title: Frequency of cells expressing CD44, a head and neck cancer stem cell marker: correlation with tumor aggressiveness.
abstract: BACKGROUND
  We previously identified by flow cytometry a Lineage-CD44+ (Lin-CD44+) subpopulation of cells with cancer stem cell properties in head and neck squamous cell carcinoma (HNSCC). We now correlate clinical and histologic factors with Lin-CD44+ cell frequency.
  
  
  METHODS
  The study included 31 patients with HNSCC, of whom 87% had stage IV disease. The frequency of Lin-CD44+ cells and the success of xenografting patient tumors in mice were correlated with clinical and pathologic data.
  
  
  RESULTS
  The mean frequency of Lin-CD44+ cells was 25% (0.4%-81%). It was 36% in patients who had recurrence versus 15% for those without recurrence (p = .04). Successful xenograft implantation occurred in 53%. Seventy-five percent of patients with successful xenografts had recurrence versus 21% of patients with unsuccessful xenografts (p = .003).
  
  
  CONCLUSIONS
  Successful xenograft implantation and a high frequency of Lin-CD44+ cells correlate with known poor prognostic factors such as advanced T classification and recurrence. These findings may support the stem cell concept in HNSCC.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Stanford University Medical Center, California. benbat7@yahoo.com
authors.forename: Benzion
authors.initials: B
authors.lastname: Joshua
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Kaplan
authors.forename: Ilana
authors.initials: I
authors.lastname: Doweck
authors.forename: Reetesh
authors.initials: R
authors.lastname: Pai
authors.forename: Irving L
authors.initials: IL
authors.lastname: Weissman
authors.forename: Mark E
authors.initials: ME
authors.lastname: Prince
authors.forename: Laurie E
authors.initials: LE
authors.lastname: Ailles
mesh_terms: D000328:Adult; D000818:Animals; D015415:Biomarkers; D014408:Biomarkers, Tumor / Q000032:analysis*; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D018960:Hyaluronan Receptors / Q000032:analysis*; D051379:Mice; D008875:Middle Aged; D009367:Neoplasm Staging; D014411:Neoplastic Stem Cells / Q000473:pathology*; D014183:Transplantation, Heterologous
chemical_list: D015415:Biomarkers; D014408:Biomarkers, Tumor; C497483:CD44 protein, human; D018960:Hyaluronan Receptors