title: Prognostic effect of epithelial cell adhesion molecule overexpression in untreated node-negative breast cancer.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Johannes Gutenberg University, Leipzig, Germany. marcus.schmidt@frauen.klinik.uni-mainz.de
authors.forename: Marcus
authors.initials: M
authors.lastname: Schmidt
authors.forename: Dirk
authors.initials: D
authors.lastname: Hasenclever
authors.forename: Mitra
authors.initials: M
authors.lastname: Schaeffer
authors.forename: Daniel
authors.initials: D
authors.lastname: Boehm
authors.forename: Cristina
authors.initials: C
authors.lastname: Cotarelo
authors.forename: Eric
authors.initials: E
authors.lastname: Steiner
authors.forename: Antje
authors.initials: A
authors.lastname: Lebrecht
authors.forename: Wulf
authors.initials: W
authors.lastname: Siggelkow
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Weikel
authors.forename: Ilka
authors.initials: I
authors.lastname: Schiffer-Petry
authors.forename: Susanne
authors.initials: S
authors.lastname: Gebhard
authors.forename: Henryk
authors.initials: H
authors.lastname: Pilch
authors.forename: Mathias
authors.initials: M
authors.lastname: Gehrmann
authors.forename: Hans-Anton
authors.initials: HA
authors.lastname: Lehr
authors.forename: Heinz
authors.initials: H
authors.lastname: Koelbl
authors.forename: Jan G
authors.initials: JG
authors.lastname: Hengstler
authors.forename: Martin
authors.initials: M
authors.lastname: Schuler
mesh_terms: 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
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D015815:Cell Adhesion Molecules; C499379:EPCAM protein, human; D000071858:Epithelial Cell Adhesion Molecule