subjects, with an average of 4.03 ( ± 0.32) versus 3.86 ( ± 0.24), respectively ( P r < r 0.0001). The concentration of soluble E-cadherin was significantly higher in the intestinal-type group than in the diffuse-type group, with an average of 4.07 ± 0.3 versus 3.98 ± 0.34, respectively ( P r = r 0.0494). In the intestinal-type group, concentrations of soluble E-cadherin were significantly higher in more advanced stages (stages III-IV) than in earlier stages (stages I-II), with an average of 4.13 ± 0.29 versus 3.96 ± 0.31, respectively ( P r = r 0.0234). In the diffuse-type group, concentrations of soluble E-cadherin were significantly higher in localized than in metastatic gastric cancer, with an average soluble E-cadherin concentration of 4.15 ± 0.3 versus 3.95 ± 0.32, respectively ( P r = r 0.0139). Conclusions: Serum soluble E-cadherin concentrations exhibit a completely different pattern in intestinal-type and diffuse-type gastric cancer. Serum levels are increased in intestinal-type gastric cancer, especially in advanced stages, whereas in diffuse-type gastric cancer E-cadherin levels are decreased in advanced, metastasized cancer. We conclude that soluble E-cadherin concentrations should be interpreted along with Laurén classification and thus might serve as a biological marker in intestinal-type gastric cancer.