Immunohistochemical Expression of E-Cadherin,Survivin and VEGF in Nonexophytic Nasopharyngeal Carcinoma

Abstract

Objectives:

E-cadherin, survivin and vascular endothelial growth factor (VEGF) have been suggested to be prognostic markers for nasopharyngeal carcinoma (NPC). Patients with biopsy-proven NPC sometimes present with a normal-appearing nasopharynx (nonexophytic NPC). These patients have been reported to have higher risk of N3 and M1 disease. The authors aim to compare the immunohistochemical expression of the above markers for nonexophytic and exophytic NPC.

Methods:

From 2003 to 2011, 30 patients with nonexophytic NPC were diagnosed in a single institution. Thirty patients diagnosed with exophytic NPC were selected for comparison, matched for age, gender and TNM stage. Expressions of E-cadherin, survivin and VEGF in tumor tissues were investigated by immunohistochemistry. Expression levels were evaluated by a pathologist blinded to the clinical data, using a semiquantitative scoring scheme.

Results:

The majority of nonexophytic NPC patients had late stage disease (Stage I: 13.3%, II: 23.3%, III: 33.3%, IV: 30%), even though 67% had T1 disease of the nasopharynx. A borderline significant result was obtained for cytoplasmic E-cadherin, with positive expression in 12% of nonexophytic NPC patients compared to 35.7% of exophytic NPC patients (P = .059). There was no difference in overall expression of survivin and VEGF between both groups (P = .612 and P = .653 respectively, Mann-Whitney U test).

Conclusions:

Reduced cytoplasmic E-cadherin suggests downregulation and provides a possible explanation for the higher risk of nodal and distant metastasis in nonexophytic NPC. The evaluation of other immunohistochemical markers should be considered to explain this phenomenon.