title: High Ep-CAM expression is associated with poor prognosis in node-positive breast cancer.
abstract: Previous studies in small series of patients with invasive breast cancer suggested a prognostic value of Ep-CAM overexpression in primary tumor tissue. To corroborate these findings, we performed a retrospective analysis of Ep-CAM expression using a tissue microarray containing tissue specimens from a large patient set. Ep-CAM expression was evaluated by immunohistochemistry in breast cancer tissue from 1715 patients with documented raw survival data. High level Ep-CAM expression (overexpression) was found in 41.7% of tumor samples, low level expression was found in 48.0% and no expression in 10.3% of tumor samples. Ep-CAM expression predicted poor overall survival in this patient cohort (p < 0.0001). Overall survival decreased significantly with increasing Ep-CAM expression. However, in this patient sample Ep-CAM expression was not an independent prognostic marker by multivariate analysis. Subgroup analysis revealed that Ep-CAM expression was a prognostic marker in node-positive (p < 0.0001) but not in node-negative (p = 0.58) breast cancer patients. Intriguingly, Ep-CAM expression was predictive for a dismal prognosis in patients receiving adjuvant cytotoxic (p = 0.03) or hormonal therapy (p < 0.0001) but not in untreated patients (p = 0.41). In summary, this study provides strong evidence that expression of Ep-CAM is a powerful marker of poor prognosis in node-positive invasive breast carcinoma and a potential predictive marker of sensitivity to adjuvant hormonal and/or cytotoxic treatment modalities.
authors.affiliation: Division of Haematology and Oncology, University of Innsbruck, Innsbruck, Austria.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Spizzo
authors.forename: Philip
authors.initials: P
authors.lastname: Went
authors.forename: Stephan
authors.initials: S
authors.lastname: Dirnhofer
authors.forename: Peter
authors.initials: P
authors.lastname: Obrist
authors.forename: Ronald
authors.initials: R
authors.lastname: Simon
authors.forename: Hanspeter
authors.initials: H
authors.lastname: Spichtin
authors.forename: Robert
authors.initials: R
authors.lastname: Maurer
authors.forename: Urs
authors.initials: U
authors.lastname: Metzger
authors.forename: Brida
authors.initials: B
authors.lastname: von Castelberg
authors.forename: Rahel
authors.initials: R
authors.lastname: Bart
authors.forename: Shanna
authors.initials: S
authors.lastname: Stopatschinskaya
authors.forename: Ossi Robert
authors.initials: OR
authors.lastname: Köchli
authors.forename: Philip
authors.initials: P
authors.lastname: Haas
authors.forename: Friedrich
authors.initials: F
authors.lastname: Mross
authors.forename: Markus
authors.initials: M
authors.lastname: Zuber
authors.forename: Holger
authors.initials: H
authors.lastname: Dietrich
authors.forename: Susanne
authors.initials: S
authors.lastname: Bischoff
authors.forename: Martina
authors.initials: M
authors.lastname: Mirlacher
authors.forename: Guido
authors.initials: G
authors.lastname: Sauter
authors.forename: Guenther
authors.initials: G
authors.lastname: Gastl
mesh_terms: D000368:Aged; D000951:Antigens, Neoplasm / Q000096:biosynthesis*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor; D001943:Breast Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology*; D017252:CD3 Complex; D002277:Carcinoma / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology*; D015815:Cell Adhesion Molecules / Q000096:biosynthesis*; D000071858:Epithelial Cell Adhesion Molecule; D005260:Female; D020869:Gene Expression Profiling; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D017252:CD3 Complex; D015815:Cell Adhesion Molecules; D000071858:Epithelial Cell Adhesion Molecule