title: CD44 variant expression is a common feature of epithelial ovarian cancer: lack of association with standard prognostic factors.
abstract: OBJECTIVE
  CD44 is a hyaluronic acid receptor that exists as a standard 90-kd form (CD44S) as well as several CD44 variant isoforms produced through alternative splicing. Expression of CD44 variants is associated with clinically aggressive behavior in some human tumors. The purpose of the present study is to define the expression of CD44 variant isoforms in ovarian cancer and to investigate whether the expression of these molecules is associated with adverse prognosis.
  
  
  METHODS
  Six specimens of normal ovarian surface epithelium (NOSE) and 31 separate cases of newly diagnosed ovarian cancer were studied by a combination of reverse-transcription polymerase chain reaction (RT-PCR) and immunoperoxidase staining. Clinical correlation was made between CD44 variant expression and stage (I/II v III/IV), residual disease (< or = 2.0- v > 2.0-cm mass), age (< or = 65 v > 65 years), histology (papillary serous v other), grade, and survival.
  
  
  RESULTS
  RT-PCR analysis revealed that NOSE predominantly expressed transcripts for CD44S, as well as a restricted pattern of transcripts characteristic of CD44 splice variants. CD44S and CD44 variant exon nine sequences (CD44-9v) were focally expressed in one of two NOSE specimens examined by immunoperoxidase staining. In comparison, the majority (71%) of ovarian cancer specimens expressed a complex pattern of CD44 splice variants by RT-PCR analysis. Immunoperoxidase studies revealed that the majority of ovarian cancer specimens expressed both CD44S and CD44-9v, whereas expression of sequences from variant exons 3, 4, and 6 was uncommon. There was no association between CD44 variant expression (transcript or protein) and stage, residual disease, age, histology, grade, or survival.
  
  
  CONCLUSIONS
  Expression of CD44S and CD44-9v is a common feature of epithelial ovarian cancer cells. The lack of a significant association between CD44 variant expression and prognosis suggests that other factors may be more important in determining the clinical behavior of this disease.
authors.affiliation: Division of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Cannistra
authors.forename: G
authors.initials: G
authors.lastname: Abu-Jawdeh
authors.forename: J
authors.initials: J
authors.lastname: Niloff
authors.forename: T
authors.initials: T
authors.lastname: Strobel
authors.forename: L
authors.initials: L
authors.lastname: Swanson
authors.forename: J
authors.initials: J
authors.lastname: Andersen
authors.forename: C
authors.initials: C
authors.lastname: Ottensmeier
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000276:immunology; D000328:Adult; D000368:Aged; D001483:Base Sequence; D002352:Carrier Proteins / Q000235:genetics / Q000378:metabolism*; D018283:Cystadenocarcinoma, Papillary / Q000276:immunology*; D004848:Epithelium / Q000276:immunology; D005260:Female; D006801:Humans; D018960:Hyaluronan Receptors; D007124:Immunoenzyme Techniques; D008875:Middle Aged; D008969:Molecular Sequence Data; D010051:Ovarian Neoplasms / Q000276:immunology*; D010053:Ovary / Q000276:immunology; D016133:Polymerase Chain Reaction / Q000379:methods; D011379:Prognosis; D011956:Receptors, Cell Surface / Q000235:genetics / Q000378:metabolism*; D016201:Receptors, Lymphocyte Homing / Q000235:genetics / Q000378:metabolism*; D014158:Transcription, Genetic
chemical_list: D002352:Carrier Proteins; D018960:Hyaluronan Receptors; D011956:Receptors, Cell Surface; D016201:Receptors, Lymphocyte Homing