• Andreea Calinescu Carol Davila University of Medicine and Pharmacy
  • Cristian Scheau
  • Sabina Zurac
  • Roxana Ioana Nedelcu
  • Alice Brinzea
  • Gabriela Turcu
  • Anastasia Coman
  • Mihaela Antohe
  • Mihaela Balaban
  • Ionela Hulea
  • Razvan Andrei
  • Daniela Adriana Ion
  • Ioana Anca Badarau
Keywords: e-cadherin, squamous cell carcinoma, cancer progression, invasive front


E-cadherin is an adhesion molecule essential in maintaining cellular integrity and preserving normal epithelial tissue architecture in adult organisms. Loss of E-cadherin expression and epithelial characteristics has been described in the late stages of carcinogenesis in various human cancers. By loosing cell-cell adhesion mediated by E-cadherin and acquiring mesenchymal properties, a process reffered to as epithelial to mesenchymal transition (EMT), carcinoma cells become more motile and invasive, thus being able to penetrate the surrounding stroma. Our aim is to investigate E-cadherin expression, part of the EMT phenomenom, in cutaneous squamous cell carcinomas (cSCCs), knowing that it represents a valuable model for understanding cancer progression. We conducted a retrospective study, performing immunohistochemical staining of E-cadherin and analyzing its expression in 32 cases of primary cSCCs. E-cadherin membrane positivity was assessed in cells from the main tumor and cells from the invasion front and described in terms of percentage of positive tumoral cells and in terms of intensity. Statistycal analysis showed the proportion of E-Cadherin positive cells in the tumor central and superficial areas is lower in higher degrees of anaplasia (marginally significant p=0.07), confirming the higher potential of poor outcome in these tumors. Median intensity and proportion values of E-Cadherin positive cells were significantly higher in the tumor central and superficial areas than in the invasion front (p<0.0001), suggesting that loss of epithelial features portends higher potential of invasion and metastasis in the setting of EMT. Further studies are required in order to establish clear correlations.


1. Vleminckx K, Kemler R. "Cadherins and tissue formation: integrating adhesion and signaling". Bioessays. 1999 Mar; 21(3):211–20. Available from:
2. Vleminckx K, Vakaet L, Mareel M, Fiers W, Van Roy F. "Genetic manipulation of E-cadherin expression by epithelial tumor cells reveals an invasion suppressor role". Cell. 1991;
3. Thiery JP. "Epithelial–mesenchymal transitions in tumour progression". Nat Rev Cancer. 2002;
4. Guarino M, Rubino B, Ballabio G. "The role of EMT in cancer pathology". Pathology. 2007 Jun;39(3):305–18. Available from:
5. Jang TJ. "Epithelial to mesenchymal transition in cutaneous squamous cell carcinoma is correlated with COX-2 expression but not with the presence of stromal macrophages or CD10-expressing cells". Virchows Arch. 2012 May 30;460(5):481–7. Available from:
6. Hesse K, Satzger I, Schacht V, Köther B, Hillen U, Klode J, et al. "Characterisation of Prognosis and Invasion of Cutaneous Squamous Cell Carcinoma by Podoplanin and E-Cadherin Expression". Dermatology. 2016;232(5):558–65. Available from:
7. Lan YJ, Chen H, Chen JQ, Lei QH, Zheng M, Shao ZR. "Immunolocalization of vimentin, keratin 17, Ki-67, involucrin, β-catenin and E-cadherin in cutaneous squamous cell carcinoma". Pathol Oncol Res. 2014;
8. Sasaki K, Sugai T, Ishida K, Osakabe M, Amano H, Kimura H, et al. "Analysis of cancer-associated fibroblasts and the epithelial-mesenchymal transition in cutaneous basal cell carcinoma, squamous cell carcinoma, and malignant melanoma". Hum Pathol. 2018;
9. Kalluri R, Weinberg RA. "The basics of epithelial-mesenchymal transition". J Clin Invest. 2009 Jun 1;119(6):1420–8. Available from:
10. Garber K. "Epithelial-to-mesenchymal transition is important to metastasis, but questions remain". Journal of the National Cancer Institute. 2008.
11. Tsai JH, Donaher JL, Murphy DA, Chau S, Yang J. "Spatiotemporal regulation of epithelial-mesenchymal transition is essential for squamous cell carcinoma metastasis". Cancer Cell. 2012;
12. Khan K, Mykula R, Kerstein R, Rabey N, Bragg T, Crick A, et al. "A 5-year follow-up study of 633 cutaneous SCC excisions: Rates of local recurrence and lymph node metastasis". J Plast Reconstr Aesthet Surg. 2018;71(8):1153–8. Available from:
13. Alam M, Ratner D. "Cutaneous squamous-cell carcinoma". N Engl J Med. 2001 Mar 29;344(13):975–83. Available from:
14. Rowe DE, Carroll RJ, Day CL. "Prognostic factors for local recurrence, metastasis, and survival rates in squamous cell carcinoma of the skin, ear, and lip. Implications for treatment modality selection". J Am Acad Dermatol. 1992 Jun;26(6):976–90. Available from:
How to Cite
Calinescu, A., Scheau, C., Zurac, S., Nedelcu, R. I., Brinzea, A., Turcu, G., Coman, A., Antohe, M., Balaban, M., Hulea, I., Andrei, R., Ion, D. A., & Badarau, I. A. (2019). ANALYSIS OF E-CADHERIN EXPRESSION IN A GROUP OF PRIMARY CUTANEOUS SQUAMOUS CELL CARCINOMAS. Romanian Journal of Clinical Research, 2(2).