Epithelial Cell Adhesion Molecule (EpCAM) Expression in Human Tumors: A Comparison with Pan-Cytokeratin and TROP2 in 14,832 Tumors

Our plain-English summary of Epithelial Cell Adhesion Molecule (EpCAM) Expression in Human Tumors: A Comparison with Pan-Cytokeratin and TROP2 in 14,832 Tumors, by A. Menz, N. Lony, M. Lennartz, et al (Diagnostics, 2024).

The study

• Authors: A. Menz, N. Lony, M. Lennartz, S. Dwertmann Rico, R. Schlichter, S. Kind, V. Reiswich, F. Viehweger, D. Dum, A.M. Luebke, M. Kluth, N. Gorbokon, C. Hube-Magg, C. Bernreuther, R. Simon, T.S. Clauditz, G. Sauter, A. Hinsch, F. Jacobsen, A.H. Marx, S. Steurer, S. Minner, E. Burandt, T. Krech, P. Lebok, S. Weidemann
• Journal: Diagnostics
• Published: 2024;14(10)
• Cited by: 20 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

EpCAM is expressed in many epithelial tumors and is used for the distinction of malignant mesotheliomas from adenocarcinomas and as a surrogate pan-epithelial marker. A tissue microarray containing 14,832 samples from 120 different tumor categories was analyzed by immunohistochemistry. EpCAM staining was compared with TROP2 and CKpan. EpCAM staining was detectable in 99 tumor categories. Among 78 epithelial tumor types, the EpCAM positivity rate was ≥90% in 60 categories-including adenocarcinomas, neuroendocrine neoplasms, and germ cell tumors. EpCAM staining was the lowest in hepatocellular carcinomas, adrenocortical tumors, renal cell neoplasms, and in poorly differentiated carcinomas. A comparison of EpCAM and CKpan staining identified a high concordance but EpCAM was higher in testicular seminomas and neuroendocrine neoplasms and CKpan in hepatocellular carcinomas, mesotheliomas, and poorly differentiated non-neuroendocrine tumors. A comparison of EpCAM and TROP2 revealed a higher rate of TROP2 positivity in squamous cell carcinomas and lower rates in many gastrointestinal adenocarcinomas, testicular germ cell tumors, neuroendocrine neoplasms, and renal cell tumors. These data confirm EpCAM as a surrogate epithelial marker for adenocarcinomas and its diagnostic utility for the distinction of malignant mesotheliomas. In comparison to CKpan and TROP2 antibodies, EpCAM staining is particularly common in seminomas and in neuroendocrine neoplasms.

In plain English

This laboratory study tested archived tumor tissue from three German pathology institutes for EpCAM, a protein found on many epithelial cells. The article did not study asbestos exposure. Small tissue cores from 14,832 tumors of 120 types, collected between 2005 and 2020, were stained with an EpCAM antibody, and 12,780 samples could be evaluated. EpCAM staining was found in 10,513 (82.3%) of these. It was seen in 16.7% of 24 epithelioid and 30.2% of 53 biphasic malignant mesotheliomas, always limited to the epithelioid cells, but in 100% of 147 lung adenocarcinomas. Compared with earlier pan-cytokeratin results from the same tissues, EpCAM was positive less often in mesotheliomas and more often in testicular seminomas (100% versus 23.2%). In breast cancer of no special type, high EpCAM staining was linked to higher grade and distant metastasis. No significant link to survival was seen in breast, urothelial or clear cell renal cancers. The authors concluded that the data confirm EpCAM's diagnostic usefulness for distinguishing malignant mesotheliomas from lung adenocarcinoma.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Laboratory immunohistochemistry study of tumor and normal tissue samples arranged on tissue microarrays
• Who was studied: 14,832 primary tumor samples from 120 tumor types and subtypes, plus 76 normal tissue types (8 donors each), from archives in Hamburg, Osnabrueck and Fuerth, Germany, collected between 2005 and 2020
• Exposure: No asbestos exposure was studied. Tissues were stained with the EpCAM antibody MSVA-326R, and results were compared with pan-cytokeratin (CKpan) and TROP2 staining data from previous studies of the same tissue cohort
• Main results:
  • 12,780 (86.2%) of 14,832 tumor samples were interpretable
  • EpCAM staining was detectable in 10,513 (82.3%) of the 12,780 analyzable tumors
  • EpCAM positivity was seen in 16.7% of 24 epithelioid and 30.2% of 53 biphasic malignant mesotheliomas, with tumor cell staining always limited to epithelioid cells
  • EpCAM positivity was seen in 100% of 147 lung adenocarcinomas
  • Compared with CKpan, the EpCAM positivity rate was higher in testicular seminomas (EpCAM 100%, CKpan 23.2%, p less than 0.0001)
  • Compared with CKpan, the EpCAM positivity rate was lower in mesotheliomas, hepatocellular carcinomas and very poorly differentiated tumors
  • In epithelioid mesotheliomas, 9.1% were positive for EpCAM alone, 13.6% for TROP2 alone, and 4.5% for both
  • In breast cancer of no special type, high EpCAM staining was linked to high grade (p less than 0.0001), distant metastasis (p = 0.0006), ER/PR loss (p less than 0.0001 each) and HER2 positivity (p = 0.0009)
  • No significant associations with overall or recurrence-free survival were seen in breast, urothelial and clear cell renal carcinomas
• The authors' conclusion: The authors concluded that their data confirm EpCAM as a surrogate epithelial marker for adenocarcinomas and its diagnostic utility for distinguishing malignant mesotheliomas from pulmonary adenocarcinoma

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Adenocarcinoma, Immunohistochemistry, Neoplasm, Germ Cell Tumor, Carcinoma, Squamous Cell Carcinoma.

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