Dual role of serum soluble E-cadherin as a biological marker of metastatic development in gastric cancer

Background: Soluble E-cadherin serum levels as a potential biological marker for gastric cancer were analysed with special consideration to clinical and pathological features. Methods: Seventy-one healthy control subjects and 166 patients with gastric cancer were enrolled. Gastric cancer patients were classified into intestinal-type (51%) and diffuse-type (49%), according to Lauren. Soluble E-cadherin serum levels were measured with enzyme-linked immunosorbent assay. Results: The mean logarithmic concentrations of soluble E-cadherin in gastric cancer patients were significantly higher than those of control subjects, with an average of 4.03 (+/-0.32) versus 3.86 (+/-0.24), respectively ( P < 0.0001). The concentration of soluble E-cadherin was significantly higher in the intestinal-type group than in the diffuse-type group, with an average of 4.07 +/- 0.3 versus 3.98 +/- 0.34, respectively ( P = 0.0494). In the intestinal-type group, concentrations of soluble E-cadherin were significantly higher in more advanced stages (stages III-IV) than in earlier stages (stages I-II), with an average of 4.13 +/- 0.29 versus 3.96 +/- 0.31, respectively ( P = 0.0234). In the diffuse-type group, concentrations of soluble E-cadherin were significantly higher in localized than in metastatic gastric cancer, with an average soluble E-cadherin concentration of 4.15 +/- 0.3 versus 3.95 +/- 0.32, respectively ( P = 0.0139). Conclusions: Serum soluble E-cadherin concentrations exhibit a completely different pattern in intestinal-type and diffuse-type gastric cancer. Serum levels are increased in intestinal-type gastric cancer, especially in advanced stages, whereas in diffuse-type gastric cancer E-cadherin levels are decreased in advanced, metastasized cancer. We conclude that soluble E-cadherin concentrations should be interpreted along with Lauren classification and thus might serve as a biological marker in intestinal-type gastric cancer.