Breast Cancer Research and Treatment

, Volume 86, Issue 3, pp 207–213 | Cite as

High Ep-CAM Expression is Associated with Poor Prognosis in Node-positive Breast Cancer

  • Gilbert Spizzo
  • Guenther Gastl
  • Peter Obrist
  • Philip Went
  • Stephan Dirnhofer
  • Susanne Bischoff
  • Martina Mirlacher
  • Guido Sauter
  • Ronald Simon
  • Shanna Stopatschinskaya
  • Philip Haas
  • Rahel Bart
  • Ossi Robert Köchli
  • Hanspeter Spichtin
  • Robert Maurer
  • Urs Metzger
  • Brida von Castelberg
  • Markus Zuber
  • Friedrich Mross
  • Holger Dietrich
Article

Abstract

Previous studies in small series of patients with invasive breast cancer suggested a prognostic value of Ep-CAM overexpression in primary tumor tissue. To corroborate these findings, we performed a retrospective analysis of Ep-CAM expression using a tissue microarray containing tissue specimens from a large patient set. Ep-CAM expression was evaluated by immunohistochemistry in breast cancer tissue from 1715 patients with documented raw survival data. High level Ep-CAM expression (overexpression) was found in 41.7% of tumor samples, low level expression was found in 48.0% and no expression in 10.3% of tumor samples. Ep-CAM expression predicted poor overall survival in this patient cohort (p < 0.0001). Overall survival decreased significantly with increasing Ep-CAM expression. However, in this patient sample Ep-CAM expression was not an independent prognostic marker by multivariate analysis. Subgroup analysis revealed that Ep-CAM expression was a prognostic marker in node-positive (p < 0.0001) but not in node-negative (p= 0.58) breast cancer patients. Intriguingly, Ep-CAM expression was predictive for a dismal prognosis in patients receiving adjuvant cytotoxic (p= 0.03) or hormonal therapy (p < 0.0001) but not in untreated patients (p= 0.41). In summary, this study provides strong evidence that expression of Ep-CAM is a powerful marker of poor prognosis in node-positive invasive breast carcinoma and a potential predictive marker of sensitivity to adjuvant hormonal and/or cytotoxic treatment modalities.

breast cancer Ep-CAM prognosis tissue microarray 

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Copyright information

© Kluwer Academic Publishers 2004

Authors and Affiliations

  • Gilbert Spizzo
    • 1
  • Guenther Gastl
    • 1
  • Peter Obrist
    • 2
  • Philip Went
    • 3
  • Stephan Dirnhofer
    • 3
  • Susanne Bischoff
    • 3
  • Martina Mirlacher
    • 3
  • Guido Sauter
    • 3
  • Ronald Simon
    • 3
  • Shanna Stopatschinskaya
    • 3
  • Philip Haas
    • 3
  • Rahel Bart
    • 4
  • Ossi Robert Köchli
    • 5
  • Hanspeter Spichtin
    • 6
  • Robert Maurer
    • 7
  • Urs Metzger
    • 8
  • Brida von Castelberg
    • 9
  • Markus Zuber
    • 10
  • Friedrich Mross
    • 11
  • Holger Dietrich
    • 12
  1. 1.Division of Haematology and OncologyUniversity of InnsbruckInnsbruckAustria
  2. 2.Department of PathologyUniversity of InnsbruckInnsbruckAustria
  3. 3.Department of PathologyUniversity of BaselSwitzerland
  4. 4.Department of Internal MedicineUniversity of BaselSwitzerland
  5. 5.Department of Obstetrics and GynaecologyUniversity of BaselSwitzerland
  6. 6.Institute of Pathology and Cytology Boss and SpichtinBaselSwitzerland
  7. 7.Department of PathologyCity Hospital ZürichZürichSwitzerland
  8. 8.Department of SurgeryCity Hospital ZürichZürichSwitzerland
  9. 9.Department of Obstetrics and GynaecologyCity Hospital ZürichZürichSwitzerland
  10. 10.Surgery Hospital OltenOltenSwitzerland
  11. 11.City Hospital LörrachLörrachGermany
  12. 12.Gynaecological Hospital RheinfeldenRheinfeldenGermany

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