Abstract
The Merkel cell carcinoma (MCC) is a highly malignant carcinoma of the skin that is characterized by granules containing neuroendocrine peptides and by the expression of simple epithelial type cytokeratins. The glycoprotein Ep-CAM is a homophilic cell-cell adhesion molecule, present in most simple, pseudostratified and transitional epithelia and the tumors derived therefrom. MUC 1 is a well-established marker for squamous cell carcinomas and is generally secreted by glandular epithelial cells. We compared the expression of Ep-CAM and MUC 1 in Merkel cells and 33 cases of MCC and 12 MCC metastases using immunohistochemistry on paraffin-embedded sections. In addition, we examined the glycosylation status of MUC 1 with specific monoclonal antibodies. MUC 1 and Ep-CAM were expressed in Merkel cells and in about 82% and 70% of all MCC irrespective of clinical outcome. Both antigens were expressed in 66% of metastases. Similar to breast cancer, the presence of MUC 1 was not correlated with clinical outcome, but the staining intensity of monoclonal antibodies against glycosylation-independent and hypoglycosylated epitopes was. In MCC we found an altered glycosylation pattern in the immunodominant APDTR region of MUC 1 as compared to normal Merkel cells. Hyperglycosylated MUC 1 epitopes were not present in either MCC or normal Merkel cells. There was no correlation between glycosylation pattern and clinical outcome. Ep-CAM expression seemed to be stronger in primary MCC that metastasized than in those that did not. In conclusion, Merkel cells and the majority of MCC express Ep-CAM and MUC 1. This opens the door for treatments based on monoclonal antibodies or vaccination strategies against these antigens, already established for other tumor entities.
Similar content being viewed by others
References
Baeckstrom D, Nilsson O, Price MR, Lindholm L, Hansson GC (1993) Discrimination of MUC1 mucins from other sialyl-Le(a)-carrying glycoproteins produced by colon carcinoma cells using a novel monoclonal antibody. Cancer Res 53:755–761
Balzar M, Winter MJ, de Boer CJ, Litvinov SV (1999) The biology of the 17-1A antigen (Ep-CAM). J Mol Med 77:699–712
Beer TW, Shepherd P, Theaker JM (2000) Ber EP4 and epithelial membrane antigen aid distinction of basal cell, squamous cell and basosquamous carcinomas of the skin. Histopathology 37:218–223
Burchell J, Taylor-Papadimitriou J (1993) Effect of modification of carbohydrate side chains on the reactivity of antibodies with core-protein epitopes of the MUC1 gene product. Epithelial Cell Biol 2:155–162
Cheung KL, Graves CR, Robertson JF (2000) Tumour marker measurements in the diagnosis and monitoring of breast cancer. Cancer Treat Rev 26:91–102
Croce MV, Rabassa ME, Price MR, Segal-Eiras A (2001) MUC1 mucin and carbohydrate associated antigens as tumor markers in head and neck squamous cell carcinoma. Pathol Oncol Res 7:284–291
Dion AS, Smorodinsky NI, Williams CJ, Wreschner DH, Major PP, Keydar I (1991) Recognition of peptidyl epitopes by polymorphic epithelial mucin (PEM)-specific monoclonal antibodies. Hybridoma 10:595–610
Fricker J (1997) Mucin-based vaccines and cancer. Mol Med Today 3:47
Gould E, Albores-Saavedra J, Dubner B, Smith W, Payne CM (1988) Eccrine and squamous differentiation in Merkel cell carcinoma. An immunohistochemical study. Am J Surg Pathol 12:768–772
Han AC, Soler AP, Tang CK, Knudsen KA, Salazar H (2000) Nuclear localization of E-cadherin expression in Merkel cell carcinoma. Arch Pathol Lab Med 124:1147–1151
Hanahan D, Weinberg RA ( 2000) The hallmarks of cancer. Cell 100:57–70
Hartschuh W, Grube D (1979) The Merkel cell—a member of the APUD cell system. Fluorescence and electron microscopic contribution to the neurotransmitter function of the Merkel cell granules. Arch Dermatol Res 265:115–122
Hartschuh W, Weihe E, Egner U (1989) Chromogranin A in the mammalian Merkel cell: cellular and subcellular distribution. J Invest Dermatol 93:641–648
Hilkens J, Wesseling J, Vos HL, Storm J, Boer M, van der Valk SW (1995) Episialin/CA15-3: its structure and involvement in breast cancer progression. Ned Tijdschr Klein Chem 20:293–298
Holmberg LA, Sandmaier BM (2001) Theratope vaccine (STn-KLH). Expert Opin Biol Ther 1:881–891
Holmberg LA, Oparin DV, Gooley T, Lilleby K, Bensinger W, Reddish MA, MacLean GD, Longenecker BM, Sandmaier BM (2000) Clinical outcome of breast and ovarian cancer patients treated with high-dose chemotherapy, autologous stem cell rescue and THERATOPE STn-KLH cancer vaccine. Bone Marrow Transplant 25:1233–1241
Kaul S, Windecker S, Bastert G (1989) Monoclonal antibodies reactive with tumor-associated epitopes of breast mucin glycoproteins. Proc Am Assoc Cancer Res 30:349
Koprowski H, Steplewski Z, Mitchel K, Herlyn M, Herlyn D, Fuhrer P (1979) Colorectal carcinoma antigens detected by hybridoma antibodies. Somat Cell Genet 5:957–963
Kurzen H, Esposito L, Langbein L, Hartschuh W (2001) Cytokeratins as markers of follicular differentiation: an immunohistochemical study of trichoblastoma and basal cell carcinoma. Am J Dermatopathol 23:501–509
Layfield L, Ulich T, Liao S, Barr R, Cheng L, Lewin KL (1986) Neuroendocrine carcinoma of the skin: an immunohistochemical study of tumor markers and neuroendocrine products. J Cutan Pathol 13:268–273
Litvinov SV, van Driel W, van Rhijn CM, Bakker HAM, van Krieken H, Fleuren GJ, Warnaar SO (1996) Expression of Ep-CAM in cervical squamous epithelia correlates with an increased proliferation and the disappearance of markers for terminal differentiation. Am J Pathol 148:865–875
Lloyd KO, Burchell J, Kudryashov V, Yin BW, Taylor-Papadimitriou J (1996) Comparison of O-linked carbohydrate chains in MUC-1 mucin from normal breast epithelial cell lines and breast carcinoma cell lines. Demonstration of simpler and fewer glycan chains in tumor cells. J Biol Chem 271:33325–33334
LoBuglio AF, Saleh MN (1992) Advances in monoclonal antibody therapy of cancer. Am J Med Sci 304:214–224
Moll I, Moll R (1992) Early development of human Merkel cells. Exp Dermatol 1:180–184
Morse MA (2001) Technology evaluation: BLP-25, Biomira Inc. Curr Opin Mol Ther 3:102–105
Mount SL, Taatjes DJ (1994) Neuroendocrine carcinoma of the skin (Merkel cell carcinoma). An immunoelectron-microscopic case study. Am J Dermatopathol 16:60–65
Nitta T, Sugihara K, Tsuyama S, Murata F (2000) Immunohistochemical study of MUC1 mucin in premalignant oral lesions and oral squamous cell carcinoma: association with disease progression, mode of invasion, and lymph node metastasis. Cancer 88:245–254
Ortonne JP, Petchot-Bacque JP, Verrando P, Pisani A, Pautrat G, Bernerd F (1988) Normal Merkel cells express a synaptophysin-like immunoreactivity. Dermatologica 177:1–10
Patton ST, Gendler SJ, Spicer AP (1995) Heterogeneity in production, secretion and glycosylation of MUC1 epithelial mucin by primary cultures of ovarian carcinoma. Int J Cancer 63:412–418
Perrin C, Pisani A, Demarchez M, Michiel JF, Ortonne JP (1996) Vla and alpha 6 beta 4 integrin expression in neuroendocrine carcinomas of the skin (their xenografts on nude mice and a corresponding primary culture). J Cutan Pathol 23:223–228
Petersen OW, van Deurs B (1986) Characterization of epithelial membrane antigen expression in human mammary epithelium by ultrastructural immunoperoxidase cytochemistry. J Histochem Cytochem 34:801–809
Punt CJ, Nagy A, Douillard JY, Figer A, Skovsgaard T, Monson J, Barone C, Fountzilas G, Riess H, Moylan E, Jones D, Dethling J, Colman J, Coward L, MacGregor S (2002) Edrecolomab alone or in combination with fluorouracil and folinic acid in the adjuvant treatment of stage III colon cancer: a randomised study. Lancet 360:671–677
Rebhan M, Chalifa-Caspi V, Prilusky J, Lancet D (1997a) GeneCards: encyclopedia for genes, proteins and diseases (GeneCard for MUC1). Bioinformatics Unit and Genome Center, Weizmann Institute of Science, Rehovot, Israel
Rebhan M, Chalifa-Caspi V, Prilusky J, Lancet D (1997b) GeneCards: encyclopedia for genes, proteins and diseases (GeneCard for TACSTD-1). Bioinformatics Unit and Genome Center, Weizmann Institute of Science, Rehovot, Israel
Reis CA, David L, Seixas M, Burchell J, Sobrinho-Simoes M (1998) Expression of fully and under-glycosylated forms of MUC1 mucin in gastric carcinoma. Int J Cancer 79:402–410
Riethmuller G, Holz E, Schlimok G, Schmiegel W, Raab R, Hoffken K, Gruber R, Funke I, Pichlmaier H, Hirche H, Buggisch P, Witte J, Pichlmayr R (1998) Monoclonal antibody therapy for resected Dukes' C colorectal cancer: seven-year outcome of a multicenter randomized trial. J Clin Oncol 16:1788–1794
Rye PD, Bovin NV, Vlasova EV, Molodyk AA, Baryshnikov A, Kreutz FT, Garinther WI, Schultes BC, Noujaim AA, Madiyalakan R, Magnani J, Nilsson O, Nilsson K, Nustad K, Norum L, Bell H, Cao Y, Suresh MR, Very DL, Freeman JV, Yeung KK, Hilgers J (1998) Summary report on the ISOBM TD-6 workshop: analysis of 20 monoclonal antibodies against Sialyl Lewisa and related antigens. Montreux, Switzerland, 19–24 September 1997. Tumour Biol 19:390–420
Ryuko K, Schol DJ, Snijdewint FG, von Mensdorff-Pouilly S, Poort-Keesom RJ, Karuntu-Wanamarta YA, Verstraeten RA, Miyazaki K, Kenemans P, Hilgers J (2000) Characterization of a new MUC1 monoclonal antibody (VU-2-G7) directed to the glycosylated PDTR sequence of MUC1. Tumour Biol 21:197–210
Schulz T, Hartschuh W (1995) Merkel cells in nevus sebaceous. An immunohistochemical study. Am J Dermatopathol 17:570–579
Schumacher U, Adam E (1998) Immunohistochemical detection of MUC1 gene product in human cancers grown in scid mice. J Histochem Cytochem 46:127–134
Smith KJ, Skelton HG 3rd, Holland TT, Morgan AM, Lupton GP (1993) Neuroendocrine (Merkel cell) carcinoma with an intraepidermal component. Am J Dermatopathol 15:528–533
Strous GJ, Dekker J (1992) Mucin-type glycoproteins. Crit Rev Biochem Mol Biol 27:57–92
Szeder V, Grim M, Halata Z, Sieber-Bluma M (2003) Neural crest origin of mammalian Merkel cells. Dev Biol 253:258–263
Tatemoto Y, Saka M, Tanimura T, Mori M (1987) Immunohistochemical observations on binding of monoclonal antibody to epithelial membrane antigen in epithelial tumors of the oral cavity and skin. Oral Surg Oral Med Oral Pathol 64:721–726
Taylor-Papadimitriou J, Epenetos AA (1994) Exploiting altered glycosylation patterns in cancer: progress and challenges in diagnosis and therapy. Trends Biotechnol 12:227–233
Tellechea O, Reis JP, Domingues JC, Baptista AP (1993) Monoclonal antibody Ber EP4 distinguishes basal-cell carcinoma from squamous-cell carcinoma of the skin. Am J Dermatopathol 15:452–455
Tsubura A, Senzaki H, Sasaki M, Hilgers J, Morii S (1992) Immunohistochemical demonstration of breast-derived and/or carcinoma-associated glycoproteins in normal skin appendages and their tumors. J Cutan Pathol 19:73–79
Yamamoto M, Bharti A, Li Y, Kufe D (1997) Interaction of the DF3/MUC1 breast carcinoma-associated antigen and beta-catenin in cell adhesion. J Biol Chem 272:12492–12494
Wesseling J, van der Valk SW, Vos HL, Sonnenberg A, Hilkens A (1995) Episialin (MUC1) overexpression inhibits integrin mediated cell adhesion to extracellular matrix components. J Cell Biol 129:255–265
White CA, Weaver RL, Grillo-Lopez AJ (2001) Antibody-targeted immunotherapy for treatment of malignancy. Annu Rev Med 52:125–145
Wick MR, Kaye VN, Sibley RK, Tyler R, Frizzera G (1986) Primary neuroendocrine carcinoma and small-cell malignant lymphoma of the skin. A discriminant immunohistochemical comparison. J Cutan Pathol 13:347–358
Xu Y, Kimura N, Yoshida R, Lin H, Yoshinaga K (2001) Immunohistochemical study of Muc1, Muc2 and human gastric mucin in breast carcinoma: relationship with prognostic factors. Oncol Rep 8:1177–1182
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kurzen, H., Kaul, S., Egner, U. et al. Expression of MUC 1 and Ep-CAM in Merkel cell carcinomas: implications for immunotherapy. Arch Dermatol Res 295, 146–154 (2003). https://doi.org/10.1007/s00403-003-0410-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00403-003-0410-y