NEURAL CELL-ADHESION MOLECULE (NCAM) IN PANCREATIC-CANCER - A MARKER OF PROGRESSION

Adhesion molecules are involved in cell-cell and cell to extracellular matrix interaction both in benign and malignant tissues. Neural cell adhesion molecule (NCAM) is more expressed in various malignant tissue s. The aim of this study was to evaluate the behavior of serum NCAM in pancreatic cancer. Serum NCAM (monoclonal antibody MAK 735, RIA-gnost NCAM -Behringwerke AG-Marburg, Germany) was determined in 15 cases of pancreatic cancer, 15 control subjects, 12 cases of chronic pancreati tis, 12 of extrapancreatic diseases, 21 of lung adenocarcinoma, and 21 of small cell lung carcinoma. Significantly lower levels of NCAM were detected in pancreatic cancer as compared to control subjects (p<0.05 ) and in lung adenocarcinoma as compared to control subjects, or cases of pancreatic cancer, chronic pancreatitis and extrapancreatic diseas es (p<0.001). Lower values were found in stage IV of pancreatic cancer as compared to stages I-II (U=36.50, p<0.05). No difference in serum NCAM was found in relation to tumor diameter (<4 cm vs >4 cm) (U=24.00 , p:ns). Pancreatic cancer patients who had palliative surgery showed decreased levels three months after their operation as compared to the baseline (t=1.89, p<0.04). Pancreatic cancer patients who survived le ss than 1 year showed a significant decrease of NCAM (t=2.27, p<0.02) whereas patients with more than 1 year survival had no significant var iation (t=0.86, p:ns), sNCAM correlated with both serum albumin (r=0.7 5, p>0.01) and % of body weight loss in the 6 months before determinat ion (r=-0.95, p>0.001). The worsening clinical conditions of patients followed up for at least 12 months were accompanied by a decrease of N CAM. In conclusion: 1. Serum NCAM is reduced in pancreatic cancer; 2. a more advanced disease seems to determine a further decrease in serum NCAM; 3. the decrease in NCAM is correlated with a poor survival.