title: Clinicopathological characterisation of duodenal adenocarcinoma with high CD44 variant 9 expression.
abstract: CD44 has been identified as a cancer stem cell (CSC) biomarker in various malignancies. The aim of this study was to elucidate the clinicopathological features of CD44v9 positive cells in duodenal adenocarcinoma (DA).Twenty-nine DA patients were selected from medical archives at our hospital. CD44v9 expression was analysed together with that of MUC2, MUC5AC, and MUC6 by immunohistochemistry. High levels of CD44v9 expression weakly correlated with inflammatory cell infiltration (r = 0.431, p = 0.020) and MUC6 expression (r = 0.425, p = 0.022). Furthermore, double immunofluorescence staining of CD44v9 and Ki-67 or cleaved caspase 3 (CC3) was performed. High- and low-density areas of CD44v9 positive cells were designated as CD44v9 positive and negative areas, respectively. Within CD44v9 positive areas, the level of Ki-67 positivity among CD44v9 positive cells was significantly lower than that of CD44v9 negative cells (p = 0.002). Meanwhile, the level of CC3 positivity among CD44v9 positive cells was significantly lower than that of CD44v9 negative cells (p < 0.001).CD44v9 expression may be affected by mononuclear cell infiltration and MUC6 expression in DA. CD44v9 positive cells also have a low mitotic activity and resist apoptosis. These characteristics suggest that CD44v9 positive cells possess CSC-like properties in DA.
authors.affiliation: 1Department of Gastroenterology 2Department of Laboratory Medicine 3Department of Biomedical Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Maruyama
authors.forename: Takeshi
authors.initials: T
authors.lastname: Uehara
authors.forename: Seiichi
authors.initials: S
authors.lastname: Daikuhara
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Nakajima
authors.forename: Akihiro
authors.initials: A
authors.lastname: Matsumoto
authors.forename: Eiji
authors.initials: E
authors.lastname: Tanaka
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Ota
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology*; D000368:Aged; D017398:Alternative Splicing; D017209:Apoptosis; D014408:Biomarkers, Tumor / Q000032:analysis; D004379:Duodenal Neoplasms / Q000401:mortality / Q000473:pathology*; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D018960:Hyaluronan Receptors / Q000032:analysis / Q000096:biosynthesis / Q000235:genetics*; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D014411:Neoplastic Stem Cells / Q000473:pathology*; D016016:Proportional Hazards Models; D020033:Protein Isoforms
chemical_list: D014408:Biomarkers, Tumor; C497483:CD44 protein, human; D018960:Hyaluronan Receptors; D020033:Protein Isoforms