Expression And Clinical Significance Of E-cadherin And MMP7 In Carcinoma Of Gallbladder

Background and Objective Carcinoma of gallbladder is highly malignant tumor with poor prognosis. It demonstrates invasive and rapid growth, and usually is at an advanced stage by the time of diagnosis. To invade into surrounding tissues and metastasize to lymph node in early stage is the major cause of ineffective therapy. Current studies suppose that E-cadherin and MMP7 play important roles in the regional invasion and distant metastasis of many malignant tumors. To our knowledge to date, the overexpression of MMP7 is correlative with the loss or dysfunction of E-cadherin, but there are few studies about the association of them in carcinoma of gallbladder. Therefore, we detected the expression of MMP7 and E-cadherin and discussed the correlation of them in carcinoma of gallbladder, and then evaluate the relationships with invasion, metastasis and prognosis.Materials and Methods 63 cases of carcinoma of gallbladderwere selected from the files of Department of Pathology, West China Hospital, Sichuan University during 1993 and 2003. We confirmed the pathological characters by hematoxylin-eosin staining, including pathologic types, differentiation, infiltration, lymph node metastasis and so on. The following immunostainings were performed on paraffin embedded and formalin fixed tissue sections: monoclonal MMP7 and E-cadherin. All patients were followed up. Statistical analysis was performed using SPSS software.Results MMP7 was negative expression in the ten chroniccholecystitis, but was positive in carcinoma of gallbladder with 61 cases(96.8%). The positive signals of MMP7 located in the cytoplasm of tumor cells, but not in the mesenchymal cells. MMP7 expression was correlative with TNM stage (p=0.001), liver invasion(p=0.001) and lymph node metastasis(p=0.014), not with histo-differentiation and nerve infiltration. The positive expression of E-cadherin located in membrane of normal epithelial cells and tumor cells of gallbladder. The positive rate was 100% and 47.6% in chronic cholecystitis and gallbladder carcinoma, respectively. E-cadherin expression was decreased or completely loss in groups of carcinoma, and was correlative with TNM stage (p=0.003), lymph node metastasis (p=0.016) and nerve infiltration (p=0.005). The Spearman correlation analysis suggested that the expression of MMP7 and E-cadherin was negative correlation (p<0.05). The survival analysis indicated that the expression of MMP7, TNM stage and nerve infiltration are associatedwith survival rate of post-operation. The expression of MMP7 and nerve infiltration may be a prognostic factor of gallbladder carcinoma by Cox regression.Conclusions The over-expression of MMP7 and the abnormal or decreased expression of E-cadherin are both correlation with tumor TNM stage and lymph node metastasis. This indicated that MMP7 and E-cadherin play important roles in the progression of carcinoma of gallbladder. The relationship of MMP7 expression and E-cadherin expression in carcinoma of gallbladder is negative correlation. MMP7 may be a useful prognostic marker for patients with advanced gallbladder carcinoma, and its detection may be useful for selecting patients for anti-matrix metalloproteinase therapy.