E-Cadherin Points to Gastric Cancer Recurrence

By David Douglas

NEW YORK AUG31, 2005 (Reuters Health) - Levels of serum soluble E-cadherin are helpful in predicting tumor recurrence after surgery for gastric cancer, Chinese researchers report in the August 15th issue of Cancer.

"The rise in soluble E-cadherin precedes the clinical detection of recurrence for a median of 13 months, thus allows time for vigilant surveillance and consideration of adjuvant therapy," lead investigator Dr. Annie On On Chan told Reuters Health.

Dr. Chan and colleagues at the University of Hong Kong note that there appeared to be no accurate marker of such recurrence. Carcinoembryonic antigen (CEA) is employed, they say, but only a "modest" proportion of patients have elevated levels.

There have been reports the E-cadherin levels may also be of use, and to investigate further, the researchers prospectively followed 69 patients who underwent curative surgery for gastric carcinoma.

The team collected and assayed blood samples preoperatively, 1 month after surgery and every 3 months thereafter. The 17 patients with recurrent disease were followed for a median of 21 months and the remaining 52 patients were followed for a median of 36 months.

Using an E-cadherin cut-off level of 10,000 ng/mL gave a sensitivity of disease recurrence at 3 months post-surgery of 47%. At 6 months, the corresponding sensitivity was 59%.

This, the investigators point out, was significantly better than the 6% sensitivity at both 3 and 6 months achieved using CEA. The median time for recurrence after the elevated E-cadherin level was 13 months. For CEA, it was 4 months.

"An elevated soluble E-cadherin -- of more than 10,000 ng/mL -- at 3 months postoperatively may prompt the clinician to consider a more detailed and careful lookout for recurrence, or to consider the addition of adjuvant therapy," co-author Kent-Man Chu told Reuters Health. "Further prospective study is, however, necessary."  

SOURCE:

• Cancer 2005;104:740-746.