Neural cadherin overexpression is a predictive marker for early postoperative recurrence in hepatocellular carcinoma patients.

Background And Aim: Recent studies have disclosed alterations in neural and/or epithelial cadherin (E-cadherin) expression in several epithelial tumors. However, the clinical relevance of these phenomena in hepatocellular carcinoma (HCC) remains to be established. In this study, we investigated the expression patterns of neural and epithelial cadherins and their clinical implications in HCC.

Methods: Immunohistochemical staining for neural and epithelial cadherins was performed on tumor and adjacent non-tumor tissue sections of 52 HCC patients subjected to curative surgical resection. Clinical, radiological, and histopathological characteristics were analyzed, relative to the degree of neural and E-cadherin expression.

Results: The neural cadherin (N-cadherin) expression was upregulated in 67% of HCC tissues, compared to adjacent non-tumoral liver tissues. Patients expressing high levels of N-cadherin experienced more frequent tumor recurrences within 2 years (50% vs 12.5%; P = 0.01) after surgical resection. Consequently, the cumulative overall survival rate tended to be lower in patients overexpressing N-cadherin (P = 0.08). The N-cadherin overexpression was the only independent predictive factor for postoperative recurrence within 2 years in both univariate and multivariate analyses (odds ratio: 8.5; 95% confidence interval: 1.625-44.46; P = 0.011). No correlation was evident between E-cadherin expression patterns and clinicopathological parameters.

Conclusion: The overexpression of N-cadherin is significantly related to postoperative recurrence within 2 years after surgical resection in HCC. Therefore, immunohistochemical staining for N-cadherin may be effectively applied as a predictive marker for early postoperative recurrence in HCC.