E-Cadherin in Relation with the Proliferating Cell Nuclear Antigen of the Bilharzia Associated and Non-Associated Urinary Bladder Carcinoma

Background: E-cadherin is a trans-membrane glycoprotein that plays a critical role in many aspects of cell adhesion as well as establishment and maintenance of epithelial cell polarity. Loss of the adhesive function of E-cadherin seems to promote invasive and metastatic properties of neoplastic cells. Objectives: The present study is a retrospective study aiming to evaluate the loss of E-cadherin immunohistochemical expression in relation with the proliferating cell nuclear antigen expression of the bilharzia associated and non-associated bladder carcinoma. Methods: Forty TUR-bladder carcinoma sections immunohistochemicaly stained with E-cadherin antibody were microscopically interpreted and results were correlated to the established prognostic factors, including proliferating index as assessed by the proliferating cell nuclear antigen (PCNA) immunostaining, histopathological types, tumor cell grade, tumor invasiveness and bilharzia association. Results: Histopathologically, 63% were transitional cell carcinoma, 33% were squamous cell carcinoma and 5% were adenocarcinoma. Loss of E-cadherin expression had a significant association with high PCNA index (p<0.01), the tumor grade (p<0.002), tumor invasiveness (p<0.001), and bilharzias- associated bladder cancer (p<0.04). There was no statistically significant association between loss or decrease of Ecadherin expression and histopathological typing of urinary bladder carcinoma (p=0.094). Conclusion: Loss of E-cadherin provides an additional aid in assessment of prognosis and planning of therapy of patients with urinary bladder carcinoma as it indicates the potentiality for metastasis by its significant association with high proliferating cell nuclear antigen index, high tumor grade and tumor invasiveness. Moreover, immunohistochemical interpretation of E-cadherin altered adhesive function is a useful histological prognostic marker in bilharzia associated urinary bladder carcinoma.