L1 Cell Adhesion Molecule (L1CAM) Expression at the Cancer Invasive Front Is a Novel Prognostic Marker of Pancreatic Ductal Adenocarcinoma

Background and Objectives: Pancreatic ductal adenocarcinoma (PDAC) is one of the most extremely aggressive cancers with a poor prognosis after curative resection. L1 cell adhesion molecule (L1CAM) is a 200-220 kDa type I transmembrane glycoprotein of the immunoglobulin superfamily, which has been shown to affect the prognosis of several cancers. No clinicopathological significance of L1CAM expression has been examined at the invasive front of PDAC. In this study, we examined the relationship between L1CAM expression and clinicopathological features in PDAC by immunohistochemistry. Methods: One hundred seven surgically resected specimens of PDAC were immunohistochemically examined using a monoclonal antibody against L1CAM. Results: Positive expression of L1CAM was found in 23 of 107 cases with PDAC. In most cases (21/23), L1CAM expression was localized at the invasive front of the tumor tissue. Positive expression of L1CAM was significantly correlated with the histological grade, lymph node involvement, and distant metastasis. In univariate analysis, a positive expression of L1CAM was associated with short overall survival (P = 0.0002), and this was significant in multivariate analysis (P = 0.009). Conclusions: L1CAM could play an important role in the invasive process in vivo, and is thought to be a good indicator of prognosis in PDAC. J. Surg. Oncol. 2011;103:669-673. (C) 2011 Wiley-Liss, Inc.