Expression of cell adhesion molecules and prognosis in breast cancer.

S Saadatmand, E M de Kruijf, A Sajet, N G Dekker-Ensink, J G H van Nes, H Putter, V T H B M Smit, C J H van de Velde, G J Liefers, P J K Kuppen

Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands.

The British journal of surgery 2013 Jan

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Cell adhesion molecules (CAMs) play an important role in the process of metastasis. The prognostic value of tumour expression of N-cadherin, E-cadherin, carcinoembryonic antigen (CEA) and epithelial CAM (Ep-CAM) was evaluated in patients with breast cancer. A tissue microarray of the patient cohort was stained immunohistochemically for all markers and analysed by microscopy. Expression was classified into two categories, with the median score as cut-off level. For CEA, the above-median category was further subdivided in two subgroups based on staining intensity (low or high intensity). The cohort consisted of 574 patients with breast cancer with a median follow-up of 19 years. Below-median expression of E-cadherin (P = 0·015), and above-median expression of N-cadherin (P = 0·004), Ep-CAM (P = 0·046) and CEA (P = 0·001) all resulted in a shorter relapse-free period. Multivariable analysis revealed E-cadherin and CEA to be independent prognostic variables. Combined analysis of CEA and E-cadherin expression showed a 3·6 times higher risk of relapse for patients with high-intensity expression of CEA, regardless of E-cadherin expression, compared with patients with below-median CEA and above-median E-cadherin tumour expression (hazard ratio 3·60, 95 per cent confidence interval 2·12 to 6·11; P < 0·001). An interaction was found between expression of these two CAMs (P < 0·001), suggesting a biological association. Combining E-cadherin and CEA tumour expression provides a prognostic parameter with high discriminative power that is a candidate tool for prediction of prognosis in breast cancer. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Citation

S Saadatmand, E M de Kruijf, A Sajet, N G Dekker-Ensink, J G H van Nes, H Putter, V T H B M Smit, C J H van de Velde, G J Liefers, P J K Kuppen. Expression of cell adhesion molecules and prognosis in breast cancer. The British journal of surgery. 2013 Jan;100(2):252-60