Up‐regulation of L1CAM is linked to loss of hormone receptors and E‐cadherin in aggressive subtypes of endometrial carcinomas

M Huszar, M Pfeifer, U Schirmer… - The Journal of …, 2010 - Wiley Online Library
M Huszar, M Pfeifer, U Schirmer, H Kiefel, GE Konecny, A Ben‐Arie, L Edler, M Münch…
The Journal of Pathology: A Journal of the Pathological Society of …, 2010Wiley Online Library
Endometrial carcinomas (ECs) are classified into type 1 (less aggressive) and type 2
(aggressive) tumours that differ in genetic alterations. So far, reliable immunohistochemical
markers that can identify patients with high risk for recurrence are rare. We have defined the
expression of L1 cell adhesion molecule (L1CAM), a biomarker previously identified for EC,
and compared its expression to oestrogen receptor (ER)/progesterone receptor (PR) and E‐
cadherin. We found that L1CAM was absent in normal endometrium and the vast majority of …
Abstract
Endometrial carcinomas (ECs) are classified into type 1 (less aggressive) and type 2 (aggressive) tumours that differ in genetic alterations. So far, reliable immunohistochemical markers that can identify patients with high risk for recurrence are rare. We have defined the expression of L1 cell adhesion molecule (L1CAM), a biomarker previously identified for EC, and compared its expression to oestrogen receptor (ER)/progesterone receptor (PR) and E‐cadherin. We found that L1CAM was absent in normal endometrium and the vast majority of endometrioid ECs (type 1) but was strongly expressed in serous and clear‐cell ECs, considered as type 2. 78/272 cases were identified as L1CAM‐positive endometrioid ECs that were correlated with a poor prognosis. Strikingly, we observed an inverse relationship between L1CAM and ER/PR/E‐cadherin expression in all ECs. In mixed ECs, composed of endometrioid (L1CAM ER/PR+ E‐cadherin+) and clear‐cell/serous (L1CAM+ ER/PR E‐cadherin), both phenotypes were co‐expressed. In some of these cases L1CAM was up‐regulated at the leading edge of the tumour, where ER/PR and E‐cadherin expression were selectively lost. In EC cell lines treated with the epithelial–mesenchymal transition (EMT) inducer TGFβ1, L1CAM and vimentin were strongly up‐regulated, while E‐cadherin expression was reduced. The treatment also resulted in an increased expression of the EMT transcription factor Slug and an enhanced cell invasion. Depletion of Slug by siRNA knockdown prevented both L1CAM up‐regulation and enhanced cell invasion. According to our analysis, we suggest that L1CAM is a novel marker for EMT in ECs and that L1CAM‐typing could identify endometrioid ECs that have type 2‐like features and are at high risk for recurrence. Copyright © 2009 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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