Prognostic and diagnostic implications of epithelial cell adhesion/activating molecule (EpCAM) expression in renal tumours: a retrospective clinicopathological study of 948 cases using tissue microarrays. (15th January 2014)

• Record Type: Journal Article
• Authors: Zimpfer, Annette; Maruschke, Matthias; Rehn, Stefan; Kundt, Guenter; Litzenberger, Anke; Dammert, Friederike; Zettl, Heike; Stephan, Carsten; Hakenberg, Oliver W.; Erbersdobler, Andreas
• Is Part Of: BJU international. Volume 114:Number 2(2014:Aug.)
• Page Start: 296
• Page End: 302
• Publication Date: 2014-01-15
• Subjects: Genitourinary organs -- Diseases -- Periodicals; Genitourinary organs -- Surgery -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1111/bju.12487
• Languages: English
• ISSNs: 1464-4096

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bju12487-sec-0001" sec-type="section"> <title>Objective</title> <p> <list id="bju12487-list-0001" list-type="bullet"> <list-item> <p>To evaluate the expression and prognostic value of epithelial cell adhesion/activating molecule (EpCAM) in a large set of renal cell carcinomas (RCCs) using a tissue microarray (TMA) approach.</p> </list-item> </list> </p> </sec> <sec id="bju12487-sec-0002" sec-type="section"> <title>Material and Methods</title> <p> <list id="bju12487-list-0002" list-type="bullet"> <list-item> <p>We studied the immunohistochemical expression and overexpression of EpCAM on TMAs containing formalin‐fixed, paraffin‐embedded samples of 948 patients with documented renal tumours.</p> </list-item> <list-item> <p>EpCAM expression was defined as the presence of a specific membranous staining in >5% of the tumour cells.</p> </list-item> <list-item> <p>EpCAM overexpression was specified by calculating a total staining score (score range 0–12) as the product of a proportion score and an intensity score, and defined as a score >4.</p> </list-item> </list> </p> </sec> <sec id="bju12487-sec-0003" sec-type="section"> <title>Results</title> <p> <list id="bju12487-list-0003" list-type="bullet"> <list-item> <p>Of 948 cases, 927 (97.8%) were evaluable morphologically (haematoxylin and eosin stain). EpCAM expression was found in 233/642 (36.3%), 126/155 (81.3%), 54/68 (78.3%), 17/45 (37.8%), 13/30 (43.3%) of clear‐cell RCC, papillary RCC (pRCC), chromophobe RCC (cpRCC), oncocytomas and other unclassified tumour types, respectively.</p> </list-item> <list-item> <p>Log‐rank tests showed a significantly longer overall survival (OS [<italic>P</italic> = 0.047]) and a trend of EpCAM expression to be associated with a longer progression‐free survival (PFS) in all RCC entities (<italic>P</italic> = 0.065).</p> </list-item> <list-item> <p>EpCAM overexpression was significantly correlated with a better PFS in all RCC subtypes, cpRCC and pRCC (<italic>P</italic> = 0.011, 0.043 and 0.025, respectively).</p> </list-item> <list-item> <p>In multivariate analysis EpCAM overexpression was an independent marker for longer PFS in all RCC entities as well as in high grade RCC (<italic>P</italic> = 0.009 and <italic>P</italic> = 0.010, respectively).</p> </list-item> </list> </p> </sec> <sec id="bju12487-sec-0004" sec-type="section"> <title>Conclusions</title> <p> <list id="bju12487-list-0004" list-type="bullet"> <list-item> <p>The histological subtypes associated with a high rate of EpCAM expression were cpRCC and pRCC.</p> </list-item> <list-item> <p>This retrospective analysis demonstrated a trend towards longer OS and PFS for all major RCC subtypes.</p> </list-item> <list-item> <p>EpCAM expression had significant prognostic value in patients with cpRCC and pRCC. Furthermore, EpCAM overexpression in high grade RCC may be a helpful marker for prognostication.</p> </list-item> </list> </p> </sec> </abstract>