CEACAM1 Expression Distinguishes Indolent from Lethal Prostate Cancer
MA Svensson, D Tilki, S Shariat, BB Singer, O Reich, CG Stief, O Andren, SO Andersson, JE Johansson, F Demichelis, S Rafii, S Ergun, MA Rubin. Weill Cornell Medical College, New York, NY; University Hospital of Orebro, Orebro, Sweden; University Hospital of Grosshadern, Munich, Germany; Memorial Sloan Kettering Cancer Center, New York, NY; University Hospital of Essen, Essen, Germany
Background: Early detection of prostate cancer (PCa) has increased with the use of prostate specific antigen (PSA) screening. Many of these tumors will never progress to lethal disease, but without a good prognostic tool the number of over treated patients increases. Therefore, it is important to assess new markers which might aid in the prognosis of PCa. Previous studies have shown human carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) to be down regulated in several carcinomas, including PCa. It has been reported as independent predictor of disease specific outcome in malignant melanoma and adenocarcinoma of the lung.
Design: In the current study, we interrogate a population-based Watchful Waiting cohort (n=220) consisting of incidental PCa cases, with respect to CEACAM1 expression using immunohistochemistry (IHC). Equal proportions of men who died of prostate cancer or developed metastasis and men who lived a minimum of 10 years without clinical recurrence are included in this study. The follow up time is now up to 30 years.
Results: PCa tumors were classified as CEACAM1 positive or negative. Cases with CEACAM1 negative tumors had a significantly (p=0.0013) poorer overall survival compared to CEACAM1 positive tumors. Multivariate analysis shows that CEACAM1 status, next to age and Gleason score, as a significant independent prognostic factor for survival (HR 2.709; 95% CI 1.069-6.864); p=0.0357).
Conclusions: Expression of CEACAM1 was an independent prognostic factor in a population-based cohort of men with localized prostate cancer followed by watchful waiting therapy. Evaluating tumors for CEACAM1 may help stratify patients with PCa into low-risk and high-risk groups, which may be used to guide clinical decision making.
Category: Genitourinary (including renal tumors)
Monday, March 22, 2010 8:15 AM
Platform Session: Section A, Monday Morning