Prognostic Role Of E-cadherin And Vimentin Expression In Soft Tissue Leiomyosarcomas

ObjectivesThe gain of E-cadherin and the loss of Vinmentin known as "Cadherin swithing " play an important role in tumor cell invasiveness and metastasis. We aimd to evaluate the prognostic impact of E-cadherin and Vimentin in45leiomyosarcoma samples, and analyzed the relationships between these markers and clinicpathological features.MethodsThe tissue specimen for the study including45paraffin blocks of primary LMS the protein expression of E-cadherin, Vimentin were analyzed by immunohistochemistry (IHC).Results1. Membranous/cytoplasmic attachment of E-cadherin was found in seven patients, making up15.6%of all cases. All patients had Vimentin positive expression, including strong positive expression in20cases and weak expression in25cases. Spearman rank correlation analysis detected a negative correlation in E-cadherin and Vimentin expression (r=-0.0384, p=0.009). There was significant lower E-cadherin expression in high clinical stages cases. Positive E-cadherin expression was found in27%patients with stage Ⅰ-Ⅱ disease (6/22) and4.3%patients with stage Ⅲ-Ⅳ disease (1/23)(p=0.034). Cases with strong positive expression of Vimentin were more liable to develop recurrence compared with the patients with weak positive expression (13/20vs.7/25, p=0.012). Patients’ gender, age, combined with tumor size, location, pathologic subtypes, differentiation and hemorrhage/cyst were not correlated with the expression of E-cadherin and Vimentin expression.2.20casees (44.4%) survived after3year of follow-up.25patients died of disease,9patients living with disease and11patients living with no evidence disease;20cases underwent recurrence and metastasis. In univariate survival analysis, markers such as clinical stages, location, pathologic subtypes, histological differentiation, hemorrhage/cyst and Vimentin significantly associated with overall survival (p=0.013, p=0.004, p=0.031, p=0.015, p=0.018, p=0.002) patients with E-cadherin expression demonstrated a trend of favorable prognosis, which had a3-year survival rate of71%compared with46%in those patients with negative E-cadherin expression. There was no significant difference of the overall survival between these two groups. Cox proportional hazards regression showed that Vimentin, tumor location, differentiation, and hemorrhage/cyst were independent prognostic factors of overall survival.Conclusions1. E-cadherin expression was found more frequently in patients in early stage (Ⅰ-Ⅱ). This phenomenon indicated that E-cadherin might play a role in the initial development of the primary tumor. There was no significant difference of the overall survival between three pathological subtypes. E-cadherin in leiomyosarcoma dose not belong to certain epithelioid subtype.2. Vimentin was associated with recurrence and metastasis and had value for predicting recurrence risk of soft tissue.3. The correlation of E-cadherin and Vimentin expression is negtive.4. Patients with E-cadherin expression and the loss of Vimentin demonstrated a trend of favorable prognosis,which can predict the prognosis of LMS. Vimentin, histological differentiation, location and hemorrhage/cyst were independent prognostic factors for OS.