Prognostic role of CD44 cell adhesion molecule expression in primary and metastatic renal cell carcinoma: a clinicopathologic study of 125 cases

Abstract

Possible prognostic utility of CD44 in renal cell carcinoma (RCC) prompted a comparison of its expression in primary and metastatic RCC. A total of 164 paraffin-embedded tissues of primary RCC and metastatic RCCs from 125 patients were immunostained with CD44 (standard form) antibody. It consisted of 86 primary RCCs (50 with subsequent metastasis [MET+] and 36 with no known metastasis [MET-]) during follow up and 78 metastatic RCCs (39 metastatic RCCs only and 39 with matched RCC primary from RCC MET + category). Immunoreactivity for CD44 was scored semiquantitatively as 0, 1, or 2 (0, <5%; 1, 5-50%; 2, > or =50%). Expression of CD44 was significantly higher in metastatic RCCs compared to primary RCCs (p = 0.036). CD44 immunoreactivity in the primary RCC (MET- and MET+) correlated with progression-free survival (p = 0.027). In metastatic RCCs, CD44 immunoreactivity also correlated with survival after detection of first metastasis (p = 0.011). In multivariate analysis, stage (p = 0.0001) and CD44 immunoreactivity (p = 0.03) in primary RCC were independent predictors of progression-free survival. Our study suggests that CD44 status in RCC provides useful prognostic information both in primary and metastatic RCCs and may have applicability in stratifying patients for therapeutic decisions.

Immunohistochemical expression of CD44s in renal cell carcinoma lacks independent prognostic significance

“…Lim et al evaluated the prognostic value of CD44s in 125 cases of RCC of which 89 cases (71%) were composed of patients with metastatic disease. The authors reported greater expression of CD44s in metastatic tumors and described such marker as an independent predictor of PFS in their series (9). We believe that the differences between our series in which only 29% of patients progressed to metastatic disease, and Lim et al series might explain the fact that CD44s was not confirmed as a predictor of survival in our study.…”

“…As a molecule involved in mechanisms of cell motility, CD44 has been used as a marker of tumor aggressiveness in a number of malignancies such as stomach, liver and breast. However, in RCC there are contradictory results, with some series supporting the role of CD44 as a prognostic marker (8)(9)(10) while in other studies its importance as a predictor of survival was not confirmed (11,12).…”

Silencing of CD44 Gene Expression in Human 143-B Osteosarcoma Cells Promotes Metastasis of Intratibial Tumors in SCID Mice

“…Moreover, several reports have described prognostic power of CD44 gene products in different cancer types [5], [6], [7]. CD44 gene products are transmembrane proteoglycans, which act as cell-cell and cell-matrix adhesion molecules and principle receptors of hyaluronan (HA) [8].…”

“…In tumor biology, evidence has accumulated that metastasis in different types of cancer is directly or inversely related to the expression of CD44 gene products, depending on the expression pattern of CD44 isoforms and on the organ of origin. Several studies have shown up-regulated expression of CD44 isoforms in many human tumors, including gastric cancer, pancreatic cancer, lung and renal cell cancer [6], [10], [11], [12]. Some reports point to important functions of CD44s in tumor progression [13].…”

Targeting Strategies for Renal Cell Carcinoma: From Renal Cancer Cells to Renal Cancer Stem Cells

“…Furthermore, CD44 + /CD24 - cells in three-dimensional (3D) spheres were reported to be resistant to radio- and chemo-therapy (Debeb et al, 2010). In another report, Lim et al (2008) suggested that CD44 expression in RCC could be used to inform the appropriate therapy and provide useful prognostic information in both primary and metastatic RCC. Meanwhile, a meta-analysis of the literature showed that CD44 was a poor prognostic marker for 5-year overall survival and that high CD44 expression levels were associated with high Fuhrman grade and recurrence (Li et al, 2015).…”