Association between EPCAM upregulation and clinicopathological parameters and outcomes of breast cancer

Nahid Nafissi; Saeed Azad Armaki; Ebrahim Babaee; Pegah Babaheidarian; Elaheh Safari; Soheila Sayad; Samine Saghafinia; Masoumeh Safaee

doi:10.62347/EGXS1506

Association between EPCAM upregulation and clinicopathological parameters and outcomes of breast cancer

Int J Clin Exp Pathol. 2024 Nov 15;17(11):421-428. doi: 10.62347/EGXS1506. eCollection 2024.

Authors

Nahid Nafissi¹, Saeed Azad Armaki², Ebrahim Babaee³, Pegah Babaheidarian⁴, Elaheh Safari⁵, Soheila Sayad⁶, Samine Saghafinia⁷, Masoumeh Safaee⁸

Affiliations

¹ Department of Breast Diseases Surgery, Breast Health and Cancer Research Center, Iran University of Medical Sciences Tehran, Iran.
² Khatam Hospital Tehran, Iran.
³ Department of Epidemiology, Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Community and Family Medicine Department, School of Medicine, Breast Health and Cancer Research Center, Iran University of Medical Sciences Tehran, Iran.
⁴ Department of Pathology, School of Medicine, Breast Health and Cancer Research Center, Iran University of Medical Sciences Tehran, Iran.
⁵ Department of Immunology, School of Medicine, Breast Health and Cancer Research Center, Iran University of Medical Sciences Tehran, Iran.
⁶ Department of Surgery, Breast Health and Cancer Research Center, Iran University of Medical Sciences Tehran, Iran.
⁷ Department of Medical Education, Student Research Committee, School of Medicine, Iran University of Medical Sciences Tehran, Iran.
⁸ Department of Surgery, School of Medicine, Isfahan University of Medical Sciences Isfahan, Iran.

Abstract

Introduction: EpCAM (epithelial cell adhesion molecule) protein expression was detected in 45 to 90% of breast cancers in different studies, and high expression levels were associated with poor outcomes in several retrospective analyses. This study aims to investigate the relationship between EpCAM and clinicopathological parameters and survival in breast cancer.

Methodology: This study was conducted as a Quasi-Experimental Cohort Study to explore 100 breast cancer patients. After the surgical excision of breast cancer, pathology blocks were deparaffinized and subjected to IHC (immunohistochemistry) for EpCAM examination. Using a Roche VENTANA Benchmark GX automated staining instrument and a well-established IHC staining protocol, the expression of EpCAM in breast cancer tissue was assessed. Independent sample T-test and Chi squared and Logistic Regression test with STATA version 17 software were used for data analysis.

Results: The difference in the distribution of the negative state of biomarkers (ER = estrogen receptor, PR = Progesterone receptor) and EPCAM positive group was significant (P-value = 0.002) (P-value = 0.006). A statistically insignificant distinction was observed in the distribution of the HER2 (human epidermal growth factor receptor) and EPCAM groups (P-value = 0.198). With 30.95% of those in the EPCAM-positive cohort experienced metastasis or recurrence. ER+ and PR+ decreased the chance of EPCAM positive by 0.25 and 0.29, respectively. HER2+ and Basal like breast cancer increase the chances of EPCAM being positive by 1.9 and 2.08, respectively. Basal like breast cancer increases the odds of EpCAM positive 2.19 times. Similarly, N2 and stage 3 increase the odds of EpCAM positive by 1.95 and 0.5 times, respectively.

Conclusion: We found that Basal like breast cancer, HER2+, and stage 3 increase the chance of EpCAM positivity. It seems that EPCAM positive cancer has more chance for recurrence and metastasis.

Keywords: Breast cancer; epithelial cell adhesion molecule; metastasis; recurrence; survival.