Article

Adhesion molecule CD44 as a prognostic factor in tongue cancer

Department of Oral Medicine, University of Granada, Spain.
Anticancer research (Impact Factor: 1.87). 01/2003; 23(6D):5197-202.
Source: PubMed

ABSTRACT Loss of expression of CD44 has been shown to be a factor of poor prognosis in some types of tumors. The purpose of this study was to analyze this in relation to the survival of patients with tongue cancer.
The expression of adhesion molecule CD44 was studied in 56 patients with tongue cancer. Data were gathered on clinical (T, N, M and stage) and pathological (T, N, stage, extracapsular spread, differentiation, tumor thickness, surgical margin and CD44 expression) parameters. Immunohistochemistry studies were carried out using DF1485 anti-CD44 monoclonal antibody.
In five tumors (8.9%) < 25%, in 11 (19.6%) 25%-49%, in 15 (26.8%) 50%-74% and in 25 (44.6%) > or = 75% of the neoplastic cells expressed CD44. A Cox proportional risks multivariate analysis identified CD44 expression as the parameter most associated with survival (p < 0.001).
The reduced expression of CD44 behaves as a marker of poor tongue tumor prognosis.

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    • "The median percentage of patients with CD44 positive expression was 57.8% (range 10.2 - 75.4%); for patients with oral cancer, pharynx cancer, and larynx cancer, the median percentages of patients with CD44 positive expression were 49.3% (range 10.2 - 70.9%), 66.4% (57.5 - 75.4%) and 54.7% (12 - 82.9%), respectively. All studies applied an immunochemistry staining method to detect CD44 expression: anti-pan-CD44 antibody was used in 15 studies [2,19-32], which detected all variations of CD44, anti-CD44-v6 antibody was used in 9 studies [33-41], anti-CD44-v3 antibody and anti-CD44s antibody were used together in 2 studies [42-45], anti-CD44-v9 was used in 1 study [46], and 1 study assessed CD44-v6,-v3 and -v4-5 simultaneously [47]. The most common cut-off values designating CD44 expression were cell membrane stainings of 50% (n = 16) and 25% (n = 5). "
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    ABSTRACT: CD44 has been reported to be involved with tumor growth and metastasis and has also been implicated as a CSC marker in head and neck squamous cell cancer (HNSCC). However, the prognostic value of CD44 still remains controversial; hence, we investigated the correlation between CD44 and the clinicopathological features of HNSCC by meta-analysis. A comprehensive search was performed using PubMed, ISI web of Science and China National Knowledge Infrastructure (CNKI) up to April 2013. Only studies with immunohistochemical staining of HNSCC were considered. Data on TNM classification, tumor grade, disease free survival and 3- or 5-year overall survival rate were extracted. Thirty studies with 2102 patients met the inclusion criteria for the meta-analysis. Fifteen studies used anti-pan-CD44 antibody, 9 used anti-CD44-v6 antibody, 2 used anti-CD44-v3 and 2 used anti-CD44s antibody, 1 used anti-CD44-v9, and 1 used anti-CD44-v6,-v3 and -v4-5 simultaneously. The total percentage of CD44 expression was 57.8%, with 49.3% in oral cancer patients, 66.4% in pharynx and 54.7% in larynx cancer patients expressing CD44. No significant correlation between clinical features and CD44 expression was revealed for oral cancer patients, but CD44 was shown to be associated with advanced T categories (larynx: RR = 1.33, 95% CI 1.01-1.76; larynx & pharynx RR = 1.21, 95% CI 1.08-1.35), worse N categories (larynx: RR = 2.53, 95% CI 1.99-3.21; larynx & pharynx RR = 1.95, 95% CI 1.35-2.82), higher tumor grades (larynx & pharynx RR = 1.71, 95% CI 1.04-2.79) and 5-year OS rates (larynx: RR = 0.62, 95% CI 0.47-0.83; larynx & pharynx RR = 0.66, 95% CI 0.47-0.94) in patients with laryngeal and pharyngolaryngeal cancer. In stratified analysis, pan-CD44 and CD44-v6 expression were both correlated with 5-year OS rate of patients with laryngeal (CD44: RR = 0.66, 95% CI 0.46-0.95; CD44-v6 RR = 0.53, 95% CI 0.37-0.77) and pharyngolaryngeal cancer (CD44: RR = 0.56, 95% CI 0.34-0.93; CD44-v6 RR = 0.53, 95% CI 0.37-0.77). Our analysis suggested that CD44 is related to worse T category, N category, tumor grade and prognosis, in pharyngeal and laryngeal cancer, but no clear association was revealed between CD44 expression and oral cancer.
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    ABSTRACT: Loss of expression of CD44 has been shown to be a factor of poor prognosis in some types of tumors. The purpose of this study was to analyze this event in relation to the survival of patients with laryngeal cancer. The expression of adhesion molecule CD44 was studied in 137 patients with laryngeal cancer. Data were gathered on clinical (primary tumor location, pyriform sinus involvement and tongue base damage) and pathologic (T, N, differentiation, inflammatory response, tumor thickness, surgical margin involvement, and CD44 expression) parameters. Immunohistochemical studies were carried out using DF1485 anti-CD44 monoclonal antibody. In 29 tumors (21.1%) < 25%, in 18 (13.1%) 25%-49%, in 42 (30.6%) 50%-74%, and in 48 (35.0%) > or = 75% of the neoplastic cells expressed CD44. A Cox proportional risks multivariate analysis identified CD44 expression and surgical margin involvement as the parameters most associated with survival (p<0.001). The reduced expression of CD44 behaves as a marker of a poor laryngeal cancer prognosis.
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    ABSTRACT: Head and neck squamous-cell carcinoma (HNSCC) is the sixth most common cancer worldwide and, disappointingly, survival rates are not improving. Moreover, HNSCC has a severe impact on the quality of life of patients and survivors, and the significant morbidity subsequent to treatment often mandates long-term multidisciplinary care, which places significant financial pressures on the treating institution. Therefore, prevention and early diagnosis of high-risk pre-malignant lesions are high priorities for reducing deaths due to head and neck cancer. Recent advances have begun to elucidate the different aetiologies of HNSCCs in relation to previous pre-malignancies and to identify which pre-malignant lesions are likely to progress to malignancy.
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