ORIGINAL ARTICLE

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

M Burkhardt^1,*, E Mayordomo^1,*, K-J Winzer², F Fritzsche¹, T Gansukh¹, S Pahl¹, W Weichert¹, C Denkert¹, H Guski¹, M Dietel¹ and G Kristiansen¹

¹ Institute of Pathology, Charité-Universitätsmedizin, Berlin, Germany
² Interdisciplinary Breast Centre, Charité-Universitätsmedizin

Correspondence to:
Correspondence to:
Dr Glen Kristiansen
Institute of Pathology, Charité Hospital, Campus Mitte, Schumannstr 20/21, D-10117 Berlin, Germany; glen.kristiansen{at}charite.de

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.

Abbreviations: ALCAM, activated leucocyte cell adhesion molecule; DCIS, ductal carcinoma in situ; IRS, immunoreactive score

Keywords: breast cancer; ALCAM; prognostic marker; immunohistochemistry

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