Department of Pathology, Emory University School of Medicine, Atlanta, GA, USA.
Mod Pathol. 2011 Feb;24(2):241-7. doi: 10.1038/modpathol.2010.187. Epub 2010 Sep 3.
Loss of E-cadherin expression has been linked to the invasive phenotypes of a variety of neoplasms, including lobular breast cancer. The expression of E-cadherin in variants of urothelial carcinoma relative to usual-type urothelial carcinoma, maximum depth of invasion and angiolymphatic invasion has not been well characterized. A total of eight cases of micropapillary urothelial carcinoma, four cases of plasmacytoid urothelial carcinoma, two cases of urothelial carcinoma with signet ring cell differentiation and two cases of urothelial carcinoma with mixed plasmacytoid and signet ring cell differentiation, all obtained from cystectomy/cystoprostatectomy cases, were identified. In all nine cases of usual-type invasive and noninvasive high-grade urothelial carcinoma were also included in the study. Immunohistochemical staining of E-cadherin was performed in all cases. Pathological parameters including depth of invasion and presence of angiolymphatic invasion were documented. Maximum depth of invasion: In micropapillary urothelial carcinoma, extravesical extension was seen in three of eight cases; muscularis propria invasion in four of eight cases; and lamina propria invasion in one of eight cases. In plasmacytoid urothelial carcinoma, extravesical extension was observed in two of four cases, and muscularis propria invasion and lamina propria invasion in one of four cases each. In urothelial carcinoma with signet ring cell differentiation, extravesical extension and muscularis propria invasion was seen in one of two cases each. In urothelial carcinoma with mixed plasmacytoid and signet ring cell differentiation, muscularis propria invasion and lamina propria invasion was observed in one of two cases each. In usual-type high-grade urothelial carcinoma, extravesical extension was seen in six of nine cases and noninvasive in three of nine cases. In angiolymphatic invasion, micropapillary urothelial carcinoma was observed in eight of eight cases; plasmacytoid urothelial carcinoma in two of four cases; urothelial carcinoma with signet ring cell differentiation in one of two cases; and urothelial carcinoma with mixed plasmacytoid and signet ring cell differentiation in one of two cases. Usual-type high-grade urothelial carcinoma was seen in six of nine cases. E-cadherin expression: All eight cases of micropapillary urothelial carcinoma were positive for E-cadherin in the micropapillary component and adjacent usual-type urothelial carcinoma. The four cases of plasmacytoid urothelial carcinoma, two cases of urothelial carcinoma with signet ring cell differentiation and two cases of urothelial carcinoma with mixed plasmacytoid and signet ring cell differentiation were all negative for E-cadherin. All nine additional cases of usual-type high-grade urothelial carcinoma were diffusely positive for E-cadherin. E-cadherin is diffusely positive in usual-type urothelial carcinoma and micropapillary urothelial carcinoma, irrespective of pathological stage and angiolymphatic invasion. Loss of E-cadherin expression may be a marker of plasmacytoid and signet ring cell differentiation in urothelial carcinoma.
E-钙黏蛋白的表达缺失与多种肿瘤的侵袭表型有关，包括乳腺小叶癌。E-钙黏蛋白在膀胱癌中的变体相对于普通型膀胱癌、浸润深度和血管淋巴管侵犯的表达尚未得到很好的描述。总共鉴定了 8 例微乳头状尿路上皮癌、4 例浆细胞样尿路上皮癌、2 例具有印戒细胞分化的尿路上皮癌和 2 例具有混合浆细胞样和印戒细胞分化的尿路上皮癌，这些病例均来自膀胱切除术/膀胱前列腺切除术。在所有 9 例普通型浸润性和非浸润性高级别尿路上皮癌中也包括了研究。对所有 9 例病例均进行了 E-钙黏蛋白的免疫组织化学染色。记录了病理参数，包括浸润深度和血管淋巴管侵犯的存在。微乳头状尿路上皮癌中，8 例中有 3 例出现膀胱外扩展，8 例中有 4 例侵犯固有肌层，8 例中有 1 例侵犯固有层。浆细胞样尿路上皮癌中，4 例中有 2 例出现膀胱外扩展，4 例中有 1 例侵犯固有肌层和固有层。具有印戒细胞分化的尿路上皮癌中，2 例各有膀胱外扩展和固有肌层侵犯。具有混合浆细胞样和印戒细胞分化的尿路上皮癌中，2 例各有固有肌层侵犯和固有层侵犯。普通型高级别尿路上皮癌中，9 例中有 6 例出现膀胱外扩展，9 例中有 3 例为非浸润性。在血管淋巴管侵犯方面，8 例微乳头状尿路上皮癌、4 例浆细胞样尿路上皮癌、2 例具有印戒细胞分化的尿路上皮癌和 2 例具有混合浆细胞样和印戒细胞分化的尿路上皮癌中均观察到血管淋巴管侵犯。9 例普通型高级别尿路上皮癌中有 6 例出现血管淋巴管侵犯。E-钙黏蛋白表达：8 例微乳头状尿路上皮癌中，微乳头状成分和相邻的普通型尿路上皮癌均为 E-钙黏蛋白阳性。4 例浆细胞样尿路上皮癌、2 例具有印戒细胞分化的尿路上皮癌和 2 例具有混合浆细胞样和印戒细胞分化的尿路上皮癌均为 E-钙黏蛋白阴性。另外 9 例普通型高级别尿路上皮癌均为 E-钙黏蛋白弥漫阳性。E-钙黏蛋白在普通型尿路上皮癌和微乳头状尿路上皮癌中均为弥漫阳性，与病理分期和血管淋巴管侵犯无关。E-钙黏蛋白表达缺失可能是膀胱癌浆细胞样和印戒细胞分化的标志物。
