CD44v/CD44s expression patterns are associated with the survival of pancreatic carcinoma patients.
OBJECTIVE
CD44 variants have been associated with tumor invasion and metastasis, but CD44 expression patterns have not been systematically investigated in pancreatic carcinoma. This study systematically investigated whether CD44 expression patterns are involved in pancreatic carcinoma metastasis and prognosis.


METHODS
We applied primers specific for all CD44 variants and CD44s to analyze the expression patterns of CD44 (CD44v2-CD44v10 and CD44s) using quantitative real-time PCR (qRT-PCR). We then further evaluated their roles in pancreatic carcinoma metastasis and prognosis using clinical survival analysis.


RESULTS
Increased CD44v expression and decreased CD44s expression were found in metastatic pancreatic carcinoma in three different cell lines and in human tumor tissue. Clinical analysis showed that CD44v6+ and CD44v9+ were correlated with lymph node metastasis, liver metastasis and TNM stage. However, CD44s- was associated with liver metastasis, tumor differentiation and TNM stage. Survival analysis showed that patients with CD44v6+/CD44s- or CD44v6+/CD44s- had lower overall survival (OS) rates, although the individual expression of CD44v6, CD44v9 and CD44s was also related to decreased OS rates. Univariate analysis showed that lymph node metastasis; vessel invasion; hepatic metastases; TNM stage; and individual or co-expression of CD44v6, CD44v9 and CD44s were risk factors affecting survival. Multivariate analysis showed that CD44v6+/CD44s- was an independent predictor of survival.


CONCLUSIONS
We found that CD44v6+, CD44v9+ and CD44s- were associated with pancreatic carcinoma metastasis and progression and that CD44v6+/CD44s- was an independent risk factor affecting survival in pancreatic carcinoma. Therefore, the different expression patterns of CD44v/CD44s may determine pancreatic carcinoma prognosis.
The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1579257224116287.
Zhonghu
Z
Li
Kai
K
Chen
Peng
P
Jiang
Xi
X
Zhang
Department of Hepatobiliary Surgery Institute, Southwest Hospital, Third Military Medical University, 30 Gaotanyan Street, Shapingba District, Chongqing 400038, China. lixw1966@163.com.
Xiaowu
X
Li
Zhihua
Z
Li
D000368:Aged; D014408:Biomarkers, Tumor / Q000235:genetics*; D002277:Carcinoma / Q000235:genetics* / Q000276:immunology / Q000401:mortality / Q000556:secondary; D045744:Cell Line, Tumor; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D014644:Genetic Variation; D006801:Humans; D018960:Hyaluronan Receptors / Q000235:genetics*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000235:genetics* / Q000276:immunology* / Q000401:mortality / Q000473:pathology; D016016:Proportional Hazards Models; D012307:Risk Factors; D013997:Time Factors
D014408:Biomarkers, Tumor; C497483:CD44 protein, human; C473647:CD44S antigen; C117722:CD44v10 antigen; D018960:Hyaluronan Receptors