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Open Access Research article

A comparative study of two PODXL antibodies in 840 colorectal cancer patients

Tuomas Kaprio12*, Jaana Hagström25, Christian Fermér3, Harri Mustonen1, Camilla Böckelman26, Olle Nilsson4 and Caj Haglund12

Author Affiliations

1 Department of Surgery, Helsinki University Central Hospital, P.O. Box 440, 00029 HUS Helsinki, Finland

2 Research Programs Unit, Translational Cancer Biology, University of Helsinki, Helsinki, Finland

3 Fujirebio Diagnostics AB, Elof Lindälvs gata 13, SE-414 58 Göteborg, Sweden

4 Onson Consulting, Södra vägen 2, SE-412 54 Göteborg, Sweden

5 Department of Pathology, Haartman Institute, University of Helsinki and HUSLAB, Helsinki FIN-00014 HY, Finland

6 Department of Surgery, Vaasa Central Hospital, Sandviksgatan 2-4, 65100 Vaasa VASA, Finland

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BMC Cancer 2014, 14:494  doi:10.1186/1471-2407-14-494

Published: 8 July 2014

Abstract

Background

Podocalyxin (PODXL) is a transmembrane sialomucin, whose aberrant expression and/or allelic variation associates with poor prognosis and unfavourable clinicopathological characteristics in different cancers. Membranous expression of PODXL has been suggested to be an independent marker of poor prognosis in colorectal cancer (CRC), and previously by an in-house monoclonal antibody, we showed that also cytoplasmic overexpression of PODXL predicts poor prognosis. The aim of this study was to compare two PODXL antibodies with different epitopes case-by-case in CRC patients.

Methods

Of 840 consecutively operated CRC patients from Helsinki University Central Hospital, PODXL expression by polyclonal HPA 2110 antibody was evaluated from 780. Associations of PODXL expression with clinicopathological parameters and the impact of PODXL expression on survival were assessed. Kappa-value was used to assess the comparability of the two antibodies.

Results

Membranous PODXL expression associated with unfavourable clinicopathological parameters and with higher risk for disease-specific death from CRC within 5 years (unadjusted hazard ratio (HR) = 1.90; 95% confidence interval (CI) (1.32-2.75); adjusted HR = 1.64; 95% CI (1.11-2.43)). The comparability of expressions by the two antibodies was low (kappa =0.219, standard error 0.060, p < 0.0001). Combination of two antibodies identified a group of patients with even worse prognosis (unadjusted HR = 6.00; 95% CI (3.27-13.0); adjusted HR = 2.14; 95% CI (1.12-4.07)).

Conclusion

Membranous expression by the polyclonal PODXL antibody and cytoplasmic overexpression by the monocolonal PODXL antibody are both independent markers of poor prognosis, but they recognise different groups of patients, both of which have poor prognosis. The combined use of the antibodies reveals a group with an even worse prognosis. The biological reasons for the difference between antibodies warrant further studies.

Keywords:
Colorectal cancer; Podocalyxin; Prognosis