Low E-cadherin expression is associated with poor prognosis in pulmonal adenocarcinoma

Our plain-English summary of Low E-cadherin expression is associated with poor prognosis in pulmonal adenocarcinoma, by F. Gehrisch, K.A. Schmid, M. Kluth, et al (Scientific Reports, 2026).

The study

• Authors: F. Gehrisch, K.A. Schmid, M. Kluth, G. Makrypidi-Fraune, K. Möller, M. Lennartz, V. Bertram, F. Lutz, S. Steurer, P. Busch, B. Hantzsch-Kuhn, M. Reck, T. Olchers, D.B. Ellebrecht, C. Fraune, R. Simon, G. Sauter, S. von Weihe
• Journal: Scientific Reports
• Published: 2026;16(1)
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

E-cadherin is a critical cell adhesion molecule with a tumor suppressive role. Reduced membranous E-cadherin expression is considered a central step in the progression and metastatic spread in human cancers. To study the prevalence and potential role of reduced E-cadherin expression in different lung cancer subtypes, E-cadherin expression was analyzed in more than 850 resected lung cancers by IHC in a tissue microarray format. A membranous E-cadherin staining was seen in 779 (96.9%) of the 804 interpretable tumor samples. A loss of E-cadherin expression was slightly more frequent in adenocarcinomas (ACs; 1.1%) than in squamous cell carcinomas (SCCs; 0.0%; p < 0.0001). Among the less common tumor entities, E-cadherin immunostaining was absent in 57.1% of 35 mesotheliomas, but retained in all cases of carcinoid (n = 52), large cell neuroendocrine carcinoma (n = 19), undifferentiated large cell carcinoma (n = 3), carcinosarcoma (n = 2), pleiomorphic carcinoma (n = 11), adenosquamous carcinoma (n = 8), mucoepidermoid carcinoma (n = 1), lymphoepithelial carcinoma (n = 1), and SMARCA4-deficient undifferentiated tumors (n = 1). Reduced E-cadherin immunostaining was significantly linked to advanced pT stage (p = 0.0265) and high grade (p = 0.0351) in ACs. Univariate outcome analysis revealed a significant association between E-cadherin expression and patient survival in all NSCLCs (p < 0.0001) and in ACs (p = 0.0133). It is concluded that loss of E-cadherin expression occurs in only a small subset of NSCLCs, that it is more frequent in ACs compared to SCCs and that reduced E-cadherin expression is linked to poor prognosis and unfavorable histopathological features in ACs. Should targeted therapy become available in the future, a small subset of pulmonary ACs and many mesotheliomas could be candidates for treatment.

In plain English

This laboratory study from Hamburg, Germany, stained archived tissue from surgically removed lung tumors (858 cases) to measure E-cadherin, a protein that helps cells stick together. Asbestos and other exposures were not studied. Of 804 readable samples, 779 (96.9%) showed E-cadherin staining. Staining was significantly more intense in adenocarcinomas than in squamous cell carcinomas (p less than 0.0001). Complete loss occurred in 1.1% of adenocarcinomas versus 0.0% of squamous cell carcinomas. The text reports that staining was absent in 57.1% of 35 mesotheliomas. All of the other, less common tumor types kept it. In adenocarcinomas, reduced staining was linked to more advanced tumor stage and to high grade. In univariate survival analysis, staining level was significantly associated with overall survival in all lung tumors (p less than 0.0001) and in adenocarcinomas (p = 0.0133). For squamous cell carcinomas the figure shows p = 0.2731. The authors concluded that E-cadherin expression is reduced in a small fraction of non-small cell lung cancers and that disturbed expression is associated with poor prognosis in adenocarcinomas. Several counts and p-values differ between the article's text and its tables.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Laboratory (immunohistochemistry) study of archived, surgically resected tumor samples arranged in a tissue microarray, with clinicopathological and survival analysis
• Who was studied: One sample each from 858 surgically resected lung cancer cases from the archives of the Institute of Pathology, University Medical Center Hamburg, Germany. 804 samples were interpretable. Survival follow-up was available for 728 patients, including 400 adenocarcinomas and 208 squamous cell carcinomas. Study years are not given.
• Exposure: Not studied. The article does not examine asbestos or any other exposure; it measured E-cadherin protein staining in tumor tissue.
• Main results:
  • E-cadherin staining was present in 779 (96.9%) of the 804 interpretable cancers.
  • Across the four staining categories, E-cadherin staining was significantly more intense in adenocarcinomas than in squamous cell carcinomas (p < 0.0001, Table 2).
  • Negative E-cadherin staining occurred in 1.1% of adenocarcinomas versus 0.0% of squamous cell carcinomas.
  • Among less common tumor types, E-cadherin staining was absent in 57.1% of 35 mesotheliomas (Table 2 lists 36 mesotheliomas with 55.6% negative). It was retained in all other less common types, such as carcinoid (n = 52).
  • In adenocarcinomas, reduced E-cadherin staining was significantly linked to advanced pT stage (p = 0.0265) and high grade (p = 0.0351).
  • In squamous cell carcinomas, low E-cadherin staining was associated with positive resection margins (p = 0.0029). It was not associated with advanced pT stage, nodal metastasis or higher grade.
  • In univariate analysis comparing negative, weak, moderate and strong staining, E-cadherin staining level was significantly associated with overall survival in all lung tumors (p < 0.0001, n = 728) and in adenocarcinomas (p = 0.0133, n = 400).
  • For squamous cell carcinomas (n = 208), the survival figure shows p = 0.2731.
• The authors' conclusion: The authors concluded that E-cadherin expression is reduced in a small fraction of non-small cell lung cancers, that loss is more common in adenocarcinomas than in squamous cell carcinomas, and that disturbed E-cadherin expression is associated with poor prognosis in adenocarcinomas.
• Limitations the authors state:
  • In squamous cell carcinomas, the subgroup with low E-cadherin expression was too small to allow a statistically powered comparison.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer.

Medical terms in this study, explained in our Lexicon: Prognosis, Adenocarcinoma, Lung Cancer, Squamous Cell Carcinoma, Mesothelioma, Carcinoma, Targeted Therapy.

Related studies

• Differential expression of N-cadherin in pleural mesotheliomas and E-cadherin in lung adenocarcinomas in formalin-fixed, paraffin-embedded tissues — A.C. Han, A. Peralta-Soler, et al. (1997)
• Reduced occludin expression is related to unfavorable tumor phenotype and poor prognosis in many different tumor types: A tissue microarray study on 16,870 tumors — S. Büyücek, F. Viehweger, et al. (2025)
• The differential expression of N-cadherin and E-cadherin distinguishes pleural mesotheliomas from lung adenocarcinomas — A. Peralta Soler, K.A. Knudsen, et al. (1995)
• E-cadherin, E-selectin and vascular cell adhesion molecule: immunohistochemical markers for differentiation between mesothelioma and metastatic pulmonary adenocarcinoma? — A.M. Müller, A. Weichert, et al. (2002)
• E-cadherin and calretinin: a useful combination of immunochemical markers for differentiation between mesothelioma and metastatic adenocarcinoma — M.P. Leers, M.M. Aarts, et al. (1998)
• E-cadherin expression is correlated with focal adhesion kinase inhibitor resistance in Merlin-negative malignant mesothelioma cells — T. Kato, T. Sato, et al. (2017)

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