Prognostic significance of E-cadherin and ezrin immunohistochemical expression in prostate cancer.

OBJECTIVE Abnormal expression of molecules connected with cell to cell adhesion, such as E-cadherin or ezrin, can be contributing factors for increased invasiveness and metastatic potential of cancer. We investigated E-cadherin and ezrin immunoreactivity in prostate carcinomas, and its relation with clinical parameters and patient outcome. METHODS E-cadherin and ezrin expression was examined by immunohistochemistical analysis of bioptate tissues from patients with prostate cancer. Normal appearing prostate epithelium was used as an internal control for each specimen. The relation between E-cadherin and ezrin staining, and other clinicopathological features (e.g. patient survival) were analyzed using Kaplan-Meier and Cox regression methods. RESULTS In moderate differentiated to poorly differentiated tumors (Gleason scores 5-10), we observed a trend of increasing percentage of tumors with aberrant staining for E-cadherin (P < 0.001 by Chi2 for linear trend). A significant inverse correlation between ezrin expression and tumor differentiation was also found (P < 0.002 by Chi Chi2 for linear trend). The survival time of patients with aberrant staining of ezrin and E-cadherin was significantly shorter than that of patients with a normal staining pattern but in Cox multivariate survival analysis, only E-cadherin immunoreactivity had independent effect on survival (P = 0.03), when controlling for the other clinicopathological factors. CONCLUSIONS The aberrant or decreased expression of E-cadherin seems to be one of most promising markers of poor prognosis in localized prostate cancer. Our study also supports a role of ezrin in progression in human prostate cancers but additional studies are mandatory to provide further evidence for an important role of ezrin in prostate tumors progression.