title: Relevance of activated leukocyte cell adhesion molecule (ALCAM) in tumor tissue and sera of cervical cancer patients.
abstract: BACKGROUND
  An altered expression of the activated leukocyte cell adhesion molecule (ALCAM) is associated with cancer progression in various cancer types. In some cancers ALCAM has a prognostic value or is predictive for the benefit of therapeutic interventions. To date there are no data on the role of ALCAM in cervical cancer available.
  
  
  METHODS
  In this study, ALCAM expression was analysed by immunohistochemistry (IHC) in tissue samples of 233 patients with cervical cancer, among them 178 with complete follow-up information. In addition, soluble (s-)ALCAM was measured in sera of a subset of the included patients (n = 55) by enzyme-linked immunosorbent assay (ELISA).
  
  
  RESULTS
  ALCAM overexpression was detected (immunoreactive score (IRS) 2-12) in 58.4% of the cervical cancer samples. The normal ectocervical or endocervical epithelium showed no ALCAM reactivity. In untreated patients, ALCAM overexpression in tumor tissue tended to be associated with shorter cancer-specific survival (CSS) and disease-free survival (DFS). Patients, whose tumor samples showed ALCAM overexpression receiving a cytotoxic therapy like radiotherapy or chemoradiation, however, had a favourable prognosis compared to those patients, whose cancers showed no or minimal ALCAM staining. This effect was particularly apparent in patients receiving chemoradiation where the CSS was significantly longer in patients with ALCAM-positive tumors (p = 0.038; cumulative incidence rates at 96 months 8%, 95% CI 0%-23%, and 26%, CI 3%-43% in ALCAM-positive and ALCAM-negative cases, respectively).Median preoperative s-ALCAM concentration in sera from tumor patients was 27.6 ng/ml (range 17.5-55.1 ng/ml, mean 28.9 ng/ml), serum levels did not correlate with intratumoral ALCAM expression.
  
  
  CONCLUSIONS
  The data of our retrospective study suggest that the prognostic value of ALCAM expression in cervical carcinoma might be therapy-dependent, and that ALCAM might function as a predictive marker for the response to chemoradiation. This should be confirmed in further, prospective studies.
authors.affiliation: Department of Gynecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Maike
authors.initials: M
authors.lastname: Ihnen
authors.forename: Kerstin
authors.initials: K
authors.lastname: Kress
authors.forename: Jan Felix
authors.initials: JF
authors.lastname: Kersten
authors.forename: Ergin
authors.initials: E
authors.lastname: Kilic
authors.forename: Matthias
authors.initials: M
authors.lastname: Choschzick
authors.forename: Hilke
authors.initials: H
authors.lastname: Zander
authors.forename: Volkmar
authors.initials: V
authors.lastname: Müller
authors.forename: Sven
authors.initials: S
authors.lastname: Mahner
authors.forename: Fritz
authors.initials: F
authors.lastname: Jänicke
authors.forename: Linn
authors.initials: L
authors.lastname: Woelber
authors.forename: Karin
authors.initials: K
authors.lastname: Milde-Langosch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000097:blood / Q000378:metabolism*; D002277:Carcinoma / Q000097:blood / Q000378:metabolism*; D015816:Cell Adhesion Molecules, Neuronal / Q000097:blood / Q000378:metabolism*; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005326:Fetal Proteins / Q000097:blood / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000097:blood / Q000378:metabolism*; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000097:blood / Q000378:metabolism*; D055815:Young Adult; D020410:Activated-Leukocyte Cell Adhesion Molecule
chemical_list: D015703:Antigens, CD; D015816:Cell Adhesion Molecules, Neuronal; D005326:Fetal Proteins; D009363:Neoplasm Proteins; C105613:ALCAM protein, human; D020410:Activated-Leukocyte Cell Adhesion Molecule