title: Clinical impact of L1CAM expression measured on the transcriptome level in ovarian cancer.
abstract: BACKGROUND
  High expression of L1 cell adhesion molecules (L1CAM) has been repeatedly shown to be associated with aggressive disease behavior, which translates in poor clinical outcome in various cancer entities. However, in ovarian cancer results based either on immunohistochemistry or cytosolic protein quantifications remained conflicting regarding clinical behavior. In the present work we assessed L1CAM expression on the transcriptome level with the highly sensitive quantitative real-time PCR (qRT-PCR) to define its relevance in ovarian cancer biology.
  
  
  RESULTS
  There was a significant difference in L1CAM high and low mRNA expressing cancers with regard to disease-free (p=0.002) and overall survival (p=0.008). L1CAM proofed to be an independent predictor for disease progression (HR 1.8, p=0.01) and overall survival (HR 1.6, p=0.04). Furthermore, a significant positive correlation between the level of L1CAM and the grade of tumor differentiation (p=0.04), the FIGO stage (p=0.025) as well as the histological subtype (p= 0.002) was found.
  
  
  METHODS
  This study included fresh frozen tissue samples of 138 patients with FIGO I-IV stage ovarian cancer. L1CAM mRNA expression was determined using qRT-PCR. In the calculations special attention was put on the various histological subtypes. In survival analysis median L1CAM mRNA expression obtained in the entire cohort of ovarian cancer samples was used as a cut-off to distinguish between high and low L1CAM mRNA expression.
  
  
  CONCLUSIONS
  L1CAM mRNA expression appears to play a substantial role in the pathophysiology of ovarian cancer that is translated into poor clinical outcome. Additionally humanized L1CAM antibodies, which can serve as potential future treatment options are under testing.
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
authors.forename: Samira
authors.initials: S
authors.lastname: Abdel Azim
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
authors.forename: Michaela
authors.initials: M
authors.lastname: Duggan-Peer
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
authors.forename: Susanne
authors.initials: S
authors.lastname: Sprung
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
authors.forename: Daniel
authors.initials: D
authors.lastname: Reimer
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Innsbruck, 6020 Innsbruck, Austria.|Department of Obstetrics and Gynecology, Laboratory for Clinical Biochemistry, Medical University of Innsbruck, 6020 Innsbruck, Austria.
authors.forename: Heidi
authors.initials: H
authors.lastname: Fiegl
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
authors.forename: Afschin
authors.initials: A
authors.lastname: Soleiman
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Marth
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
authors.forename: Alain G
authors.initials: AG
authors.lastname: Zeimet
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism; D016022:Case-Control Studies; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D039842:Neural Cell Adhesion Molecule L1 / Q000378:metabolism*; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D012333:RNA, Messenger / Q000378:metabolism*; D060888:Real-Time Polymerase Chain Reaction; D012189:Retrospective Studies; D059467:Transcriptome
chemical_list: D014408:Biomarkers, Tumor; D039842:Neural Cell Adhesion Molecule L1; D012333:RNA, Messenger
keywords: L1CAM; RT-PCR; ovarian cancer; survival; targeted therapy