Cytoplasmic overexpression of ALCAM is prognostic of disease progression in breast cancer

• Published in: Journal of clinical pathology Vol. 59; no. 4; pp. 403 - 409
• Main Authors: Burkhardt, M, Mayordomo, E, Winzer, K-J, Fritzsche, F, Gansukh, T, Pahl, S, Weichert, W, Denkert, C, Guski, H, Dietel, M, Kristiansen, G
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Association of Clinical Pathologists 01-04-2006; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: activated leucocyte cell adhesion molecule; Activated-Leukocyte Cell Adhesion Molecule - analysis; Adult; Aged; Aged, 80 and over; ALCAM; Biological and medical sciences; Biomarkers, Tumor - analysis; Breast - chemistry; Breast cancer; Breast Neoplasms - chemistry; Breast Neoplasms - mortality; Breast Neoplasms - pathology; Carcinoma, Ductal, Breast - chemistry; Carcinoma, Ductal, Breast - mortality; Carcinoma, Ductal, Breast - pathology; Case-Control Studies; Cell Membrane - chemistry; Chemotherapy; Cytoplasm - chemistry; DCIS; Disease Progression; Disease-Free Survival; ductal carcinoma in situ; Female; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; immunohistochemistry; Immunohistochemistry - methods; immunoreactive score; Investigative techniques, diagnostic techniques (general aspects); IRS; Localization; Lymphatic Metastasis; Mammary gland diseases; Medical prognosis; Medical sciences; Melanoma; Metastasis; Middle Aged; Multivariate Analysis; Neoplasm Staging; Original; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Prognosis; prognostic marker; Prostate cancer; Protein expression; Skin cancer; Studies; Survival analysis; Survival Rate; Tumors; Variables; Germany; Mammary gland diseases; Anatomic pathology; Prognosis; Breast disease; Tumor progression; Cell adhesion molecule; Gene overexpression; Activated leukocyte cell adhesion molecule; Breast cancer; Malignant tumor; Cytoplasm
• ISSN: 0021-9746; 1472-4146
• DOI: 10.1136/jcp.2005.028209

Background: Activated leucocyte cell adhesion molecule (ALCAM, CD166) is a cell surface member of the immunoglobulin superfamily. ALCAM expression has prognostic relevance in prostate and colon cancer. Objective: To evaluate ALCAM protein expression in breast cancer by immunohistochemistry and to correlate expression levels with clinicopathological data. Methods: 162 primary breast carcinomas with a mean clinical follow up time of 53 months were immunostained using a monoclonal ALCAM antibody. The staining was evaluated as an immunoreactive score (IRS) and grouped into low v high for both membranous and cytoplasmic staining. Results: Intraductal and invasive carcinomas showed a higher ALCAM expression (median IRS 4 and 6 respectively) than normal breast tissue (IRS 2). In univariate survival analyses a significant association of high cytoplasmic ALCAM expression with shortened patient disease-free survival (mean (SD) five year non-progression rate, 69.4 (4.6)% v 49.4 (11.1)%, p = 0.0142) was found. In multivariate analyses of disease-free survival times, high cytoplasmic ALCAM expression (relative risk (RR) = 2.086, p = 0.026) and nodal status (RR = 2.246, p = 0.035) were significantly associated with earlier disease progression, whereas tumour grading (RR = 1.6, p = 0.052) was of borderline significance. Conclusions: The data suggest that strong cytoplasmic ALCAM expression in primary breast cancer, as detected by immunohistochemistry, might be a new marker for a more aggressive breast cancer biology.