BMC Cancer Research article BioMed Central Open Access Ep-CAM expression in squamous cell carcinoma of the esophagus: a potential therapeutic target and prognostic marker Nikolas H Stoecklein*1, Annika Siegmund2, Peter Scheunemann1,5, Andreas M Luebke2, Andreas Erbersdobler3, Pablo E Verde4, Claus F Eisenberger1,5, Matthias Peiper1,5, Alexander Rehders1,5, Jan Schulte am Esch1, Wolfram Trudo Knoefel1,5 and Stefan B Hosch1,5 Address: 1Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Düsseldorf, D-40225 Düsseldorf, Germany, 2Klinik für Allgemein-, Viszeral- und Thoraxchirugie, Universitätsklinikum Hamburg-Eppendorf, D-20246 Hamburg, Germany, 3Institut für Pathologie, Universitätsklinikum Hamburg-Eppendorf, D-20246 Hamburg, Germany, 4Koordinierungszentrum für klinische Studien, Universitätsklinikum Düsseldorf, D-40225 Düsseldorf, Germany and 5Chirurgische Klinik, Universitätsklinikum Hamburg-Eppendorf, D-20246 Hamburg, Germany Email: Nikolas H Stoecklein* - Nikolas.Stoecklein@uni-duesseldorf.de; Annika Siegmund - annika.siegmund@med.uni-heidelberg.de; Peter Scheunemann - scheunemann@med.uni-duesseldorf.de; Andreas M Luebke - luebke@uke.uni-hamburg.de; Andreas Erbersdobler - erbersdo@uke.uni-hamburg.de; Pablo E Verde - PabloEmilio.Verde@uni-duesseldorf.de; Claus F Eisenberger - eisenberger@uni-duesseldorf.de; Matthias Peiper - matthias.peiper@uni-duesseldorf.de; Alexander Rehders - rehders@med.uni-duesseldorf.de; Jan Schulte am Esch - jan.schulteamesch@uni-duesseldorf.de; Wolfram Trudo Knoefel - knoefel@uni-duesseldorf.de; Stefan B Hosch - stefan.hosch@uni-duesseldorf.de * Corresponding author Published: 23 June 2006 BMC Cancer 2006, 6:165 doi:10.1186/1471-2407-6-165 This article is available from: http://www.biomedcentral.com/1471-2407/6/165 Received: 19 August 2005 Accepted: 23 June 2006 © 2006 Stoecklein et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: To evaluate the expression and test the clinical significance of the epithelial cellular adhesion molecule (Ep-CAM) in esophageal squamous cell carcinoma (SCC) to check the suitability of esophageal SCC patients for Ep-CAM directed targeted therapies. Methods: The Ep-CAM expression was immunohistochemically investigated in 70 primary esophageal SCCs using the monoclonal antibody Ber-EP4. For the interpretation of the staining results, we used a standardized scoring system ranging from 0 to 3+. The survival analysis was calculated from 53 patients without distant metastasis, with R0 resection and at least 2 months of clinical follow-up. Results: Ep-CAM neo-expression was observed in 79% of the tumors with three expression levels, 1+ (26%), 2+ (11%) and 3+ (41%). Heterogeneous expression was observed at all expression levels. Interestingly, tumors with 3+ Ep-CAM expression conferred a significantly decreased median relapse-free survival period (log rank, p = 0.0001) and median overall survival (log rank, p = 0.0003). Multivariate survival analysis disclosed Ep-CAM 3+ expression as independent prognostic factor. Conclusion: Our results suggest Ep-CAM as an attractive molecule for targeted therapy in esophageal SCC. Considering the discontenting results of the current adjuvant concepts for esophageal SCC patients, Ep-CAM might provide a promising target for an adjuvant immunotherapeutic intervention. Page 1 of 8 (page number not for citation purposes)