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CEACAM6 is Upregulated by Helicobacter Pylori CagA and is a Biomarker for Early Gastric Cancer (Oncotarget, Jul 2016)

Rony K. Roy1,*, Michal M. Hoppe1,*, Supriya Srivastava1, Animesh Samanta2, Neel Sharma3, Kar Tong Tan1, Henry Yang1, Dominic C. Voon1, Brendan Pang4, Ming Teh4, Naoko Murata-Kamiya5, Masanori Hatakeyama5, Young-Tae Chang2, Wei Peng Yong1,6, Yoshiaki Ito1,6, Khek Yu Ho2,6, Patrick Tan1,6, Richie Soong1, Phillip H. Koeffler1,2, Khay Guan Yeoh2,6, Anand D. Jeyasekharan1,6

1Cancer Science Institute of Singapore, National University of Singapore, Singapore
2Department of Chemistry, National University of Singapore, Singapore
3Division of Gastroenterology and Hepatology, National University Hospital, Singapore
4Department of Pathology, National University Hospital, Singapore
5University of Tokyo, Japan
6Singapore Gastric Cancer Consortium, National University of Singapore, Singapore
*These authors have contributed equally to this work


Early detection of gastric cancers saves lives, but remains a diagnostic challenge. In this study, we aimed to identify cell-surface biomarkers of early gastric cancer. We hypothesized that a subset of plasma membrane proteins induced by the Helicobacter pylorioncoprotein CagA will be retained in early gastric cancers through non-oncogene addiction. An inducible system for expression of CagA was used to identify differentially upregulated membrane protein transcripts in vitro. The top hits were then analyzed in gene expression datasets comparing transcriptome of gastric cancer with normal tissue, to focus on markers retained in cancer. Among the transcripts enriched upon CagA induction in vitro, a significant elevation of CEACAM6 was noted in gene expression datasets of gastric cancer. We used quantitative digital immunohistochemistry to measure CEACAM6 protein levels in tissue microarrays of gastric cancer. We demonstrate an increase in CEACAM6 in early gastric cancers, when compared to matched normal tissue, with an AUC of 0.83 for diagnostic validity. Finally, we show that a fluorescently conjugated CEACAM6 antibody binds avidly to freshly resected gastric cancer xenograft samples and can be detected by endoscopy in real time. Together, these results suggest that CEACAM6 upregulation is a cell surface response to H. pylori CagA, and is retained in early gastric cancers. They highlight a novel link between CEACAM6 expression and CagA in gastric cancer, and suggest CEACAM6 to be a promising biomarker to aid with the fluorescent endoscopic diagnosis of early neoplastic lesions in the stomach.