title: Prognostic role of CD44 cell adhesion molecule expression in primary and metastatic renal cell carcinoma: a clinicopathologic study of 125 cases.
abstract: Possible prognostic utility of CD44 in renal cell carcinoma (RCC) prompted a comparison of its expression in primary and metastatic RCC. A total of 164 paraffin-embedded tissues of primary RCC and metastatic RCCs from 125 patients were immunostained with CD44 (standard form) antibody. It consisted of 86 primary RCCs (50 with subsequent metastasis [MET+] and 36 with no known metastasis [MET-]) during follow up and 78 metastatic RCCs (39 metastatic RCCs only and 39 with matched RCC primary from RCC MET + category). Immunoreactivity for CD44 was scored semiquantitatively as 0, 1, or 2 (0, <5%; 1, 5-50%; 2, > or =50%). Expression of CD44 was significantly higher in metastatic RCCs compared to primary RCCs (p = 0.036). CD44 immunoreactivity in the primary RCC (MET- and MET+) correlated with progression-free survival (p = 0.027). In metastatic RCCs, CD44 immunoreactivity also correlated with survival after detection of first metastasis (p = 0.011). In multivariate analysis, stage (p = 0.0001) and CD44 immunoreactivity (p = 0.03) in primary RCC were independent predictors of progression-free survival. Our study suggests that CD44 status in RCC provides useful prognostic information both in primary and metastatic RCCs and may have applicability in stratifying patients for therapeutic decisions.
authors.affiliation: Department of Pathology, Konkuk University School of Medicine, Gwangjin-Gu, Seoul, Republic of Korea.
authors.forename: So Dug
authors.initials: SD
authors.lastname: Lim
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Young
authors.forename: Gladell P
authors.initials: GP
authors.lastname: Paner
authors.forename: Mahul B
authors.initials: MB
authors.lastname: Amin
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism; D002292:Carcinoma, Renal Cell / Q000378:metabolism* / Q000401:mortality / Q000556:secondary; D018572:Disease-Free Survival; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D018960:Hyaluronan Receptors / Q000378:metabolism*; D007124:Immunoenzyme Techniques; D007680:Kidney Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; C497483:CD44 protein, human; D018960:Hyaluronan Receptors