Expression of cell adhesion molecules and prognosis in breast cancer

Br J Surg. 2013 Jan;100(2):252-60. doi: 10.1002/bjs.8980. Epub 2012 Nov 22.


Background: Cell adhesion molecules (CAMs) play an important role in the process of metastasis. The prognostic value of tumour expression of N-cadherin, E-cadherin, carcinoembryonic antigen (CEA) and epithelial CAM (Ep-CAM) was evaluated in patients with breast cancer.

Methods: A tissue microarray of the patient cohort was stained immunohistochemically for all markers and analysed by microscopy. Expression was classified into two categories, with the median score as cut-off level. For CEA, the above-median category was further subdivided in two subgroups based on staining intensity (low or high intensity).

Results: The cohort consisted of 574 patients with breast cancer with a median follow-up of 19 years. Below-median expression of E-cadherin (P = 0·015), and above-median expression of N-cadherin (P = 0·004), Ep-CAM (P = 0·046) and CEA (P = 0·001) all resulted in a shorter relapse-free period. Multivariable analysis revealed E-cadherin and CEA to be independent prognostic variables. Combined analysis of CEA and E-cadherin expression showed a 3·6 times higher risk of relapse for patients with high-intensity expression of CEA, regardless of E-cadherin expression, compared with patients with below-median CEA and above-median E-cadherin tumour expression (hazard ratio 3·60, 95 per cent confidence interval 2·12 to 6·11; P < 0·001). An interaction was found between expression of these two CAMs (P < 0·001), suggesting a biological association.

Conclusion: Combining E-cadherin and CEA tumour expression provides a prognostic parameter with high discriminative power that is a candidate tool for prediction of prognosis in breast cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antigens, Neoplasm / metabolism
  • Breast Neoplasms / metabolism
  • Breast Neoplasms / mortality*
  • Cadherins / metabolism
  • Carcinoembryonic Antigen / metabolism
  • Carcinoma, Ductal, Breast / metabolism
  • Carcinoma, Ductal, Breast / mortality*
  • Cell Adhesion Molecules / metabolism*
  • Epithelial Cell Adhesion Molecule
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Neoplasm Proteins / metabolism*
  • Prognosis


  • Antigens, Neoplasm
  • Cadherins
  • Carcinoembryonic Antigen
  • Cell Adhesion Molecules
  • EPCAM protein, human
  • Epithelial Cell Adhesion Molecule
  • Neoplasm Proteins