title: Reduced CD44 standard expression is associated with tumour recurrence and unfavourable outcome in differentiated thyroid carcinoma.
abstract: CD44 was detected with an antibody recognizing all forms of CD44 (CD44 standard) and others specific for its v3 and v6 variant isoforms; their prognostic value was evaluated in 213 patients with differentiated thyroid carcinoma (DTC). The staining patterns of CD44 standard (s) and CD44v6 in tumour tissue were quite similar, 176 cases (83%) being highly positive for CD44s and 153 cases (72%) for CD44v6. Only 18 (9%) tumours showed high expression of CD44v3. Papillary carcinomas were significantly more often high expressors of CD44s and CD44v6 than follicular carcinomas (p<0.001 for both). Age older than 60 years, distant metastases, and advanced pTNM stage were related to loss of expression of CD44s (p<0.001, p=0.021, and p=0.003, respectively). Tumour recurrence and cancer-related mortality were related to the reduced level of CD44s (p=0.049 and p=0.042). CD44v3 did not associate with any of the clinicopathological factors. In univariate analysis, CD44s was the only significant prognostic factor for disease-free survival (p=0.0488). In multivariate analysis, CD44s and thyroglobulin level were significant prognostic factors for disease-free survival (p=0.040 and p<0.001, respectively). The reduced level of CD44s in DTC patients seems to be an independent prognostic factor for unfavourable disease outcome.
authors.affiliation: Department of Pathology and Forensic Medicine, University of Kuopio and Kuopio University Hospital, Finland.
authors.forename: J P
authors.initials: JP
authors.lastname: Böhm
authors.forename: L K
authors.initials: LK
authors.lastname: Niskanen
authors.forename: R T
authors.initials: RT
authors.lastname: Pirinen
authors.forename: K
authors.initials: K
authors.lastname: Kiraly
authors.forename: J K
authors.initials: JK
authors.lastname: Kellokoski
authors.forename: K I
authors.initials: KI
authors.lastname: Moisio
authors.forename: M J
authors.initials: MJ
authors.lastname: Eskelinen
authors.forename: H E
authors.initials: HE
authors.lastname: Tulla
authors.forename: S
authors.initials: S
authors.lastname: Hollmen
authors.forename: E M
authors.initials: EM
authors.lastname: Alhava
authors.forename: V M
authors.initials: VM
authors.lastname: Kosma
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor; D018265:Carcinoma, Papillary, Follicular / Q000276:immunology* / Q000556:secondary; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D018960:Hyaluronan Receptors / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis / Q000276:immunology; D009364:Neoplasm Recurrence, Local / Q000276:immunology*; D011379:Prognosis; D013954:Thyroglobulin / Q000032:analysis; D013964:Thyroid Neoplasms / Q000276:immunology* / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods
chemical_list: D014408:Biomarkers, Tumor; D018960:Hyaluronan Receptors; D013954:Thyroglobulin