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PubMed1994

Expression of CD44 splice variants during lymphocyte activation and tumor progression.

Recently, splice variants of CD44 have been described that confer metastatic potential to non-metastasizing rat pancreatic carcinoma and sarcoma cell lines. Using antibodies against variant CD44 (CD44v) sequences, we have examined the expression of variant CD44 glycoproteins on human lymphoid cells and tissues and in colorectal neoplasia. Lymphohematopoietic cells express low levels of CD44v glycoproteins. During the process of lymphocyte activation in vitro and in vivo, expression of CD44v glycoproteins is transiently upregulated. 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 confers metastatic capability. In human colorectal neoplasia we observed overexpression of CD44 splice variants in all invasive carcinomas. Already at early stages of colorectal tumor progression exon v5 epitopes were overexpressed. Tumor progression was strongly related to expression of CD44 isoforms containing exon v6 encoded domains. The findings establish CD44 variants as tumor progression markers in colorectal cancer.

Alternative Splicing↗

PubMed1995

Alternative RNA splicing of the hyaluronic acid receptor CD44 in the normal human brain and in brain tumors.

The cell-surface receptor for hyaluronic acid, CD44, is expressed by both normal and malignant cells. Numerous CD44 isoforms have recently been identified that are derived by alternative ribonucleic acid splicing. The expression of some CD44 isoforms has been shown to be involved in tumor progression and metastatic spread in a rat carcinoma model and in human carcinomas. In the present study, CD44 isoform expression was evaluated by reverse transcriptase-polymerase chain reaction (PCR) analysis in frozen sections derived from three samples of normal brain tissue and from 40 brain tumors, including samples of glioblastoma multiforme, anaplastic astrocytoma, low-grade astrocytoma, cerebral primitive neuroectodermal tumor, medulloblastoma, metastatic colon carcinoma, and metastatic melanoma. Normal brain tissue adjacent to the tumors was also examined in 14 of 18 glioblastomas. In all normal brain and tumor samples, with the exception of metastases from colon carcinoma, PCR analysis demonstrated one prominent product that corresponded to the CD44H hematopoietic form of CD44. Metastases from colon carcinoma demonstrated two prominent PCR amplification products corresponding to CD44H and CD44R1. These results suggest that CD44H is the predominant isoform of this protein in normal human brain tissue and in human neuroectodermal tumors of varying degrees of malignancy. The ability of CD44H to mediate tumor cell motility and invasiveness (in contrast to CD44R1) suggests that the CD44 alternative splicing pattern of neuroectoderm-derived tumors may enhance their local biological aggressiveness and intracerebral spread. The lack of expression of larger molecular weight CD44 variants by primary brain tumors may also partially explain why these tumors rarely metastasize to distant sites.

Alternative Splicing↗

PubMed2000

The significance of CD44 variants expression in colorectal cancer and its regional lymph nodes.

CD44 is a cell adhesion molecule with numerous isoforms created by mRNA alternative splicing. Expression of CD44 variants has been suggested to play a potential role in tumor progression and metastasis. We designed primers CD44V, CD44V6/7, CD44R1 and CD44V6-10 to analyze and compare the roles of each CD44 variants. Expressions of CD44 variants were investigated in normal colonic mucosa, the lymph nodes which was histopathologically free of cancer cell, and cancer tissues of 44 human colorectal cancer patients by RT-PCR method. The expression of CD44V was observed in 28 out of 39 (71.8%) tumors and 7 out of 11 (63.6%) N1 normal regional lymph nodes, and CD44V6/7 was observed in 28 out of 39 (71.8%) tumors and 9 out of 11 (81.8%) N1 normal regional lymph nodes. The expressions of CD44V and CD44V6/7 were most frequently observed compared with any other CD44 variants. In normal colonic mucosa, the expression of CD44 variants are low but in cancer tissue and its regional lymph node, the expression of CD44V and CD44V6/7 were significantly higher and more frequent than any other CD44 variants (p<0.05). These results suggest that CD44V and CD44V6/7 can be a molecular marker for colorectal cancer and its micrometastasis to the regional normal lymph node.

Alternative Splicing↗

PubMed2001

A role for CD44 in the production of IFN-gamma and immunopathology during infection with Toxoplasma gondii.

The interaction of activated CD44 with its ligand, low m.w. hyaluronan, is involved in inflammation, but no role has been identified for this interaction in the regulation of an immune response to infection. In these studies, infection of C57BL/6 mice with Toxoplasma gondii resulted in increased expression of CD44 on T cells, B cells, NK cells, and macrophages, and a small percentage of CD4(+) T cells express an activated form of CD44. Administration of anti-CD44 to infected mice prevented the development of a CD4(+) T cell-dependent, infection-induced inflammatory response in the small intestine characterized by the overproduction of IFN-gamma. The protective effect of anti-CD44 treatment was associated with reduced production of IFN-gamma, but not IL-12, in vivo and in vitro. Furthermore, the addition of low m.w. hyaluronan to cultures of splenocytes or purified CD4(+) T cells from infected mice resulted in the production of high levels of IFN-gamma, which was dependent on IL-12 and TCR stimulation. Together, these results identify a novel role for CD44 in the regulation of IFN-gamma production by CD4(+) T cells during infection and demonstrate a role for CD44 in the regulation of infection-induced immune pathology.

Adjuvants, Immunologic↗

PubMed2006

Urothelial CD44 facilitates Escherichia coli infection of the murine urinary tract.

Escherichia coli is the most common pathogen found in urinary tract infections (UTIs), mainly affecting children and women. We report that CD44, a hyaluronic acid (HA) binding protein that mediates cell-cell and cell-matrix interactions, facilitates the interaction of E. coli with urothelial cells and thus the infection of the host. We found that CD44 is constitutively expressed on urothelial cells and that HA accumulates in E. coli-induced UTI. In CD44-deficient mice, the bacterial outgrowth was dramatically less compared with wild-type mice despite similar granulocyte influx in the bladder and in the kidney as well as comparable cytokines/chemokines levels in both genotypes. E. coli was able to bind HA, which adhered to CD44-positive tubular epithelial cells. Most importantly, the interaction of CD44 on tubular epithelial cells with HA facilitated the migration of E. coli through the epithelial monolayer. The results provide evidence that CD44 on urothelial cells facilitates E. coli UTI. Disruption of the interaction between CD44 and HA in the bladder may provide a new approach to prevent and to treat UTI.

Animals↗

PubMed2005

Roles of and correlation between alpha-smooth muscle actin, CD44, hyaluronic acid and osteopontin in crescent formation in human glomerulonephritis.

BACKGROUND: alpha-Smooth muscle actin (SMA), CD44, hyaluronic acid (HA) and osteopontin (OPN) are involved in crescent formation; however, the correlation between these molecules during the formation and progression of the crescents in human glomerulonephritis (GN) has not been fully evaluated. METHODS: To investigate the expression of alpha-SMA, CD44, HA, OPN and CD68 renal biopsy specimens from 14 patients with crescentic GN were examined by immunohistochemistry. All crescents were separated into cellular, fibrocellular and fibrous. The extent of staining in each crescent was scored semiquantitatively. The change in the expression of each molecule and its correlation with other molecules during the formation and progression of the crescents were estimated statistically. RESULTS: The expression of alpha-SMA was significantly up-regulated in the fibrocellular crescents compared with that in the cellular and fibrous crescents. The expression of CD44, OPN and CD68 was significant in the cellular crescents compared with that in the fibrocellular and fibrous crescents. The deposition of HA in the three groups of crescents was high level. However, that of HA was not significant among three groups of crescent. The expression of CD44 in the cellular crescents correlated significantly with the expression of OPN and CD68, and the deposition of HA in the cellular crescents. The expression of OPN in the cellular crescents correlated with the deposition of HA and the expression of CD68 in the cellular crescents. The expression of alpha-SMA in the cellular and fibrocellular crescents correlated with the deposition of HA in the cellular and fibrocellular crescents. CONCLUSION: The expression of CD44, HA, OPN and CD68 was up-regulated at the early stage of the crescent formation in human crescentic GN. Moreover, myofibroblasts and cell-matrix interactions mediated by the CD44-OPN and CD44-HA receptor-ligand pairs may play important roles in the formation and progression of the crescents.

Actins↗

PubMed1999

Hyaluronate receptor CD44 is expressed by astrocytes in the adult chicken and in astrocyte cell precursors in early development of the chick spinal cord.

The role of the hyaluronate receptor, CD44, is well known in adult mammal astrocytes where it modulates neuron-glia interactions. However, no data exist regarding its expression in other vertebrates during their development. In order to detect the expression of CD44 in the chicken and its possible involvement in glial precursor migratory patterns during spinal cord development, a monoclonal antibody (MoAb) against the mammalian standard isoform, CD44-H, was used in immunohistochemical and immunoblot assays. With these methods, CD44 hyaluronate receptors were found on mature astrocyte membranes of adult chicken spinal cord. Astrocytes were identified using a MoAb against GFAP. During development, small clusters of CD44 labelled cells were seen lining the central canal starting from embryonic stage E10. These labelled cells were dispersed in the dorsal, lateral and ventral funiculi of the spinal cord in the subsequent stages. After stage E15, the CD44 labelled cells were identified as astrocytes because of their GFAP immunoreactivity. We conclude that CD44 receptors on immature astrocyte precursors should be considered as early astrocyte markers which have a possible role during cell migratory dispersal.

Animals↗

PubMedDate not supplied

Expression of CD44 isoforms in human breast carcinoma xenografts is not influenced by the treatment of mice with cytostatics or (anti-)hormones.

CD44 standard (s) and variant (v) isoforms have been discussed to be implicated in progression and metastasis of different malignomas. For breast carcinomas, the results of different studies are contradictory. These apparent discrepancies suggest that CD44 isoforms are not available on the tumour cell surface, but could be regulated by different endogenous and exogenous factors. Here we report the regulation of CD44 isoforms in xenografted breast cancer cell lines by cytostatics, hormones and antihormones. The human breast cancer models MDA-MB 435, MCF-7, NCI/ADR, 4296, 4151 and 4134 were transplanted into the mammary fat pad of nude mice. When tumours reached a palpable size, animals were treated with farmorubicine, cyclophosphamide, estradiol, tamoxifen or progesterone, respectively. At different times after treatment, serum and tumours were taken. The expression of CD44 and its isoforms was determined by immunohistochemistry and RT-PCR, serum levels were measured by human specific ELISA kits. Serum levels of CD44s and v6 varied among the tumours. For 3/6 tumours we found differences between control groups and treated animals. Immunohistochemical results remained unchanged: each tumour showed a specific pattern of CD44 expression, but this pattern did not change when the animals received cytostatics, hormones or antihormones. The same held true for RT-PCR-results. Also, the time of tumour collection had no influence on CD44 expression. Therefore, it can be concluded, that in the xenografted breast cancer cell lines a regulation of CD44 isoforms by farmorubicine, cyclophosphamide, estradiol, progesterone or tamoxifen could not be found, while serum levels were influenced in some cases probably due to tumour cell kill and shedding of surface proteins into blood stream.

Animals↗

PubMed1999

CD44-deficient mice develop normally with changes in subpopulations and recirculation of lymphocyte subsets.

Cell adhesion molecules are considered to be pivotal elements required for proper embryo development. The transmembrane glycoprotein CD44, which is expressed in numerous splice variants on the surface of many different cell types and tissues, has been suggested to be involved in several physiological processes such as cell-cell interactions, signal transduction, and lymphocyte homing and trafficking during embryogenesis and in the adult organism. Some splice variants are thought to play an important role in tumor progression. To investigate the physiological roles of CD44 in vivo, we abolished expression of all isoforms of CD44 in mice by targeted insertion of a lacZ/neo cassette into the reading frame of the leader peptide. CD44-deficient mice are viable without obvious developmental defects and show no overt abnormalities as adults. However, CD44-deficient lymphocytes exhibit impaired entry into the adult thymus, although lymphocyte development is apparently unaltered. Our data indicate that all splice variants of CD44 are dispensable for embryonic development and implicate a critical function for CD44 in lymphocyte recirculation.

Animals↗

PubMed1999

Crosslinking of CD44 on rheumatoid synovial cells augment interleukin 6 production.

CD44 is a ubiquitous molecule also known as hyaluronic acid or homing receptor. However, its cellular functions and its role in inflammation, for example rheumatoid synovitis, are currently unknown. Here we propose a novel function for CD44. Using synovial cells from patients with rheumatoid arthritis (RA), we demonstrated that CD44 crosslinking and binding to hyaluronan augmented IL-6 production. Briefly, we found that (a) rheumatoid synovial cells highly expressed CD44; (b) crosslinking of CD44 augmented IL-6 production and its mRNA transcription; (c) hyaluronan, especially when fragmented, also increased IL-6 production; and (d) CD44 activated the transcription factor activator protein-1 and CAMP-responsive element binding protein. These results indicate that the adhesion of RA synovial cells to matrices such as hyaluronic acid through CD44 could activate transcription factor, resulting in cytokine production. We therefore propose that the function of adhesion molecules as a signaling molecule may be pivotal in the pathogenesis of inflammation, including RA synovitis.

Arthritis, Rheumatoid↗

PubMed2000

CD44 and its v6 spliced variant in lung carcinomas: relation to NCAM, CEA, EMA and UP1 and prognostic significance.

CD44 is a polymorphic family of cell surface glycoproteins that was recently reported to have important role in cell adhesion and migration as well as modulation of cell-matrix interactions. Thus, expression of CD44 has been proposed to be associated with malignant behavior of tumors like invasive growth and formation of metastasis. The expression of CD44s and its v6 isoform (CD44v6) was determined immunohistochemically in 106 lung tumors of various histophenotypes, degrees of differentiation, and clinical stages. The results were compared with the expression of NCAM, CEA, EMA and UP1 and with clinicopathological parameters including patients' survival. CD44s was expressed in all histophenotypes of non-small cell lung carcinomas (NSCLC) with tendency being squamous cell lung carcinoma (SqCC) > bronchioloalveolar adenocarcinoma (BAC) > conventional adenocarcinoma (ConAC) (91, 66.7 and 38.9%, respectively). Almost identical distribution of positivity revealed CD44v6 in all three subgroups of NSCLC mentioned above (91, 66.7 and 36.1%, respectively). In the subgroup of neuroendocrine tumors, CD44s and CD44v6 were restrictedly expressed in small cell lung carcinomas (2/14 tumors), while all 3 typical carcinoids were strongly positive for these markers. Expression of NCAM and CEA was significantly higher in adenocarcinoma subgroup than those in SqCC subgroup (45.7 and 75% vs. 14.8 and 39%, respectively). NCAM expression was also significantly different in BACs and in ConACs (69.2 vs. 36.4%, p < 0.05). The expression of CD44 was related to the differentiation of SqCC. The carcinomas with keratinization were CD44 positive. Adenocarcinomas producing mucin were CD44 negative. The expression of CD44, NCAM, CEA, EMA and UP1 did not correlate with lymph node metastasis and disease stage. CD44V6 was the only marker that its expression was closely related to patients' survival. The absence CD44v6 but not CD44s in NSCLC group was associated with significantly longer survival of patients compared to patients with CD44v6 positive tumors. This difference was even higher in tumors negative for CD44v6 and simultaneously NCAM and/or CEA positive. The data of this study suggest that CD44v6 might be an independent prognostic factor in NSCLC. Moreover, our data give another evidence of diverse role of CD44 in the differentiation and progression of non-small cell lung carcinomas and neuroendocrine carcinomas of the lung.

Adenocarcinoma↗

PubMed2002

A correlation between immunoexpression of CD44, alpha-SMA and CD68+ cells in IgA-nephropathy and in mesangial proliferative IgA-negative glomerulonephritis.

Immunoperoxidase staining was carried out using monoclonal antibodies against CD44, alpha-smooth muscle actin and CD68 on renal biopsy specimens from patients with IgA nephropathy (IgAN, n = 16) and mesangial proliferative IgA-negative glomerulonephritis (MesProGN, n = 15). As a control 10 biopsy specimens of the kidneys removed because of trauma were used. The results showed increase in glomerular CD44+ cells and CD68+ cells in IgAN biopsies as compared with controls and MesProGN. The intensity of glomerular alpha-SMA was increased in IgAN and MesProGN as compared with controls, but no statistical differences were shown in glomerular expression of alpha-SMA between IgAN and MesProGN. In both study groups there were significant positive correlations between glomerular CD44+ cells and CD68+ cells, as well as the intensity of alpha-SMA immunostaining. The interstitial expression of CD44 and alpha-SMA in IgAN patients was significantly higher as compared with controls and MesProGN group, whereas the mean values of interstitial CD68+ cell did not differ significantly in these glomerulopathies. In both IgAN and MesProGN there were significant positive correlations between interstitial expression of CD44 and alpha-SMA, between intensity of CD44 immunostaining and CD68+ cells as well as interstitial volume. In conclusion, our study suggests possible role of CD44 interaction in macrophage recruitment and the development of interstitial fibrosis and glomerular sclerosis in both glomerulopathies.

Actins↗

PubMed2003

Glycoprotein CD44 expression in normal, hyperplasic and neoplastic endometrium. An immunohistochemical study including correlations with p53, steroid receptor status and proliferative indices (PCNA, MIB1).

PURPOSE OF INVESTIGATION: We have studied by immunohistochemistry the presence and localization of CD44, estrogen and progesterone receptors, p53 and proliferative associated indices (MIB1, PCNA) in archival endometrial tissue, in order to determine their diagnostic and prognostic value as well as the possible correlations between them. METHODS: We examined 186 samples of endometrial tissue (100 endometrial carcinomas of endometrioid type, 40 cases of hyperplasia and 46 of normal endometrium). Patient records were examined for FIGO stage, grade, and depth of myometrial invasion, histology, and lympho-vascular space invasion. RESULTS: Strong membranous immunostaining (> 10% of neoplastic cells) was observed in 45% of the carcinomas. A statistically significant correlation was found in the expression of protein in stromal cells, when compared with epithelial cells (p < 0.0001). Immunohistochemical expression of CD44 was significantly lower in cancer cases than in normal endometrium, mainly in the secretory phase (p < 0.0001). CD44 positive cases by immunohistochemistry failed to show any statistical correlation with tumor grade or with vessel invasion. The expression of the protein was lower in FIGO Stage II compared with Stage I (p = 0.03). A positive relation of CD44 expression with progesterone receptor status (p = 0.02) was detected. CD44 expression was also positively associated with the proliferation associated with the proliferative index MIB1 (p = 0.001). CONCLUSION: CD44 is closely related to the secretory phase of the normal menstrual cycle and its expression is decreased in hyperplasia (simple or complex with or without atypia) and in cancer cases. These observations suggest that decreased CD44 expression might be functionally involved in the multiple mechanisms of the development and progression of endometrial lesions.

Biomarkers, Tumor↗

PubMedDate not supplied

CD44 family and gynaecological cancer.

CD44 refers to a multifunctional family of type I transmembrane proteins. The CD44 gene contains at least 21 exons, 11 of which can be variably spliced and produce a variety of heavily glycosylated cell surface proteins, known as CD44 variant isoforms. These proteins have been implicated in many biological processes, such as cell adhesion, cell substrate, cell to cell interactions, including lymphocyte homing haemopoiesis, cell migration and metastasis. These abilities are of great importance in chronic inflammation and in cancer. Published data have shown that CD44 has the ability to recruit leucocytes to vascular endothelium at sites of inflammation, which is one of the first steps in the inflammatory response. In cancer, deregulation of the adhesion mechanisms increases the ability of tumor cells to metastasis. This behavior seems to be explained by the existing relationship between hyaluronan, a basic component of the extracellular matrix and CD44, which is its major cell surface receptor. There are CD44 variant isoforms which are expressed on different types of normal cells. In addition some isoforms are overexpressed on tumor cells including breast, cervical, endometrial and ovarian cancer. This property seems to be correlated with the metastatic potential of these cells. This review summarizes the available data on the possible prognostic role of the polymorphic CD44 protein family and its role as a tumor marker in gynaecological cancer.

Biomarkers, Tumor↗

PubMedDate not supplied

Adhesion molecule CD44 as a prognostic factor in tongue cancer.

BACKGROUND: 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. MATERIALS AND METHODS: 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. RESULTS: 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). CONCLUSION: The reduced expression of CD44 behaves as a marker of poor tongue tumor prognosis.

Adult↗

PubMed2004

[Study on MYCN gene amplification and CD44 expression in neuroblastoma].

OBJECTIVE: To assess the relationship between MYCN amplification in neuroblastoma (NB), tumor stage and prognosis; and to evaluate the usefulness of CD44 in predicting prognosis of NB. METHODS: Differential polymerase chain reaction (D-PCR) with serial dilution assay was used to quantify the MYCN gene copy number in 33 paraffin-embedded tissue samples of NB. All the samples were also studied by immunohistochemistry for CD44. The results were correlated with various prognostic factors of NB, including patient age, tumor stage, pathologic type and MYCN gene amplification. RESULTS: MYCN amplification was identified in 10 of the 33 samples studied (30.3%), which all were in high clinical stage (stage III or IV) and occurred in patients older than 1 year of age. MYCN amplification also significantly correlated with poor clinical outcome (P < 0.01). CD44 was positive in 21 cases and often occurred in patients below 1 year of age, in low clinical stage, with favorable histology and without MYCN gene amplification. The two-year survival rate of CD44-positive group (57.1%) was higher than that of CD44-negative group (8.3%, P < 0.01). Stronger CD44 expression was also associated with better prognosis (P < 0.01). CONCLUSIONS: MYCN gene amplification is significantly associated with advanced tumor stage and poor prognosis in patients with NB. CD44 expression is a reliable marker for better prognosis and is complementary to MYCN amplification assay. D-PCR with serial dilution assay is also suitable for clinical use in quantifying MYCN copy number in NB.

Adolescent↗

PubMed1992

Multiple variants of the human lymphocyte homing receptor CD44 generated by insertions at a single site in the extracellular domain.

The human CD44 cell-surface glycoprotein participates in a wide variety of cell-cell interactions including lymphocyte homing and tumor metastasis. The CD44 antigen is known to display extensive size heterogeneity when compared between different tissue sources although the structural basis for this variation is not yet clear. Recently, two further isotypes in addition to the basic hemopoietic form of the CD44 antigen have been cloned and sequenced and these have been found to contain all or part of a 200-400-base pair insert within the extracellular domain, suggesting that the characteristic heterogeneity in the molecule may be generated by a mechanism of alternative splicing. We have obtained further evidence for alternative splicing, and we report here the cloning and sequencing of six different CD44 sequence variants from a variety of cell lines using a combination of expression cloning and the polymerase chain reaction. Comparison of these variants indicates that each is probably assembled by the insertion of five different exon units in tandem into a discrete site within the membrane proximal region of the extracellular domain. One of the variants contains an exon that shares extensive amino acid sequence homology with a recently described rat CD44 variant that mediates tumor metastasis. Another variant contains a new exon that encodes a tandem repeat of the consensus sequence SG for covalent modification with chondroitin sulfate and is expressed predominantly on mammary tumors. We suggest that a mechanism of alternative exon splicing generates much of the observed structural heterogeneity of CD44 and that the particular set of CD44 variants expressed in a single cell may represent a precise postal code directing the final destination of migrating cells and metastatic tumors.

Amino Acid Sequence↗

PubMedDate not supplied

Adhesion molecule CD44 as a prognostic factor in laryngeal cancer.

BACKGROUND: 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. PATIENTS AND METHODS: 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. RESULTS: 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). CONCLUSION: The reduced expression of CD44 behaves as a marker of a poor laryngeal cancer prognosis.

Adult↗