Activated leukocyte cell adhesion molecule: a novel biomarker for breast cancer

Abstract

Activated leukocyte cell adhesion molecule (ALCAM) has been implicated in tumorigenesis. Our goal was to examine the levels of ALCAM, in addition to the classical breast cancer tumor markers carbohydrate antigen 15-3 (CA15-3) and carcinoembryonic antigen (CEA), in serum by quantitative enzyme-linked immunosorbent assay for diagnosis in breast cancer patients. The 3 proteins were measured in serum of 100 healthy women, 50 healthy men and 150 breast carcinoma patients. The diagnostic sensitivity and specificity of the tests were calculated and the association of serum marker concentrations with various clinicopathologic variables was examined using nonparametric Kruskal-Wallis tests. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of the biomarkers. ALCAM, with area under the curve (AUC) of 0.78 [95% CI: 0.73, 0.84] outperformed CA15-3 (AUC = 0.70 [95% CI: 0.64, 0.76]) and CEA (AUC= 0.63 [95% CI: 0.56, 0.70]). The incremental values of AUC for ALCAM over that for CA15-3 were statistically significant (Delong test, p < 0.05). Combining CA15-3 and ALCAM yielded a ROC curve with an AUC of 0.81 (95% CI [0.75, 0.87]). Serum ALCAM appears to be a new biomarker for breast cancer and may have value for disease diagnosis.

Figure 1

Distribution of markers A) ALCAM, B) CA15-3 and C) CEA in the three groups (normal female, normal male and breast carcinoma) examined by an immunoassay specific to the molecule. The solid horizontal line indicates the median value for each of the groups. The dotted horizontal line indicates the cut-off values to discriminate cancer from control subjects A) ALCAM: 78 μg/L, 95% specificity cut-off; B) CA15-3: 30 U/mL and C) CEA: 5 ng/mL.

Figure 2

ROC curves for the three markers (CA15-3, CEA, ALCAM).