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PubMed2005

Prevalence of CD44+/CD24-/low cells in breast cancer may not be associated with clinical outcome but may favor distant metastasis.

PURPOSE: Breast cancer is composed of phenotypically diverse populations of cancer cells. The ability to form breast tumors has been shown by in vitro/in vivo studies to be restricted to epithelial tumor cells with CD44(+)/CD24(-/low) characteristics. Validation of these findings with respect to detection in clinical samples, prognosis, and clinical relevance is in demand. EXPERIMENTAL DESIGN: We investigated breast cancer tissues for the prevalence of CD44(+)/CD24(-/low) tumor cells and their prognostic value. The study included paraffin-embedded tissues of 136 patients with and without recurrences. In addition, a breast cancer progression array with normal, carcinoma in situ, and carcinoma tissues was analyzed. We applied double-staining immunohistochemistry for the detection of CD44(+)/CD24(-/low) cells. Evaluation was by microscopic pathologic inspection and automated image analysis. RESULTS: CD44(+)/CD24(-/low) cells ranged from 0% to 40% in normal breast and from 0% to 80% in breast tumor tissues. The prevalence of CD44(+)/CD24(-/low) tumor cells in 122 tumors was < or =10% in the majority (78%) of cases and >10% in the remainder. There was no significant correlation between CD44(+)/CD24(-/low) tumor cell prevalence and tumor progression. Although recurrences of tumors with high percentages of CD44(+)/CD24(-/low) tumor cells were mainly distant, preferably osseous metastasis, there was no correlation with the event-free and overall survival. There was no influence on the response to different treatment modalities. CONCLUSIONS: Our findings suggest that the prevalence of CD44(+)/CD24(-/low) tumor cells in breast cancer may not be associated with clinical outcome and survival but may favor distant metastasis.

Adult↗
PubMed1991

Human T cell activation by OKT3 is inhibited by a monoclonal antibody to CD44.

The CD44 molecule, also known as Hermes lymphocyte homing receptor, human Pgp-1, and extracellular matrix receptor III, has been shown to play a role in T cell adhesion and activation. Specifically, anti-CD44 mAb block binding of lymphocytes to high endothelial venules, inhibit T cell-E rosetting, and augment T cell proliferation induced by the CD2 or CD3-TCR pathways. We have characterized an anti-CD44 mAb (212.3) which immunoprecipitates a 90-kDa protein and is specific for CD44 as shown by peptide mapping and antibody competition studies. Interestingly, our studies with 212.3 demonstrate that this CD44-specific mAb completely inhibits T cell proliferation stimulated by the anti-CD3 mAb, OKT3. Inhibition is not a result of reduced cell viability, but is associated with 1) inhibition of IL-2 production, 2) inhibition of IL-2R expression, and 3) inhibition of OKT3-mediated increases in intracellular Ca2+ levels. In addition, 212.3 does not inhibit proliferation by the T cell mitogens PHA or PWM nor does it inhibit proliferation in a mixed lymphocyte reaction. Similar to other anti-CD44 mAb, 212.3 also augments T cell proliferation induced by mAb directed against the T11(2) and T11(3) epitopes of CD2. Thus, these studies describe a novel CD44-specific mAb (212.3) that inhibits T cell activation by OKT3 by blocking early signal transduction. Furthermore, these studies suggest that "receptor cross-talk" between the CD3-TCR complex and CD44 may regulate T cell activation.

Animals↗
PubMed1990

Expression of a human homing receptor (CD44) in lymphoid malignancies and related stages of lymphoid development.

Lymphocyte adhesion to high endothelial venules, a central step during extravasation into lymphoid tissues, involves an 85 to 95-kD class of lymphocyte surface glycoproteins, which fall in the cluster of CD44 antigens. In this paper we describe the expression of this homing receptor glycoprotein during lymphoid development. CD44 expression was examined on a large panel of non-Hodgkin's lymphomas (n = 234) and lymphoid leukemias (n = 44). These tumors, which are the malignant counterparts of normal lymphoid cells "frozen" at a certain stage of maturation/activation, are thought to represent a complete spectrum of lymphoid development from stem cell to mature, activated T and B lymphocyte. It was found that CD44 exhibits a trimodal distribution on developing lymphocytes of both the T and B lineage: the CD44 antigen is expressed at relatively high levels during early stages of lymphoid differentiation, i.e., on prothymocytes and immature precursor B cells (null acute lymphoblastic leukemia (ALL) and common ALL). Subsequently, at the stage of the immature/common thymocyte, the pre-B cell and early B cell (pre-B-ALL and B-ALL), the CD44 antigen is temporarily lost from the cell surface to be reacquired during further T and B cell maturation. At the activated (germinal center) B cell stage. CD44 is heterogeneously expressed. This distribution pattern of the CD44 molecule closely matches the recirculatory versus sessile nature of lymphoid cells at consecutive phases of their development, and thus apparently reflects its homing receptor function. In addition, the relatively high expression of the CD44 antigen in the earliest phases of T and B cell development suggests that the molecule may also be involved in the migration of bone marrow derived lymphoid precursors to their site of maturation.

Antigens, Differentiation↗
PubMed1989

CD44 antibody against In(Lu)-related p80, lymphocyte-homing receptor molecule inhibits the binding of human erythrocytes to T cells.

The cluster of differentiation 44 (CD44) Ag system, originally described in brain and mature T cells, has been subsequently shown to be identical with the human lymphocyte homing-receptor defined by the Hermes-1 antibody and to be involved in T cell/endothelial cell interactions in synovium, mucosa, and lymph node. CD44 is also present on human E. On E, CD44 has been shown to be regulated by the In(Lu) dominant inhibitor gene and to express the Ina and Inb blood group Ag. Because human E have been shown to interact with human T cells via CD2 on T cells and LFA-3 on human E, we have studied the ability of human E and T lymphocyte CD44 Ag to participate in CD2/LFA-3 interactions between human E and T cells. In this study, we demonstrate that a mAb (A3D8) against the CD44, In(Lu)-related p80, lymphocyte homing-receptor molecule inhibited the binding of human E to human T cells. Whereas whole CD44 antibody molecules inhibited human E binding to T cells, saturating amounts of CD44 Fab fragments did not inhibit human E to T cell binding. Our data demonstrated that anti-CD44 antibody A3D8 acted at the level of the E to inhibit CD2/LFA-3 interactions between human E and T cells.

Antibodies, Monoclonal↗
PubMed1993

CD44 splice variants: expression during lymphocyte activation and tumor progression.

A recently described splice variant of CD44 has been shown to confer metastatic potential to non-metastasizing rat pancreatic carcinoma and sarcoma cell lines. Using antibodies raised against a bacterial fusion protein encoded by variant CD44 sequences, we have explored the expression of variant CD44 glycoproteins in human lymphoid cells and tissues, in non-Hodgkin's lymphomas, and in colorectal neoplasia. Normal lymphohematopoietic cells express barely detectable low levels of variant CD44 glycoproteins, while T lymphocytes, upon activation by mitogen or antigen, transiently upregulate expression of specific CD44 variant glycoproteins. The reaction pattern of various antibodies indicates that these CD44 variants contain the domain encoded by exon v6, which is part of the variant that in the rat confers metastatic capability. Interestingly, overexpression of v6 was also found in several aggressive, but not in low-grade, non-Hodgkin's lymphomas (NHL). In human colorectal neoplasia we also observed strong overexpression of CD44 splice variants in all invasive carcinomas and carcinoma metastasis. Interestingly, focal expression was already observed in adenomatous polyps, expression being related to areas of dysplasia. The findings establish CD44 variants as tumor progression markers in colorectal cancer.

Alternative Splicing↗
PubMed1994

CD44 expression in T-cell lymphoblastic leukemia.

1. CD44 is an adhesion molecule expressed by B and T lymphocytes that mediates cell attachment to extracellular matrix components and specific cell surface ligands. In normal process of T-cell development, CD44 can be implicated in homing of bone marrow-derived T-cell precursors into the thymus. In hematopoietic malignancies, CD44 and other adhesion molecules can mediate the behavior of neoplastic cells such as metastatic migration. In the leukemic process, CD44 expression is correlated with increased numbers of circulating blasts and it is present at other sites such as the central nervous system. 2. In the present study, CD44 was investigated in lymphoblasts from 30 patients with T-cell lymphoblastic leukemia (T-ALL) and in peripheral lymphocytes from 10 healthy individuals. CD44 expression was detected in 23 (77%) of T-ALL cases studied and was correlated with clinical features such as mediastinal mass, adenomegaly, and infiltration of the central nervous system and other organs. Interestingly, CD44 expression in patients with tumor infiltration was higher than in patients with no tumor infiltration. 3. These data suggest that CD44 may be regarded as an additional marker for tumor expansion in T-cell leukemias.

Adolescent↗
PubMed1994

CD44 can mediate the adhesion of platelets to hyaluronan.

CD44 represents a family of glycoproteins that are present on the surfaces of some types of lymphocytes, macrophages, and epithelial cells. In the present study, we have found that CD44 is also present on murine megakaryocytes and peripheral blood platelets as judged by immunohistochemical staining. Western blotting of platelet proteins indicated that this CD44 was predominantly of the 85-kD form. This form of CD44 also had the capacity to bind hyaluronan, because detergent extracts of platelets as well as intact platelets could bind soluble [3H]hyaluronan, and this property was blocked by antibodies directed against CD44. More importantly, isolated platelets could attach to the hyaluronan-containing extracellular matrix produced by cultured rat fibrosarcoma cells. This attachment took place in the absence of divalent cations and could be blocked by pretreating the rat fibrosarcoma cells with hyaluronidase or by the addition of an antibody to CD44. These results suggested that CD44 was responsible for the attachment of platelets to hyaluronan. Histochemical staining also showed that hyaluronan was present immediately beneath the endothelial cells of many blood vessels of various tissues, such as the dermis, lamina propria of the intestinal tract, the lungs, and the pericardium. Thus, it is possible that CD44 plays an important role in the attachment of platelets to the surface of exposed connective tissue after injury to endothelial cells.

Animals↗
PubMed1993

CD44 and hyaluronan expression in human cutaneous scar fibroblasts.

Fibrotic disorders of skin and other organs are typically associated with an abnormal accumulation of extracellular matrix. This study focuses on a matrix constituent, hyaluronan-which is known to be altered in fibrotic disorders of skin- and on CD44, a cell adhesion molecule and putative receptor for hyaluronan. Tissue samples were obtained from biopsies of human normal skin, normal cutaneous scar; and hypertrophic cutaneous scar. After culturing, cells were studied by single- and double-labeling immunohistochemistry using the two anti-CD44 monoclonal antibodies, BU-52 and J173, and a biotinylated hyaluronan binding complex probe, b-HABR. Certain cultures were pretreated with Streptomyces hyaluronidase to assess the dependency of CD44 expression on the presence of endogenous hyaluronan. CD44 expression, both in the presence and the absence of exogenous hyaluronan, was quantitated by radioimmunobinding assay. Overall glycosaminoglycan synthesis and identification of hyaluronan were accomplished by precursor incorporation assays and by quantitative cellulose acetate electrophoresis. CD44 was found to be a normal human adult fibroblastic antigen whose expression is markedly increased for hypertrophic scar fibroblasts compared with normal skin fibroblasts. Although hyaluronan was found to be the predominant glycosaminoglycan constituent of the pericellular matrix for these fibroblasts, CD44 attachment to the cell surface is neither mediated by hyaluronan nor is the presence of hyaluronan a prerequisite for CD44 expression. Exogenous hyaluronan induced a decline in measurable CD44 expression for normal skin fibroblasts but not for hypertrophic scar fibroblasts. These observations are compatible with current understanding of the way cells manage the hyaluronan economy of the extracellular matrix and emphasize phenotypic heterogeneities between fibroblasts derived from normal versus scar tissues.

Cicatrix↗
PubMed1996

Hyaluronan-dependent motility of B cells and leukemic plasma cells in blood, but not of bone marrow plasma cells, in multiple myeloma: alternate use of receptor for hyaluronan-mediated motility (RHAMM) and CD44.

We investigated the ability of blood B cells, bone marrow (BM) plasma cells, and terminal leukemic plasma cells (T-PCL) from patients with multiple myeloma (MM) to migrate on extracellular matrix proteins. Hyaluronan (HA), but not collagen type I, collagen type IV, or laminin, promoted migration of MM blood B cells, as determined by time-lapse video microscopy. Between 13% and 20% of MM blood B cells migrated on HA with an average velocity of 19 micron/min, and greater than 75% of MM blood B cells exhibited vigorous cell movement and plasma membrane deformation, as did circulating T-PCL and extraskeletal plasma cells from patients with MM. In contrast, plasma cells obtained from BM of patients with MM lacked motility on all substrates tested and did not exhibit cell membrane protrusions or cellular deformation. MM blood B cells and MM plasma cells from all sources examined expressed the HA-binding receptors receptor for HA-mediated motility (RHAMM) and CD44. On circulating MM B cells, both RHAMM and CD44 participated in HA-binding, indicating their expression ex vivo in an activated conformation. In contrast, for the majority of BM plasma cells in the majority of patients with MM, expression of RHAMM or CD44 was not accompanied by HA binding. A minority of patients did have HA-binding BM plasma cells, involving both RHAMM and CD44, as evidenced by partial blocking with monoclonal antibodies (MoAbs) to RHAMM or to CD44. Despite HA binding by both RHAMM and CD44, migration of MM blood B cells on HA was inhibited by anti-RHAMM but not by anti-CD44 MoAbs, indicating that RHAMM but not CD44 mediates motility on HA. Thus, circulating B and plasma cells in MM exhibit RHAMM- and HA-dependent motile behavior indicative of migratory potential, while BM plasma cells are sessile. We speculate that a subset(s) of circulating B or plasma cells mediates malignant spread in myeloma.

B-Lymphocyte Subsets↗
PubMed1996

[Expression of CD44 variant isoforms in human primary colon carcinomas and metastasis].

The CD44 is a cell adhesion molecule that is present as numerous isoforms created by mRNA alternative splicing. A variety of human carcinomas display the overexpression of CD44 variant isoforms. To identify the relationship between the expression of CD44 variant isoforms and the metastatic potential of colon carcinomas, we performed a polymerase chain reaction analysis following reverse transcriptase treatment for CD44 expression in fresh surgical specimens obtained from 25 colon carcinomas and corresponding normal colonic mucosa. The CD44H, a common type of the CD44 isoform, was amplified from all carcinomas and normal tissues, whereas a splice variant form corresponding to CD44E was expressed in 19 out of 23 colon carcinomas (83%) and 7 out of 19 normal mucosa specimens (37%), suggesting that the CD44E expression was predominantly observed in colon carcinomas compared to normal tissues (p < 0.05). The multivariant form of CD44 was identified in 10 out of 23 carcinomas (44%) and 5 out of 19 normal samples (26%). The CD44E/CD44H (E/H) ratio was significantly higher in colon carcinomas than in normal mucosa (p < 0.01). However, neither the E/H ratio nor CD44 multivariant expression correlated with the clinicopathological features. These results suggest that CD44E expression and high E/H ratio are commonly observed in colon carcinomas and that the expression of the CD44 multivariants is not associated with clinicopathological parameters.

Aged↗
PubMed1996

[Expression of CD44 isoforms--a new histopathologic parameter in colorectal carcinoma?].

Expression of CD44H and CD44-isoforms were examined by immunohistochemistry in 102 patients with colorectal tumors in correlation to histological grading, staging and clinical outcome. From normal mucosa to colorectal tumors we found an upregulation of CD44H and CD44-v9 and a de-novo expression of CD44-v6. When compared to histological grading it was found that CD44-v6 expression indicates more differentiated tumors in contrast to less differentiated colorectal carcinomas showing decreasing CD44-v6 expression. Further we came to the result that increasing CD44-v6 expression correlates with progressive tumor stage. In the metastases we found a significant decrease in expression of CD44H, CD44-v9 and-v6 when compared to corresponding primary colorectal tumors. Wether the differential CD44 expression can be used as a prognostic histopathological marker for the progression of colorectal cancer has to be further validated. For final interpretation, our prospective study has to be continued further.

Biomarkers, Tumor↗
PubMed1997

Effect of changes in the CD44 gene on tumour cell invasion in gliomas.

Cell adhesion is a critical factor in the multistep process of tumour invasion. CD44 is one of the cell surface adhesion molecules responsible for interaction with hyaluronic acid, a component of the CNS extracellular matrix. The aim of the present study was to demonstrate whether alterations in the CD44 gene might account for different invasive behaviour. EcoRI restriction analysis by Southern blot hybridization revealed several additional hybridization signals in tissue specimens of two out of 16 patients with glioblastoma, indicating DNA rearrangements or point mutations, respectively, within the region of the CD44 gene. Expression patterns of CD44 isoforms in these two rearranged gliomas and in 28 other patients with malignant gliomas were analysed by RT-PCR. All cases displayed only the splice variant CD44H, which acts as hyaluronic acid receptor in glioma tumour cells. Tumour cell invasion was studied with Boyden chamber assays using hyaluronic acid as ligand and functional CD44H blocking antibody. Invasion of cells derived from those gliomas carrying the rearranged CD44 gene locus was decreased by about 50% compared with gliomas without rearrangement, indicating that the altered hybridization patterns in the two glioma samples influenced CD44H mediated glioma cell invasion through hyaluronic acid in vitro. Our results on CD44 isoform expression suggest that, in contrast to other solid tumours, gliomas seem to express only the CD44 variant. Genetic alterations within the CD44 gene might alter the binding domain of the receptor and thus account for different invasive behaviour in glioblastomas.

Alternative Splicing↗
PubMed1998

CD44 expression in uterine cervical intraepithelial neoplasia and squamous cell carcinoma: an immunohistochemical study.

CD44 is an integral membrane glycoprotein, functioning as the receptor for hyaluronic acid. CD44 is expressed on epithelial, mesenchymal, lymphoid, and glial cells. CD44 distribution, pattern of staining, and isoform types are altered in neoplastic conditions, including cervical dysplasia and carcinoma. We have studied CD44 expression by immunohistochemistry in 49 patients with cervical intraepithelial neoplasia (CIN) I, II, III invasive squamous cell carcinoma of the uterine cervix and controls. Only membranous staining was considered positive. Diffuse membranous staining was observed in all controls and CIN I cases, but only in 7/10, 3/10, and 4/9 cases of CIN II, CIN III and squamous cell carcinoma, respectively. The remaining cases showed either complete lack of staining, only focal membranous staining or only diffuse inconsistent (weak/cytoplasmic/fragmented) staining. Three invasive carcinomas showed both areas of membranous staining and areas of inconsistent staining in the same section. No correlation was observed between tumor grade and CD44 pattern of staining. Human papillomavirus (HPV) was found in 24/29 high-grade intraepithelial lesions and carcinomas. HPV expression did not correlate with CD44 staining. In conclusion, CD44 expression was found to be reduced in more than 50% of high-grade intraepithelial neoplastic lesions and invasive carcinomas. This might be associated with the loss of cellular adhesion characteristics of pre-invasive and invasive lesions. HPV presence did not seem to influence CD44 expression.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Intron 9 retention in gene transcripts suggests involvement of CD44 in the tumorigenesis of ovarian cancer.

Increased or de novo expression of certain CD44 variant isofoms as well as abnormal processing of pre-mRNA of the CD44 gene have been found in different malignant human tumors. Retention of the non-coding intron 9 sequence in CD44 mRNA especially, appears to be a discriminating aberrant splicing pattern in several cancer tissues and cells. We examined the expression of the CD44 intron 9 sequence in the mRNA of 45 permanent ovarian cancer cell lines and in normal ovarian tissue. Abnormal retention of intron 9 was found in 19 (60%) cell lines expressing CD44 std. Normal ovarian tissue as well as all ovarian cancer cells without CD44 s t d expression were found to be negative for intron 9 retention. Our results indicate that besides newly acquired expression of certain CD44 isoforms abnormal retention of the non-coding intron 9 sequence in CD44 gene transcripts is also a common and maybe crucial event in the tumorigenesis of ovarian cancer. Since intron 9 is not retained in normal ovarian tissue this aberration might serve as a marker for human adenocarcinoma of the ovary.

Adenocarcinoma↗
PubMed1998

Cooperation between CD44 and LFA-1/CD11a adhesion receptors in lymphokine-activated killer cell cytotoxicity.

IL-2-activated NK cells exhibit cytotoxic activity against a wide variety of tumor cells in a non-MHC-restricted fashion and in the absence of prior sensitization. The molecular mechanisms that regulate the cytotoxicity and attachment of activated killer cells to tumor target cells are not known. We provide genetic evidence in CD44(-/-) and LFA-1(-/-) mice that the cell adhesion receptors LFA-1 and CD44 regulate the cytotoxic activity of IL-2-activated NK cells against a variety of different tumor cells. This defect in cytotoxicity was significantly enhanced in mice that carried a double mutation of both CD44 and LFA-1. In vitro differentiation, TNF-alpha and IFN-gamma production, and expression of the cytolytic effector molecules perforin and Fas-L were comparable among IL-2-activated NK cells from LFA-1(-/-), CD44(-/-), CD44(-/-)LFA-1(-/-), and control mice. However, CD44(-/-), LFA-1(-/-), and CD44(-/-)LFA-1(-/-) IL-2-activated NK cells showed impaired binding and conjugate formation with target cells. We also show that hyaluronic acid is the principal ligand on tumor cells for CD44-mediated cytotoxicity of IL-2-activated NK cells. These results provide the first genetic evidence of the role of adhesion receptors in IL-2-activated NK killing. These data also indicate that distinct adhesion receptors cooperate to mediate binding between effector and target cells required for the initiation of "natural" cytotoxicity.

Animals↗
PubMed1999

CD44 variants but not CD44s cooperate with beta1-containing integrins to permit cells to bind to osteopontin independently of arginine-glycine-aspartic acid, thereby stimulating cell motility and chemotaxis.

The expression of osteopontin (OPN), CD44 variants, and integrins has been correlated with tumorigenesis and metastasis. Here we show that these proteins cooperate to enhance cell motility. First, we demonstrate that several different CD44 variants bind to OPN in an arginine-glycineaspartic acid-independent manner, but that the standard form of CD44 does not. These CD44 variants bind to both the amino- and COOH-terminal portions of OPN independently of the arginine-glycine-aspartic acid sequence, suggesting that multiple domains on OPN can be bound by the CD44 variants. Antibodies directed against the integrin beta1 subunit are able to inhibit this binding. The binding of CD44 variants to OPN is significantly augmented by both anti-CD44s and anti-CD44v antibodies. This augmentation by anti-CD44 antibodies is OPN specific and, again, can be blocked by anti-beta1 antibodies. Finally, we show that OPN binding by CD44 variants/beta1-containing integrins promotes cell spreading, motility, and chemotactic behavior.

Animals↗
PubMed1999

Cross-linking of CD44 on rheumatoid synovial cells up-regulates VCAM-1.

CD44 is a ubiquitous molecule also known as hyaluronic acid or homing receptor. However, the cellular functions and its role in inflammation, for example, rheumatoid synovitis, are currently unknown. In this study, we propose a novel function for CD44. Using synovial cells from rheumatoid arthritis (RA) patients, we demonstrated that CD44 cross-linking and binding to hyaluronan augmented VCAM-1 expression and subsequently VCAM-1-mediated cell adhesion. Briefly, we found that 1) rheumatoid synovial cells highly expressed CD44; 2) cross-linking of CD44 markedly but transiently augmented VCAM-1 expression and its mRNA transcription much more than did IL-1beta and TNF-alpha; 3) hyaluronan, especially when fragmented, also up-regulated VCAM-1; 4) CD44 activated the transcription factor AP-1; and 5) the integrin-dependent adhesive function of RA synovial cells to T cells was also amplified by CD44 cross-linking. These results indicate that the adhesion of RA synovial cells to matrices such as hyaluronic acid through CD44 could up-regulate VCAM-1 expression and VCAM-1-mediated adhesion to T cells, which might in turn cause activation of T cells and synovial cells in RA synovitis. We therefore propose that such cross-talking among distinct adhesion molecules may be involved in the pathogenesis of inflammation, including RA synovitis.

Adjuvants, Immunologic↗
PubMed1999

Prognostic significance of CD44 and nm23 expression in patients with stage II and stage IIIA gastric carcinoma.

BACKGROUND AND OBJECTIVES: Predicting the prognosis in gastric carcinoma patients with intermediate stages is difficult. We investigated the prognostic impacts of CD44 and nm23 expression in a homogeneous group of patients with stage II and IIIA gastric carcinoma who had undergone curative resections. METHODS: A total of 261 paraffin-embedded gastric carcinomas were stained with the monoclonal antibodies CD44 and nm23 using the labeled streptovidin biotin method. RESULTS: The expression of CD44 and nm23 was detected, respectively, in 31.0% (81/261) and 70.1% (183/261) of all tumors. There was no correlation between CD44 expression and clinicopathological variables. However, nm23 was more frequently expressed in older patients with differentiated adenocarcinoma. A significant difference in 5-year survival rates was found between patients with CD44-positive (43.2%) and CD44-negative tumors (63.4%), (P = 0.0018). However, there was no significant difference in 5-year survival rates between patients with nm23-positive (54.7%) and nm23-negative tumors (62.7%) (P = 0.2734). CONCLUSIONS: CD44 expression was a significant adverse prognostic factor in gastric carcinoma and may be a predictor of metastatic potential of the primary tumor. By contrast, immunohistochemical detection of nm23 expression was not a predictor of outcome of patients with gastric carcinoma.

Adult↗