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J Clin Pathol doi:10.1136/jcp.2006.037333

Ep-CAM expression in pancreatic and ampullary carcinomas: frequency and prognostic relevance

  1. Dominic Fong (dominic.fong{at}uibk.ac.at)
  1. Department of Hematology & Oncology, Innsbruck Medical University, Austria
    1. Michael Steurer (michael.steurer{at}uibk.ac.at)
    1. Department of Hematology & Oncology, Innsbruck Medical University, Austria
      1. Peter Obrist
      1. Department of Pathology, Innsbruck Medical University, Austria
        1. Verena Barbieri
        1. Department of Biostatistics, Innsbruck Medical University, Austria
          1. Raimund Margreiter
          1. Tyrolean Cancer Research Institute, Austria
            1. Albert Amberger
            1. Tyrolean Cancer Research Institute, Austria
              1. Klaus Laimer
              1. Tyrolean Cancer Research Institute, Austria
                1. Guenther Gastl
                1. Department of Hematology & Oncology, Innsbruck Medical University, Austria
                  1. Alexandar Tzankov
                  1. Department of Pathology, Innsbruck Medical University, Austria
                    1. Gilbert Spizzo (gilbert.spizzo{at}uibk.ac.at)
                    1. Department of Hematology & Oncology, Innsbruck Medical University, Austria
                      • Published Online First 14 June 2006

                      Abstract

                      Aims: Pancreatic adenocarcinoma is an aggressive gastrointestinal malignancy with only a few long-term survivors even after radical surgery. Patients with ampullary cancer have a better prognosis but adjuvant therapy needs further improvement. Epithelial cell adhesion molecule (Ep-CAM) is strongly expressed in a variety of epithelial cancers and represents a promising target for immunologic tumor therapy. Thus, the aim of this study was to investigate Ep-CAM expression and its potential prognostic impact in pancreatic and ampullary carcinomas.

                      Methods: Ep-CAM expression was investigated retrospectively by immunohistochemistry in paraffin-embedded primary tumor tissue samples from a series of consecutive patients with pancreatic (n=153) and ampullary cancer (n=34).

                      Results: Ep-CAM overexpression was observed in 85 of 153 pancreatic cancer specimens (56%) and in 29 of 34 ampullary cancer samples (85%). Overall, Ep-CAM failed to be an independent prognostic marker. However, subgroup analyses showed that Ep-CAM overexpression correlated with shorter overall survival amongst patients with ampullary cancer and advanced stage pancreatic cancer, respectively. In the latter subgroup survival gradually worsened with increasing Ep-CAM scores. Furthermore, in ampullary cancer Ep-CAM overexpression was found to correlate with tumor stage.

                      Conclusions: Ep-CAM overexpression was detectable in the majority of cases with pancreatic and ampullary cancer. Therefore, Ep-CAM represents an attractive target for immune-based therapeutic interventions in these tumor entities. However, the prognostic value of Ep-CAM overexpression remains undetermined.

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