Prognostic effect of epithelial cell adhesion molecule overexpression in untreated node-negative breast cancer.
OBJECTIVE
Epithelial cell adhesion molecule (Ep-CAM) recently received increased attention not only as a prognostic factor in breast cancer but also as a potential target for immunotherapy. We examined Ep-CAM expression in 402 consecutive node-negative breast cancer patients with long-term follow-up not treated in the adjuvant setting.


METHODS
Ep-CAM expression was evaluated by immunostaining. Its prognostic effect was estimated relative to overexpression/amplification of HER-2, histologic grade, tumor size, age, and hormone receptor expression.


RESULTS
Ep-CAM status was positive in 106 (26.4%) patients. In multivariate analysis, Ep-CAM status was associated with disease-free survival independent of age, pT stage, histologic grade, estrogen receptor (ER), progesterone receptor (PR), as well as HER2 status (P = 0.028; hazard ratio, 1.60; 95% confidence interval, 1.05-2.44). Recently, so-called triple-negative (HER-2, ER, and PR) breast cancer has received increased attention. We noticed a similar association of Ep-CAM with disease-free survival in the triple-negative group as for the entire cohort.


CONCLUSIONS
In this study of untreated breast cancer patients, Ep-CAM overexpression was associated with poor survival in the entire cohort and in the subgroup of triple-negative breast cancer. This suggests that Ep-CAM may be a well-suited target for specific therapies particularly in HER-2-, ER-, and PR-negative tumors.
Schmidt
Marcus
M
Department of Obstetrics and Gynecology, Johannes Gutenberg University, Leipzig, Germany. marcus.schmidt@frauen.klinik.uni-mainz.de
Hasenclever
Dirk
D
Schaeffer
Mitra
M
Boehm
Daniel
D
Cotarelo
Cristina
C
Steiner
Eric
E
Lebrecht
Antje
A
Siggelkow
Wulf
W
Weikel
Wolfgang
W
Schiffer-Petry
Ilka
I
Gebhard
Susanne
S
Pilch
Henryk
H
Gehrmann
Mathias
M
Lehr
Hans-Anton
HA
Koelbl
Heinz
H
Hengstler
Jan G
JG
Schuler
Martin
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000378:metabolism*; D014408:Biomarkers, Tumor; D001943:Breast Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D015815:Cell Adhesion Molecules / Q000378:metabolism*; D016503:Drug Delivery Systems; D000071858:Epithelial Cell Adhesion Molecule; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009376:Neoplasms, Hormone-Dependent; D011379:Prognosis
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D015815:Cell Adhesion Molecules; C499379:EPCAM protein, human; D000071858:Epithelial Cell Adhesion Molecule