title: Lack of CD44 variant 6 expression in rectal cancer invasive front associates with early recurrence.
abstract: OBJECTIVE
  To investigate the prognostic value of CD44 variant 6 (CD44v6), a membranous adhesion molecule, in rectal cancer.
  
  
  METHODS
  Altogether, 210 rectal cancer samples from 214 patients treated with short-course radiotherapy (RT, n = 90), long-course (chemo) RT (n = 53) or surgery alone (n = 71) were studied with immunohistochemistry for CD44v6. The extent and intensity of membranous and cytoplasmic CD44v6 staining, and the intratumoral membranous staining pattern, were analyzed.
  
  
  RESULTS
  Membranous CD44v6 expression was seen in 84% and cytoplasmic expression in 81% of the cases. In 59% of the tumors with membranous CD44v6 expression, the staining pattern in the invasive front was determined as "front-positive" and in 41% as "front-negative". The latter pattern was associated with narrower circumferential margin (P = 0.01), infiltrative growth pattern (P < 0.001), and shorter disease-free survival in univariate survival analysis (P = 0.022) when compared to the "front-positive" tumors.
  
  
  CONCLUSIONS
  The lack of membranous CD44v6 in the rectal cancer invasive front could be used as a method to identify patients at increased risk for recurrent disease.
authors.affiliation: Department of Oncology and Radiotherapy, University of Turku and Turku University Hospital, FIN-20521 Turku, Finland. stavor@utu.fi
authors.forename: Suvi Tuulia
authors.initials: ST
authors.lastname: Avoranta
authors.forename: Eija Annika
authors.initials: EA
authors.lastname: Korkeila
authors.forename: Kari Juhani
authors.initials: KJ
authors.lastname: Syrjänen
authors.forename: Seppo Olavi
authors.initials: SO
authors.lastname: Pyrhönen
authors.forename: Jari Toivo Tapio
authors.initials: JT
authors.lastname: Sundström
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism; D002462:Cell Membrane / Q000378:metabolism / Q000473:pathology; D049109:Cell Proliferation; D003131:Combined Modality Therapy; D003593:Cytoplasm / Q000378:metabolism / Q000473:pathology; D005260:Female; D015972:Gene Expression Regulation, Neoplastic / Q000235:genetics*; D014644:Genetic Variation / Q000235:genetics*; D006801:Humans; D018960:Hyaluronan Receptors / Q000235:genetics* / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000235:genetics* / Q000401:mortality; D012004:Rectal Neoplasms / Q000235:genetics* / Q000378:metabolism* / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D018960:Hyaluronan Receptors