ALCAM (CD166) expression and serum levels are markers for poor survival of esophageal cancer patients

• Published in: International journal of cancer Vol. 131; no. 2; pp. 396 - 405
• Main Authors: Tachezy, Michael, Effenberger, Katharina, Zander, Hilke, Minner, Sarah, Gebauer, Florian, Vashist, Yogesh K., Sauter, Guido, Pantel, Klaus, Izbicki, Jakob R., Bockhorn, Maximilian
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 15.07.2012; Wiley-Blackwell; Wiley Subscription Services, Inc
• Subjects: Activated-Leukocyte Cell Adhesion Molecule - blood; Activated-Leukocyte Cell Adhesion Molecule - metabolism; Adult; Aged; Aged, 80 and over; ALCAM; Biological and medical sciences; biomarker; Biomarkers; Biomarkers, Tumor - blood; Biomarkers, Tumor - metabolism; Bone marrow; Cancer; Esophageal cancer; Esophageal Neoplasms - metabolism; Esophageal Neoplasms - mortality; Esophageal Neoplasms - pathology; Esophagus; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Immunohistochemistry; Keratins - analysis; Male; Medical research; Medical sciences; Middle Aged; Mortality; Multivariate analysis; Neoplasm Grading; Prognosis; Protein Array Analysis; Retrospective Studies; Tumors; Human; Prognosis; esophageal cancer; Esophageal disease; Cell adhesion molecule; Biological marker; Malignant tumor; biomarker; Survival; Esophagus cancer; Cancerology; ALCAM; Digestive diseases; Activated leukocyte cell adhesion molecule; Serum; Cancer
• ISSN: 0020-7136; 1097-0215; 1097-0215
• DOI: 10.1002/ijc.26377

The expression of the activated leukocyte cell adhesion molecule (ALCAM and CD166) is increased in various types of cancer. We aimed to evaluate its role as a prognostic marker for esophageal cancer (EC). We retrospectively analyzed ALCAM expression in 299 primary lesions, 147 lymph node and 46 distant metastases from EC patients, on a tissue microarray using immunohistochemistry. Bone marrow samples from representative cancer patients (n = 16), taken before primary surgery, were stained by double‐immunofluorescence for ALCAM and cytokeratins (CK). Blood serum samples from 236 cancer patients and 127 controls were analyzed for serum ALCAM (s‐ALCAM) by ELISA. The immunohistochemical analysis showed increased ALCAM expression in the majority of lesions (primary tumor 71%, lymph node 76% and distant metastases 80%). ALCAM expression was not associated with histopathological parameters except for tumor grading (p = 0.015). ALCAM‐positive patients had significantly worse recurrence‐free and overall survival (OS; p = 0.002). Disseminated tumor cells (DTC) in bone marrow showed two phenotypes, ALCAM+/CK+ (36%) and ALCAM‐/CK+ (64%). Multivariate analysis revealed that ALCAM expression and elevated s‐ALCAM serum values are powerful prognostic variables for OS in patients with EC (hazard ratio [HR] 3.987, 95% confidence interval [95%CI] 1.906–8.340, p < 0.001 and HR 1.915, 95%CI 1.021–3.592, p = 0.043). The results of our study provide preliminary evidence for the potential clinical utility of ALCAM as a prognostic biomarker for EC, which might be a basis for future clinical application. In addition, ALCAM expression in a subset of DTC of the bone marrow indicates a potential function in the metastatic cascade of EC.