Zhang Xia, Li Jie, Gao Ming, Zhang Yan
Department of Oncology, Division of Fifth Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China.
Department of Pathology, Division of First Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China.
BMC Cancer. 2025 Apr 30;25(1):803. doi: 10.1186/s12885-025-14034-x.
The epithelial cell adhesion molecule (EpCAM) is a transmembrane glycoprotein that is overexpressed in various epithelial tumors and has been associated with tumor aggressiveness and unfavorable prognosis. This study aimed to explore the association between ultrasonic characteristics and EpCAM expression in papillary thyroid carcinoma (PTC), as well as the value in predicting the risk of cervical lymph node metastasis (CLNM).
Participants with suspected thyroid cancer underwent conventional and contrast-enhanced ultrasonography (CEUS) before surgery. Age, sex, and nodule features in ultrasound were recorded. Participants were classified based on the presence of CLNM. EpCAM expression was detected using immunohistochemistry. The risk predictors of CLNM were evaluated by using univariate and multivariate Cox model.
The final dataset included 53 participants, of whom 27(50.94%) had CLNM, while 26(49.06%) did not. The EpCAM-positive area (p < 0.001), score (p < 0.001), and nuclear expression (p = 0.027) were significantly different between the CLNM and non-CLNM groups. Receiver operating characteristic curve analysis showed that EpCAM score with 4.5 had sensitivity and specificity of 85.2% and 76.9%, respectively, for diagnosing CLNM. Multivariate logistic regression results showed that overexpression EpCAM (score ≧ 4.5) [OR:46.54, p = 0.007], tumor size ≧ 1.05 cm [OR:14.21,p = 0.01] and extrathyroidal extension (ETE) on CEUS [OR:113.33, p = 0.01] were independent risk factors of CLNM. Overexpression of EpCAM (62.07%, 18/29) correlated with ETE of PTC confirmed by postoperative pathology (p = 0.01, 0.027). No significant difference in PTC histological variants was detected based on EpCAM expression (p = 0.05).
EpCAM overexpression demonstrated a significant association with ETE and CLNM in PTC. The integration of ultrasonography with EpCAM expression profiling offers A promising multiparameter diagnostic model to enhance predictive accuracy. Further studies evaluating EpCAM expression in fine-needle aspiration biopsy (FNAB) samples are required to determine its possible preoperative predictive value.
上皮细胞粘附分子（EpCAM）是一种跨膜糖蛋白，在多种上皮性肿瘤中过度表达，并与肿瘤侵袭性和不良预后相关。本研究旨在探讨甲状腺乳头状癌（PTC）的超声特征与EpCAM表达之间的关联，以及其在预测颈部淋巴结转移（CLNM）风险中的价值。
疑似甲状腺癌的参与者在手术前行常规超声和超声造影（CEUS）检查。记录年龄、性别及超声下结节特征。根据是否存在CLNM对参与者进行分类。采用免疫组织化学法检测EpCAM表达。使用单因素和多因素Cox模型评估CLNM的风险预测因素。
最终数据集包括53名参与者，其中27名（50.94%）有CLNM，26名（49.06%）无CLNM。CLNM组和非CLNM组之间的EpCAM阳性面积（p < 0.001）、评分（p < 0.001）和核表达（p = 0.027）有显著差异。受试者工作特征曲线分析显示，EpCAM评分为4.5时，诊断CLNM的敏感性和特异性分别为85.2%和76.9%。多因素逻辑回归结果显示，EpCAM过表达（评分≧4.5）[比值比（OR）：46.54，p = 0.007]、肿瘤大小≧1.05 cm [OR：14.21，p = 0.01]和CEUS显示的甲状腺外侵犯（ETE）[OR：113.33，p = 0.01]是CLNM的独立危险因素。EpCAM过表达（62.07%，18/29）与术后病理证实的PTC的ETE相关（p = 0.01，0.027）。基于EpCAM表达未检测到PTC组织学变异的显著差异（p = 0.05）。
EpCAM过表达在PTC中与ETE和CLNM显著相关。超声检查与EpCAM表达谱分析相结合提供了一个有前景的多参数诊断模型，以提高预测准确性。需要进一步研究评估细针穿刺活检（FNAB）样本中EpCAM的表达，以确定其可能的术前预测价值。
