Expression Profile of E-cadherin and N-cadherin in Urothelial Carcinoma of the Upper Urinary Tract is Associated with Disease Recurrence in Patients Undergoing Nephroureterectomy

Abstract

To investigate the impact of the expression profile of E-cadherin and N-cadherin in urothelial carcinoma of the upper urinary tract (UC-UUT) on the probability of intra- and extravesical disease recurrence in patients undergoing nephroureterectomy. This study included 59 consecutive patients diagnosed as having clinically localized UC-UUT who underwent nephroureterectomy. Expression levels of E-cadherin and N-cadherin in resected specimens from these patients were measured by immunohistochemical staining. In this series, intra- and extravesical recurrence occurred in 20 (33.9%) and 19 (32.2%) patients, respectively. Both intra- and extravesical recurrence-free survivals significantly favored patients with positive E-cadherin or negative N-cadherin expression compared with those of patients with reduced E-cadherin or positive N-cadherin expression, respectively. Univariate analysis identified pathologic T stage, multifocality, and N-cadherin expression as significant predictors of intravesical recurrence, of which multifocality and N-cadherin expression were independently related to intravesical recurrence-free survival on multivariate analysis. Furthermore, pathologic T stage, grade, lymph node metastasis, E-cadherin expression, and N-cadherin expression were significantly associated with extravesical recurrence-free survival on univariate analysis. Of these significant factors, pathologic T stage, grade, lymph node metastasis, and N-cadherin expression were shown to be independent predictors of extravesical recurrence on multivariate analysis. These findings suggest that expression profiles of E-cadherin and N-cadherin, particularly the gain of N-cadherin rather than loss of E-cadherin expression, in UC-UUT appeared to be significantly associated with disease recurrence after nephroureterectomy.