title: Subcellular localization of activated leukocyte cell adhesion molecule is a molecular predictor of survival in ovarian carcinoma patients.
abstract: OBJECTIVE
  Currently available clinicopathologic prognostic factors are imperfect predictors of clinical course in advanced-stage epithelial ovarian cancer patients. New molecular predictors are needed to identify patients with higher risk of relapse or death from disease. In a retrospective study, we investigated the prognostic impact of activated leukocyte cell adhesion molecule (ALCAM) expression in epithelial ovarian cancer.
  
  
  METHODS
  We analyzed the effect of cell-anchorage loss on ALCAM cellular localization in vitro and assessed ALCAM expression by immunohistochemistry in a series of 109 well-characterized epithelial ovarian cancer patient samples. Chi-square test, Kaplan-Meier method, and Cox proportional hazard analyses were used to relate ALCAM cellular localization to clinical-pathologic parameters and to overall survival (OS) rate.
  
  
  RESULTS
  Loss of epithelial ovarian cancer cell anchorage was associated both in vitro and in vivo with decreased ALCAM membrane expression. In vivo, ALCAM was localized to cell membrane in normal surface ovarian epithelium, whereas in 67% of the epithelial ovarian cancer samples, membrane localization was decreased or even lost, and the molecule was mainly expressed in cytoplasm. Median OS in this group of patients was 58 months, whereas a median OS was not yet reached in patients with ALCAM membrane localization (P = 0.036, hazard ratio [HR] = 2.0, 95% confidence interval [CI] 1.1 to 3.5). In a multivariate Cox regression model including all the available clinicopathologic variables, loss of ALCAM membrane expression was an independent factor of unfavorable prognosis (P = 0.042, HR = 2.15, 95% CI: 1.0 to 4.5).
  
  
  CONCLUSIONS
  Decreased/lost ALCAM membrane expression is a marker of poorer outcome in epithelial ovarian cancer patients and might help to identify patients who could benefit from more frequent follow-up or alternative therapeutic modalities.
authors.affiliation: Department of Experimental Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Delia
authors.initials: D
authors.lastname: Mezzanzanica
authors.forename: Marina
authors.initials: M
authors.lastname: Fabbi
authors.forename: Marina
authors.initials: M
authors.lastname: Bagnoli
authors.forename: Samantha
authors.initials: S
authors.lastname: Staurengo
authors.forename: Marco
authors.initials: M
authors.lastname: Losa
authors.forename: Emanuela
authors.initials: E
authors.lastname: Balladore
authors.forename: Paola
authors.initials: P
authors.lastname: Alberti
authors.forename: Lara
authors.initials: L
authors.lastname: Lusa
authors.forename: Antonino
authors.initials: A
authors.lastname: Ditto
authors.forename: Silvano
authors.initials: S
authors.lastname: Ferrini
authors.forename: Marco A
authors.initials: MA
authors.lastname: Pierotti
authors.forename: Mattia
authors.initials: M
authors.lastname: Barbareschi
authors.forename: Silvana
authors.initials: S
authors.lastname: Pilotti
authors.forename: Silvana
authors.initials: S
authors.lastname: Canevari
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000378:metabolism; D002277:Carcinoma / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality*; D002448:Cell Adhesion / Q000502:physiology; D015816:Cell Adhesion Molecules, Neuronal / Q000378:metabolism*; D002462:Cell Membrane / Q000378:metabolism; D003593:Cytoplasm / Q000378:metabolism; D015536:Down-Regulation; D005260:Female; D005326:Fetal Proteins / Q000378:metabolism*; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality*; D011379:Prognosis; D016019:Survival Analysis; D014018:Tissue Distribution; D014407:Tumor Cells, Cultured; D020410:Activated-Leukocyte Cell Adhesion Molecule
chemical_list: D015703:Antigens, CD; D014408:Biomarkers, Tumor; D015816:Cell Adhesion Molecules, Neuronal; D005326:Fetal Proteins; C105613:ALCAM protein, human; D020410:Activated-Leukocyte Cell Adhesion Molecule