title: Activated leukocyte cell adhesion molecule is a marker for thyroid carcinoma aggressiveness and disease-free survival.
abstract: BACKGROUND
  Currently, there are no protein biomarkers for aggressive subtypes of thyroid carcinomas (TC) in clinical use that would allow for early detection and patient management. We hypothesized that activated leukocyte cell adhesion molecule (ALCAM or CD166) expression in thyroid tissues will reveal ALCAM to be a potential diagnostic and/or prognostic marker for TC aggressiveness.
  
  
  METHODS
  Forty-five benign and 158 malignant thyroid tissues were analyzed for ALCAM expression using immunohistochemistry. ALCAM expression was correlated with different subtypes and clinicopathological features of TC, as well as patient disease-free survival.
  
  
  RESULTS
  Combined membranous and cytoplasmic (total) expression of ALCAM was significantly reduced in patients with poorly/undifferentiated (aggressive) TC as compared to well-differentiated (nonaggressive) tumors (p<0.001; area-under-curve=0.865, sensitivity=82%, specificity=74%). The decreased ALCAM expression in TC correlated significantly with extrathyroidal extension, distant metastasis, and TC histotype. Notably, Kaplan-Meier survival analysis for follow-up data of 134 patients revealed significantly reduced disease-free survival for patients with TC with decreased ALCAM membranous, cytoplasmic, and total expression. Median survival of patients with decreased cytoplasmic ALCAM expression was 6 years, as compared to 13.7 years for patients with higher ALCAM expression (p<0.001).
  
  
  CONCLUSIONS
  ALCAM has the potential to serve as a diagnostic and prognostic biomarker for aggressive TC. This protein can be taken forward for analysis in sera of patients with TC to determine its applicability as a minimally invasive serum biomarker for TC aggressiveness and patient disease-free survival.
authors.affiliation: Alex and Simona Shnaider Research Laboratory in Molecular Oncology, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Canada.
authors.forename: Seham
authors.initials: S
authors.lastname: Chaker
authors.forename: Ipshita
authors.initials: I
authors.lastname: Kak
authors.forename: Christina
authors.initials: C
authors.lastname: MacMillan
authors.forename: Ranju
authors.initials: R
authors.lastname: Ralhan
authors.forename: Paul G
authors.initials: PG
authors.lastname: Walfish
mesh_terms: D020410:Activated-Leukocyte Cell Adhesion Molecule / Q000032:analysis*; D018572:Disease-Free Survival; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D011379:Prognosis; D013961:Thyroid Gland / Q000378:metabolism*; D013964:Thyroid Neoplasms / Q000378:metabolism* / Q000473:pathology
chemical_list: D020410:Activated-Leukocyte Cell Adhesion Molecule