High Ep-CAM expression is associated with poor prognosis in node-positive breast cancer.
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.
Spizzo
Gilbert
G
Division of Haematology and Oncology, University of Innsbruck, Innsbruck, Austria.
Went
Philip
P
Dirnhofer
Stephan
S
Obrist
Peter
P
Simon
Ronald
R
Spichtin
Hanspeter
H
Maurer
Robert
R
Metzger
Urs
U
von Castelberg
Brida
B
Bart
Rahel
R
Stopatschinskaya
Shanna
S
Köchli
Ossi Robert
OR
Haas
Philip
P
Mross
Friedrich
F
Zuber
Markus
M
Dietrich
Holger
H
Bischoff
Susanne
S
Mirlacher
Martina
M
Sauter
Guido
G
Gastl
Guenther
G
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
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D017252:CD3 Complex; D015815:Cell Adhesion Molecules; D000071858:Epithelial Cell Adhesion Molecule