Wnt signaling-associated proteins, β-catenin, and E-cadherin as a potential immunohistochemical bi-omarker of the progression of adenoma to colorectal carcinoma

Abstract

Background: Colorectal carcinoma (CRC) is the most common and one of the main causes of mortality and morbidity globally among gastrointestinal tract tumors. A benign polyp is the first step in the multistage pathogenesis of colorectal cancer, which eventually progresses to an adenoma and a carcinoma. Wnt/ βeta-catenin signaling pathway plays an initiating and rate-limiting role in colorectal tumorigenesis. Aim of the work: To evaluate the association between the immunohistochemistry (expression of E-cadherin, and β-catenin with the histopathological grade, and stage of colorectal cancer. Materials and Methods: The study was retrospectively collected from the archives of the Department of Pathology in Tobruk Medical Center. Eighty-two histopathologically confirmed cases of adenomas (n = 48) (tubular, villous, and tubulovillous), and colorectal adenocarcinoma (Mucinous, and Non-mucinous) (n = 34) were included in this study over two years (2021-2023). The histopathological diagnosis, grade, and staging of the tumors were obtained. While clinical information was obtained from medical records and pathology reports. immunohistochemical staining was performed for all the cases using E-cadherin and β-catenin antibodies, and the results were analyzed. Results: A total of 82 patients were studied out of these, 51(62.2%) patients were male, whereas 31 (37.8%) were females with a male: female ratio of 1.6:1. Age ranged from 30 years to 80 years. The mean age was the mean age of 52.9 (SD±15.8). A high prevalence of adenoma cases was observed in the age group 30– 40 years. The peak incidence for both types of colorectal carcinoma was in 61-70 years. By scoring the intensity of β-catenin there are significant correlation of β-catenin expression with tumor grade, stage, lymph node metastasis, and types of adenomas. The intensity of staining of E-cadherin in 48 cases of adenomas was showing high expression in 39 cases (81.3%), and low expression in only 9 cases (18.7%). While, the majority of the patients with CRC (58.8%) had low expression of E-cadherin levels, and (41.2%) had high expression. Conclusion: Our findings imply that E-cadherin and β-catenin may contribute to the invasion and progression of colorectal cancer, which may serve as prognostic indicators for colorectal carcinoma