The Prognostic Impact of the Carcinoembryonic Antigen in Ampullary Cancer - A Retrospective Single Center Study

Hannah Fuellgraf^1,5✉, Oliver Schilling^5,6,7, Zon Weng Lai⁶, Birte Kulemann², Sylvia Timme¹, Frank Makowiec^2,4, Jasmin H. Shahinian⁸, Jens Hoeppner^2,4, Martin Werner^1,4,5, Ulrich T. Hopt², Ulrich F. Wellner^3*, Peter Bronsert^1,4,5*

1. Institute for Surgical Pathology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany;
2. Clinic for General and Visceral Surgery, University of Freiburg, Faculty of Medicine, University of Freiburg, Germany;
3. Clinic for Surgery, University Clinic Schleswig-Holstein Campus Lübeck, Germany;
4. Comprehensive Cancer Center Freiburg, Medical Center - University of Freiburg, Germany;
5. German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany;
6. Institute of Molecular Medicine and Cell Research, University of Freiburg, Freiburg, Germany;
7. BIOSS Centre for Biological Signaling Studies, University of Freiburg, Freiburg, Germany.
8. Division of Cardiac Surgery, University Hospital Basel, Basel, Switzerland.
*Ulrich Wellner and Peter Bronsert share last Authorship.

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Citation:
Fuellgraf H, Schilling O, Lai ZW, Kulemann B, Timme S, Makowiec F, Shahinian JH, Hoeppner J, Werner M, Hopt UT, Wellner UF, Bronsert P. The Prognostic Impact of the Carcinoembryonic Antigen in Ampullary Cancer - A Retrospective Single Center Study. J Cancer 2017; 8(4):657-664. doi:10.7150/jca.16200. Available from http://www.jcancer.org/v08p0657.htm

Abstract

Background: Carcinoembryonic antigen cell adhesion molecule (CEA) is a commonly immunohistochemically used antibody in pathological routine diagnostics with an overexpression in different cancers. We aimed to examine the immunohistochemically detectable CEA level in ampullary cancer and to correlate it with clinico-pathological data.

Methods: Shot-gun proteomics revealed CEA in undifferentiated ampullary cancer cell lines. Next, tumor tissue of 40 ampullary cancers of a retrospective single center cohort of 40 patients was stained immunohistochemically for CEA; CEA expression was determined and correlated with clinico-pathological data.

Results: Thirty-six patient specimens were included in statistical analysis. CEA expression and lymph node ratio (LNR) were the only independent predictors of overall survival in multivariate analysis.

Conclusion: To our knowledge, cell line and patient cohorts are the largest and characterized cohorts examined for CEA so far. Hereby, CEA expression in ampullary cancer cells permits an estimation of outcome and suggests an opportunity for individualized CEA-directed therapy. Further trials with larger cohorts are needed to verify our results and to integrate CEA immunohistochemistry into clinical routine.

Keywords: CEA, ampullary cancer, carcinoembryonic antigen.