Prince Sagit, Zeidman Aliza, Dekel Yoram, Ram Edward, Koren Rumelia
Department of Internal Medicine B, Rabin Medical Center, Petach Tikva.
Am J Clin Pathol. 2008 Mar;129(3):424-9. doi: 10.1309/H8JEEAEB69J3KYND.
Gallbladder carcinoma is rare and fatal, and conventional therapies have been disappointing. Epithelial cell adhesion molecule (EpCAM) serves as a prognostic marker in various carcinomas and is a target of antibody-based therapies. Our purpose was to examine the expression of EpCAM in gallbladder carcinomas in relation to tumor grade, disease stage, and patient survival. Gallbladder carcinoma tissue specimens from 25 patients attending our center between 1991 and 2004 were immunohistochemically stained for EpCAM. The intensity and extent of staining were analyzed, and the specimens were classified accordingly: (1) weak, weak or no EpCAM expression in less than 10% of the selected area; (2) moderate, moderate expression in 10% to 49% of the selected area; or (3) strong, heavy staining in 50% or more of the selected area. The correlation between EpCAM expression and clinicopathologic variables was analyzed statistically.EpCAM overexpression predicted decreased survival (P = .005), but EpCAM expression did not correlate with tumor grade (P = .28) or disease stage (P = .10). EpCAM expression in gallbladder tumors may serve as a prognostic factor for poor survival. Its detection may help clinicians select patients likely to benefit from novel molecular therapies.
胆囊癌罕见且致命,传统疗法一直令人失望。上皮细胞粘附分子(EpCAM)在多种癌症中作为一种预后标志物,并且是基于抗体疗法的靶点。我们的目的是研究EpCAM在胆囊癌中的表达与肿瘤分级、疾病分期及患者生存率的关系。对1991年至2004年间在我们中心就诊的25例患者的胆囊癌组织标本进行EpCAM免疫组化染色。分析染色强度和范围,并据此将标本分类:(1)弱,在选定区域少于10%的细胞中EpCAM表达弱、弱或无表达;(2)中度,在选定区域10%至49%的细胞中表达中度;或(3)强,在选定区域50%或更多的细胞中染色重。对EpCAM表达与临床病理变量之间的相关性进行统计学分析。EpCAM过表达预示生存率降低(P = 0.005),但EpCAM表达与肿瘤分级(P = 0.28)或疾病分期(P = 0.10)无关。胆囊肿瘤中EpCAM表达可能是生存率低的一个预后因素。其检测可能有助于临床医生选择可能从新型分子疗法中获益的患者。