Kroepil Feride, Dulian Agnieszka, Vallböhmer Daniel, Geddert Helene, Krieg Andreas, Vay Christian, Topp Stefan A, am Esch Jan Schulte, Baldus Stephan E, Gires Olivier, Knoefel Wolfram T, Stoecklein Nikolas H
Department of Surgery (A), Heinrich-Heine-University and University Hospital Duesseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany.
BMC Res Notes. 2013 Jul 5;6:253. doi: 10.1186/1756-0500-6-253.
The association of EpCAM expression with the progression of gastric cancer remains unclear. Here, we investigated the expression of EpCAM in gastric cancer subtypes and correlated the data to tumor cell proliferation and clinicopathologic factors.
The intratumoral expression of EpCAM was assessed in 163 primary gastric cancers (61 diffuse-, 62 intestinal-, 32 mixed-type and 8 unclassified tumors) by immunohistochemistry, using the monoclonal antibody Ber-EP4. Intensity of staining was classified according the HercepTest-score using a standardized scoring system. Ki-67 was used to examine the proliferation in tumor tissue.
Strong EpCAM expression was observed in 77% of the tumors and in 85% of the corresponding lymph nodes. Of the primary tumors, 58% (n=74) presented a homogeneous intratumoral EpCAM expression while 42% were characterised by a heterogenous expression pattern. Tumors with high EpCAM expression at the invasive front were associated with significantly (p=0.03) higher proportion of lymph node metastases and lower median overall survival (p=0.001). Diffuse type tumors presented a significantly higher EpCAM expression at the invasion front compared with the tumor centre (p=0.036). Multivariate survival analysis identified high EpCAM expression at the invasive front as an independent prognostic factor.We observed a significant (p=0.001) correlation between high EpCAM expression and higher tumor cell proliferation.
High EpCAM expression associates with proliferation and progression of gastric cancer, especially in the diffuse type. Considering the discontenting results of the current adjuvant concepts for gastric cancer patients, EpCAM might be target in the adjuvant therapy of this malignant disease.
上皮细胞粘附分子（EpCAM）表达与胃癌进展之间的关联尚不清楚。在此，我们研究了EpCAM在胃癌亚型中的表达情况，并将数据与肿瘤细胞增殖及临床病理因素相关联。
采用单克隆抗体Ber-EP4，通过免疫组织化学法评估163例原发性胃癌（61例弥漫型、62例肠型、32例混合型和8例未分类肿瘤）中EpCAM的瘤内表达。使用标准化评分系统，根据赫赛汀检测评分对染色强度进行分类。采用Ki-67检测肿瘤组织中的增殖情况。
77%的肿瘤及85%的相应淋巴结中观察到EpCAM强表达。在原发性肿瘤中，58%（n = 74）呈现瘤内EpCAM均匀表达，而42%的特征为异质性表达模式。侵袭前沿EpCAM高表达的肿瘤与淋巴结转移比例显著更高（p = 0.03）及较低的中位总生存期相关（p = 0.001）。与肿瘤中心相比，弥漫型肿瘤在侵袭前沿的EpCAM表达显著更高（p = 0.036）。多因素生存分析确定侵袭前沿EpCAM高表达为独立预后因素。我们观察到EpCAM高表达与较高的肿瘤细胞增殖之间存在显著相关性（p = 0.001）。
EpCAM高表达与胃癌的增殖及进展相关，尤其是在弥漫型中。鉴于目前胃癌患者辅助治疗概念的不尽人意结果，EpCAM可能成为这种恶性疾病辅助治疗的靶点。
