Impact of the EpCAM expression on biochemical recurrence-free survival in clinically localized prostate cancer
Impact of the EpCAM expression on biochemical recurrence-free survival in clinically localized prostate cancer
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DOI：
10.1016/j.urolonc.2011.03.007
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发表时间：
2013-05-01
影响因子：
2.7
通讯作者：
Tomas, Davor
中科院分区：
文献类型：
--
作者：
Benko, Goran;Spajic, Borislav;Tomas, Davor
背景：上皮细胞黏附分子(EpCAM)是一种跨膜糖蛋白，最初被认为是肿瘤的标志物，因为它在快速增殖的上皮性肿瘤中高表达。EpCAM的作用不仅限于细胞黏附，还包括信号传导、细胞迁移、增殖和分化等多种过程。目的：多项研究探讨了EpCAM在前列腺癌中的表达，但没有一项研究证实其在前列腺癌中的预后作用。本研究的目的是探讨EPCAM在前列腺癌中的表达及其与确定的预后特征的关系。材料和方法：本研究包括102例因临床局限性前列腺癌而接受根治性前列腺癌切除术的患者。采用免疫组织化学方法检测前列腺癌和非肿瘤性前列腺癌组织中EpCAM的表达。结果：前列腺癌组织中EpCAM的表达程度明显高于良性前列腺组织(P<；0.001)。前列腺癌组织中EPCAM的表达与术前(P=0.009)、术后(P=0.004)Gleason评分和随访时间(P<；0.001)等预后不良指标相关。术前术后Gleason评分越高、随访时间越短的患者，其EPCAM的表达水平越高。随访时间与EpCAM表达呈负相关，提示BCR患者肿瘤组织中EPCAM表达水平较高。此外，bcr组EPCAM的表达明显高于非bcr组(P<；0.001)。T3期肿瘤的EPCAM表达明显高于T2期肿瘤(P=0.002)。单因素(P<；0.001)和多因素(P<；0.001)分析表明，EpCAM的表达是预测前列腺癌患者较短的生化复发无生存时间的重要因素。结论：我们的结果证实了EPCAM在前列腺癌中的高水平表达，并支持其在前列腺癌进展中的潜在作用。此外，EpCAM可以作为一个额外的预后标志物，用于识别需要引入二次治疗的疾病复发风险增加的患者。(C)2013 Elsevier Inc.保留所有权利。
Background: The epithelial cell adhesion molecule (EpCAM) is a transmembrane glycoprotein that was originally identified as a marker for carcinoma, attributable to its high expression on rapidly proliferating tumors of epithelial origin. The role of EpCAM is not limited to cell adhesion but includes diverse processes such as signaling, cell migration, proliferation, and differentiation.Objective: Several studies investigated EpCAM expression in prostate carcinoma but none of them confirmed its prognostic role. The aim of our study was to investigate EpCAM expression and its relationship with established prognostic features in prostate carcinoma.Materials and methods: The study included a cohort of 102 patients treated with radical prostatectomy for clinically localized prostate carcinoma. Immunohistochemistry was performed to evaluate the EpCAM expression in prostate cancer and non-neoplastic prostate tissue. The percentage of positively stained carcinoma and benign glands was examined in the whole mount of the chosen slide.Results: The extent of EpCAM expression was significantly higher in malignant than in benign prostatic tissue (P < 0.001). EpCAM expression in prostate cancer was associated with established features indicative of worse prognosis, such as preoperative (P = 0.009) and postoperative (P = 0.004) Gleason score and follow-up time (P < 0.001). Patients with higher preoperative and postoperative Gleason score and short follow-up time had tumors with a significantly higher expression of EpCAM. Negative correlation of follow-up time and EpCAM expression indicated that tumors in patients with biochemical recurrence (BCR) harbored higher EpCAM expression. Moreover, expression of EpCAM was significantly higher in patients with BCR compared with patients without BCR (P < 0.001). Tumors in T3 stage of the disease showed significantly higher EpCAM expression compared with T2 tumors (P = 0.002). Univariate (P < 0.001) and multivariate (P < 0.001) analyses showed that EpCAM expression was a significant predictor of shorter biochemical recurrence free-survival.Conclusion: Our results confirmed high level of EpCAM expression in prostate cancer and support its potential role in prostatic cancer progression. In addition, EpCAM could serve as an additional prognostic marker for the recognition of patients with an increased risk of disease recurrence that need introduction of secondary therapy. (C) 2013 Elsevier Inc. All rights reserved.