In our earlier studies, performed on a group of 60 patients with ductal breast cancer, postoperatively treated with tamoxifen, expression of metallothionein (MT), which is downregulated by ER was found to be an unfavourable prognostic factor (Surowiak et al, 2005b).
High levels of CAIX were found to be associated with unfavourable patient outcome in several epithelial cancers [ 11- 14].
A few biopsy studies have been reported that examined mediators of synovial tissue inflammation and joint damage that were found to be associated with unfavourable clinical and radiological outcomes (Table 2).
An increased expression of MDR1 was found to be associated with an unfavourable prognosis of ovarian cancer in some studies (Materna et al, 2004; Penson et al, 2004), but not in others (Yokoyama et al, 1999; Ozalp et al, 2002).
The presence of a CSF protein level over 0.6 g l-1 at diagnosis was found to be the most significant unfavourable prognostic factor in univariate analysis and had not previously been reported.
A partial explanation for this may lie in the fact that an early onset of illness has been found to be a predictor of unfavourable prognosis and is correlated with higher global severity [ 57], higher rates of chronicity, and more probable impairments in cognitive performance [ 58].
Although the exact mechanism by which these cells are drawn into the tumour micro-environment remains unexplained, their immunosuppressive effect has been proven with a high density of tumour-infiltrating Foxp3+ cells found to be associated with an unfavourable prognosis in a wide range of human carcinomas, including breast and lung cancer (Bates et al, 2006; Petersen et al, 2006).
Kim et al (2009b) reported that E-cadherin loss and the expression of vimentin was found to be significantly associated with an unfavourable prognosis of patients with gastric cancer, but no significant difference in patient outcome was found regarding cytokeratin expression status.
Contrary to our results high ALCAM expression in the primary tumor was found to be associated with reduced survival or unfavourable prognostic markers in some tumor types, i.e. colorectal [ 4, 7], oral [ 10, 21], esophageal [ 11], pancreatic [ 22] and gastric carcinomas [ 23] as well as neuroblastoma [ 24].
Unfavourable differences were found to be statistically significant (34 out of 38).
