Stains & molecular markers
E-cadherin


Minor changes: 8 September 2020

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PubMed Search: E-cadherin [title] free full text[SB] review[PT]

Samuel Bidot, M.D.
Xiaoxian (Bill) Li, M.D., Ph.D.
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Cite this page: Bidot S, Li X. E-cadherin. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/stainsecadherin.html. Accessed October 24th, 2020.
Definition / general
  • E-cadherin is a transmembrane protein involved in cellular adhesion and polarity maintenance
  • E-cadherin is expressed in almost all epithelial cells
  • Loss of E-cadherin expression is associated with gain of tumor cell motility and invasiveness
Essential features
  • E-cadherin is a transmembrane protein involved in cellular adhesion
  • Expressed in almost all epithelial cells
  • Normal pattern of expression is membranous
  • Abnormal pattern is loss or decrease of membranous expression
  • Common use is to differentiate invasive and in situ / invasive lobular carcinoma (-) from in situ / invasive ductal carcinoma (+) of the breast
Terminology
  • Synonym: cadherin-1
Pathophysiology
  • Epithelial cadherin (E-cadherin) is a transmembrane protein (Histopathology 2016;68:57)
    • Extracellular domain involved in intercellular adhesion and polarity maintenance
    • Cytoplasmic domain attached to actin units α / γ / β- and p120 catenins
  • Encoded by CDH1 (CaDHerin-1) gene located on chromosome 16 (16q22.1)
  • Biallelic inactivation of CDH1 results in the loss of membranous expression of E-cadherin and gain of motility of tumor cells
Clinical features
  • Heterozygous germline alteration of the CDH1 gene is associated with hereditary diffuse gastric cancer syndrome and invasive lobular carcinoma of the breast (Prog Mol Biol Transl Sci 2013;116:337)
Interpretation
  • Normal pattern is strong circumferential membranous staining
  • Abnormal pattern is loss or decrease / attenuation of membranous staining
  • Uninvolved epithelial cells can be used as reference
    • Useful in lobular neoplasia of the breast: staining is patchy, weak or complete loss compared with uninvolved luminal cells
Uses by pathologists
  • To distinguish lobular carcinoma in situ from ductal carcinoma in situ (Histopathology 2016;68:57)
    • May be critical, as management could be different
    • Only useful in challenging cases
    • Morphology takes precedence over E-cadherin stain as aberrant protein expression may be present despite non-functional E-cadherin-catenin complex (Am J Surg Pathol 2008;32:773)
  • To distinguish invasive lobular from invasive ductal carcinoma
    • Less critical, as treatment remains similar
    • High grade invasive ductal carcinoma may have aberrant E-cadherin staining patterns
  • Others
Prognostic factors
  • Loss of E-cadherin is associated with tumor progression, chemoresistance and metastases (Cells 2020;9:428)
Microscopic (histologic) images

Contributed by Xiaoxian (Bill) Li, M.D., Ph.D.
Ductal carcinoma in situ with lobular features Ductal carcinoma in situ with lobular features

Ductal carcinoma in situ with lobular features

Florid lobular carcinoma in situ Florid lobular carcinoma in situ

Florid lobular carcinoma in situ


Invasive lobular carcinoma of the breast Invasive lobular carcinoma of the breast Invasive lobular carcinoma of the breast Invasive lobular carcinoma of the breast Invasive lobular carcinoma of the breast Invasive lobular carcinoma of the breast

Invasive lobular carcinoma of the breast


Invasive lobular carcinoma of the breast

Invasive lobular carcinoma of the breast

Lobular carcinoma in situ Lobular carcinoma in situ Lobular carcinoma in situ

Lobular carcinoma in situ

Virtual slides

Images hosted on other servers:

Pleomorphic lobular carcinoma

E-cadherin

Positive staining - normal
Positive staining - disease
Negative staining
Board review style question #1


    The pictures show both an H&E and an E-cadherin stain from a breast lesion. Which is the correct diagnosis?

  1. Cannot diagnose due to inconsistent H&E and E-cadherin staining pattern
  2. DCIS with positive E-cadherin expression
  3. Invasive ductal carcinoma
  4. LCIS with decreased E-cadherin expression
Board review answer #1
D. LCIS with decreased E-cadherin expression. The morphology shows typical features of lobular carcinoma in situ with eccentric nuclei and cytoplasmic mucin. E-cadherin stain shows decreased membranous expression, consistent with aberrant E-cadherin staining in LCIS.

Reference: E-cadherin

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