title: Prognostic value of CD40 in adult soft tissue sarcomas.
abstract: OBJECTIVE
  The purpose is to evaluate the expression of CD40, a membrane protein predominantly expressed on B cells, dendritic cells, and macrophages, in a series of adult soft tissue sarcomas and to test its possible prognostic value.
  
  
  METHODS
  CD40 expression was studied by immunohistochemistry. Correlations with other baseline characteristics of patients and tumors were analyzed with chi(2) test. The prognostic value was studied with univariable and multivariable analysis adjusted by age, sex, tumor size, grade, location, and distant metastases.
  
  
  RESULTS
  Eighty-two patients, between January 1994 and May 2001, were analyzed. Membrane or cytoplasmic staining for CD40 protein was absent in 30% of the tumors but present in <10% of cells in 22 (27%), in 10% to 50% in 23 (28%), and in >50% of cells in 12 (15%) tumors. There was no correlation between CD40 expression and age, sex, size, grade, and location of the primary tumor and distant metastases. With 61 patients (74.4%) progressed and 31 (37.8%) dead, CD40 expression was a significant prognostic factor for disease-free and overall survival at univariable and multivariable analysis. Patients with tumors expressing CD40 in >50% of cells had a dramatically unfavorable prognosis with median disease-free and overall survival of 7 and 17 months, respectively, and hazard ratios of relapse and death as compared with patients with CD40-negative tumors of 2.89 (95% confidence interval: 1.26-6.60) and 6.92 (95% confidence interval: 2.18-22.0), respectively.
  
  
  CONCLUSIONS
  These data suggest that expression of CD40 protein in >50% of cells might indicate an unfavorable prognosis in adult soft tissue sarcomas.
authors.affiliation: Division of Medical Oncology B, National Cancer Institute, Naples, Italy. ale.otto@libero.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ottaiano
authors.forename: Anna
authors.initials: A
authors.lastname: De Chiara
authors.forename: Francesco
authors.initials: F
authors.lastname: Perrone
authors.forename: Gerardo
authors.initials: G
authors.lastname: Botti
authors.forename: Flavio
authors.initials: F
authors.lastname: Fazioli
authors.forename: Vincenzo
authors.initials: V
authors.lastname: De Rosa
authors.forename: Nicola
authors.initials: N
authors.lastname: Mozzillo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ravo
authors.forename: Brunello
authors.initials: B
authors.lastname: Morrica
authors.forename: Ciro
authors.initials: C
authors.lastname: Gallo
authors.forename: Carmela
authors.initials: C
authors.lastname: Pisano
authors.forename: Maria
authors.initials: M
authors.lastname: Napolitano
authors.forename: Paolo Antonio
authors.initials: PA
authors.lastname: Ascierto
authors.forename: Rosario Vincenzo
authors.initials: RV
authors.lastname: Iaffaioli
authors.forename: Gaetano
authors.initials: G
authors.lastname: Apice
mesh_terms: D000367:Age Factors; D000368:Aged; D001402:B-Lymphocytes / Q000378:metabolism; D019013:CD40 Antigens / Q000096:biosynthesis*; D002462:Cell Membrane / Q000378:metabolism; D003593:Cytoplasm / Q000378:metabolism; D003713:Dendritic Cells / Q000378:metabolism; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008024:Ligands; D008264:Macrophages / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012509:Sarcoma / Q000175:diagnosis* / Q000378:metabolism* / Q000473:pathology; D012983:Soft Tissue Neoplasms / Q000175:diagnosis* / Q000378:metabolism* / Q000473:pathology; D013997:Time Factors
chemical_list: D019013:CD40 Antigens; D008024:Ligands