title: Higher expression of EpCAM is associated with poor clinical and pathological responses in breast cancer patients undergoing neoadjuvant chemotherapy.
abstract: Neoadjuvant chemotherapy (NAC) is a standard regimen in treatment of breast cancer patients, but some are resistant to NAC. We hypothesized that breast cancer cells overexpressing epithelial cell adhesion molecule (EpCAM) could be resistant to NAC, contributing to a poor prognosis. Seventy patients with breast cancer were treated with NAC. Core needle biopsy (CNB) specimens and resected tumors before and after NAC, respectively, were examined for expression of EpCAM. In resected tumors, high EpCAM expression correlated with lymphovascular invasion status and nuclear grade (P = 0.01 and 0.008, respectively), and was associated with poor pathological and clinical responses (P < 0.001). High tumoral EpCAM expression in resected tumor was independently related to a poor pathological response. Patients with high EpCAM expression before and after NAC (high-to-high group) showed worse pathological and clinical responses (P = 0.008 and <0.001, respectively) than the patients with high and low EpCAM expression before and after NAC, respectively (high-to-low group). The overall survival rate of the high-to-high group appeared shorter compared with the high-to low-group (P = 0.049). Our findings imply that higher levels of EpCAM in breast cancer may be associated with poor response to NAC via a potential chemoresistant effect.
authors.affiliation: Department of Diagnostic Pathology, Nippon Medical School Hospital, Tokyo, Japan.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Ohashi
authors.affiliation: Department of Integrated Diagnostic Pathology, Nippon Medical School, Tokyo, Japan.
authors.forename: Kiyoko
authors.initials: K
authors.lastname: Kawahara
authors.affiliation: Department of Integrated Diagnostic Pathology, Nippon Medical School, Tokyo, Japan.
authors.forename: Takenori
authors.initials: T
authors.lastname: Fujii
authors.affiliation: Division of Breast Surgery, Nippon Medical School Hospital, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takei
authors.affiliation: Department of Diagnostic Pathology, Nippon Medical School Hospital, Tokyo, Japan.|Department of Integrated Diagnostic Pathology, Nippon Medical School, Tokyo, Japan.
authors.forename: Zenya
authors.initials: Z
authors.lastname: Naito
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D019008:Drug Resistance, Neoplasm; D000071858:Epithelial Cell Adhesion Molecule / Q000235:genetics / Q000378:metabolism*; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D060787:Neoplasm Grading; D016019:Survival Analysis
chemical_list: C499379:EPCAM protein, human; D000071858:Epithelial Cell Adhesion Molecule
keywords: EpCAM; breast cancer; neoadjuvant chemotherapy; pathological response to NAC in breast cancer patients