E-Cadherin Immunohistochemical Expression as a Prognostic Biomarker in Colorectal Adenocarcinoma: Correlations with Clinicopathological Variables and Tumor Progression in AL-Beyda Medical Center

• Bushra Abogharsa

  Department of Pathology, Faculty of Medicine, Omar Almohktar University, Al-Beyda, Libya

  Author

• Ahmed Elsayed

  Department of Pathology, Director of Medical Program, Apollonia University, Benghazi, Libya

  Author

• Jameelah Sulayman

  Department of Pathology, Faculty of Medicine, Omar Almohktar University, Al-Beyda, Libya

  Author

• Ahmad Mohammad

  Pathology department, Tanta Cancer Center, Egypt

  Author

Colorectal carcinoma (CRC) continues to be a significant global health concern, underscoring the need for reliable prognostic markers to enhance risk assessment and therapeutic planning. This study assessed the potential of E-cadherin expression, determined via immunohistochemistry, as a prognostic marker in 30 CRC cases diagnosed at AL-Beyda Medical Center between 2014 and 2022. Using paraffin-embedded tissue samples, hematoxylin-eosin staining was performed for histopathological grading, complemented by E-cadherin immunohistochemistry with monoclonal antibodies. The expression levels were semiquantitatively scored from 0 to 3 based on the intensity and extent of membranous staining, with  Scores 0-1 were classified as low expression; 2-3 as high expression. High E-cadherin expression was detected in 24 out of 30 cases (80%). Statistical analysis showed significant correlations between high E-cadherin expression and several clinicopathological factors: younger age (<49 years, 93.8% vs. ≥ 49 64.3% in older patients; p = 0.044), male gender (90.9% vs. 50% in females; p = 0.013), absence of a family history of CRC (94.7% vs. 54.5% in individuals with positive family history; p < 0.001), non-metastatic disease status (95.2% vs. 44.4% in cases with metastasis; p = 0.001), well to moderately differentiated tumors (83.3--90.0% while poorly differentiated tumors showed predominantly low expression (75.0%) with only 25.0% high expression; p = 0.012), and earlier tumor stages (85.7--93.8% in stages I--II vs. 33.3--50.0% in stages III--IV; p = 0.039). The findings highlight the critical role of E-cadherin in preserving epithelial integrity, with its loss being associated with aggressive characteristics such as advanced disease stages, poor differentiation, and heightened metastatic potential. These results support incorporating E-cadherin immunohistochemistry into standard pathological evaluations to improve prognostic accuracy and identify high-risk patients who may benefit from closer monitoring or tailored therapeutic strategies. Further multicenter studies are needed to confirm these findings and investigate potential treatments targeting E-cadherin-related pathways.

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