LOW INTERCELLULAR-ADHESION MOLECULE-1 AND HIGH 5T4 EXPRESSION ON TUMOR-CELLS CORRELATE WITH REDUCED DISEASE-FREE SURVIVAL IN COLORECTAL-CARCINOMA PATIENTS

The purpose of this study was to investigate the prognostic value of t he expression of intercellular adhesion molecule 1 (ICAM-1), leukocyte function antigen 3 (LFA-3), human leukocyte differentiation antigen ( HLA)-ABC, HLA-DR, and 5T4 with regard to disease-free survival in Duke s' B and C colorectal carcinoma patients. Forty-one patients (28 Dukes ' B and 13 Dukes' C) were entered into this study. Immunocytochemistry was performed on cytospin preparations of enzymatically digested colo rectal carcinoma cell suspensions. The frequency of metastases and the duration of disease-free survival were compared between the 25% lowes t expressers and the 75% remaining patients for ICAM-1, LFA-3, HLA-ABC , and HLA-DR, and between the 25% highest expressers and the 75% remai ning patients for 5T4. Low numbers of ICAM-1-expressing tumor cells we re associated with a shorter disease-free survival (P < 0.001), indepe ndent of Dukes' stage. High numbers of 5T4-expressing tumor cells were associated with shorter disease-free survival in Dukes' B patients (P = 0.04). Cox proportional hazard analysis indicated that low numbers of ICAM-1(+) and high numbers of 5T4(+) cells were independent prognos tic factors with relative risks of 13.0 (P = 0.0002) and 4.7 (P = 0.02 ), respectively. The combination of 5T4 and ICAM-1 marker information identified subgroups of patients with a good (high ICAM-1) or poor (lo w ICAM-1/high 5T4) prognosis. Neither a lack of HLA-ABC and LFA-3 expr ession nor the presence of HLA-DR on the tumor cells gave additional p rognostic information. These findings demonstrate that low ICAM-1 and high 5T4 expression on tumor cells are prognostic markers, additional to Dukes' stage, for reduced disease-free survival in Dukes' B and C c olorectal carcinoma patients.