Evaluation of the Correlation between CD44, Tumor Prognosis and the 5-Year Survival Rate in Patients with Oral Tongue SCC

Document Type: Original

Authors

1 Department of Otorhinolaryngology and Head and Neck Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.

2 Otorhinolaryngology Research Center, Tehran University of Medical Siences, Tehran, Iran.

3 Neurologist, Shiraz University of Medical Sciences, Shiraz, Iran.

4 Department of Otorhinolaryngology, Amir Alam Hospital, Tehran University of Medical Siences, Tehran, Iran.

5 Department of Pathology, Amir Alam Hospital, Tehran University of Medical Siences, Tehran, Iran

Abstract

Introduction:
90% of the tumors in the head and neck are squamous-cell carcinomas (HNSCC), which have overall 5- year survival rate between 50% -60%. CD44 has been shown to be associated with the prognosis.
 Materials and Methods:
Biopsy specimens of 51 patients with oral tongue SCC were evaluated by Immunohistochemistry (IHC) for the CD44 antibody.
 Results:
There was no significant correlation between CD44 and survival (P=0.77), age (P=0.4), CD44 and lymph node metastasis (P=0.87), sex (P=0.947), smoking (P=0.287) and tumor size (P=0.813). However, there was significant correlation between smoking and survival. 
 Conclusion:
There are widespread discrepancies among the findings in the literature regarding the prognosis of CD44 expression in OCSCC. Our study shows that the expression of CD44 is not a marker of aggressive behavior in oral tongue SCC. Consequently, CD44 cannot be considered as handy tool to establish the tumor behavior, prognosis and 5- year survival rate of these tumors. 

Keywords

Main Subjects


1. Jemal A, Bray F, Center MM, et al. Global Cancer Statistics. Ca-Cancer J Clin. 2011;61(2):69-90.

2. Blomberg M, Nielsen A, Munk C, Kjaer SK. Trends in head and neck cancer incidence in Denmark, 1978-2007: focus on human papillomavirus associated sites. Int J Cancer. 2011;129(3):733-41.

3. Chaturvedi AK, Engels EA, Anderson WF, Gillison ML. Incidence trends for human papillomavirus-related and -unrelated oral squamous cell carcinomas in the United States. J Clin Oncol. 2008; 26(4):612-9.

4. Turley EA, Noble PW, Bourguignon LYW. Signaling properties of hyaluronan receptors. Journal of Biological Chemistry. 2002; 277(7): 4589-92.

5. Bourguignon LY, Zhu H, Zhou B, et al. Hyaluronan promotes CD44v3-Vav2 interaction with Grb2-p185(HER2) and induces Rac1 and Ras signaling during ovarian tumor cell migration and growth. The Journal of biological chemistry. 2001;276(52):48679-92.

6. Maula SM, Luukkaa M, Grenman R, et al. Intratumoral lymphatics are essential for the metastatic spread and prognosis in squamous cell carcinomas of the head and neck region. Cancer research. 2003;63(8):1920-6.

7. Situ DR, Long H, Lin P, et al. Expression and prognostic relevance of CD44v6 in stage I non-small cell lung carcinoma. J Cancer Res Clin. 2010;136(8):1213-9.

8. Stoll C, Baretton G, Soost F, et al. Prognostic importance of the expression of CD44 splice variants in oral squamous cell carcinomas. Oral oncology. 1999; 35(5):484-9.

9. Xie X, Clausen OPF, Boysen M. Prognostic significance of p21WAF1/CIP1 expression in oral tongue squamous cell carcinomas. Int J Cancer. 2002: 259.

10. Kokko LL, Hurme S, Maula SM, et al. Significance of site-specific prognosis of cancer stem cell marker CD44 in head and neck squamous-cell carcinoma. Oral oncology. 2011; 47(6): 510-6.

11. Mostaan LV, Khorsandi MT, Sharifian SM, et al. Correlation between E-cadherin and CD44 adhesion molecules expression and cervical lymph node metastasis in oral tongue SCC: Predictive significance or not. Pathol Res Pract. 2011;207(7):448-51.

12. Forastiere AA, Goepfert H, Maor M, et al. Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. The New England journal of medicine. 2003; 349(22):2091-8.

13. Marur S, Forastiere AA. Challenges of integrating chemotherapy and targeted therapy with radiation in locally advanced head and neck squamous cell cancer. Current opinion in oncology. 2010;22(3):206-11.

14. Pignon JP, Bourhis J, Domenge C, Designe L, Grp MNC. Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. Lancet. 2000;355(9208):949-55.

15. Shah JP, Gil Z. Current concepts in management of oral cancer - Surgery. Oral oncology. 2009;45(4-5): 394-401.

16. Klieb HB, Raphael SJ. Comparative study of the expression of p53, Ki67, E-cadherin and MMP-1 in verrucous hyperplasia and verrucous carcinoma of the oral cavity. Head and neck pathology. 2007;1(2):118-22.

17. Massano J, Regateiro FS, Januario G, Ferreira A. Oral squamous cell carcinoma: review of prognostic and predictive factors. Oral surgery, oral medicine,  oral pathology, oral radiology, and endodontics. 2006;102(1):67-76.

18. Mattijssen V, Peters HM, Schalkwijk L, et al. E-Cadherin Expression in Head and Neck Squamous-Cell Carcinoma Is Associated with Clinical Outcome. Int J Cancer. 1993;55(4):580-5.

19. Nakayama S, Sasaki A, Mese H, Alcalde RE, Matsumura T. Establishment of high and low metastasis cell lines derived from a human tongue squamous cell carcinoma. Invasion & metastasis. 1998;18(5-6):219-28.

20. Sakaki T, Tamura I, Kadota H, Kakudo K. Changing expression of E- and P-cadherin during rat tongue carcinogenesis induced by 4-nitroquinoline 1-oxide. Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology. 2003;32(9):530-7.

21. Chou YE, Hsieh MJ, Hsin CH, et al. CD44 gene polymorphisms and environmental factors on oral cancer susceptibility in Taiwan. Plos One. 2014; 9(4): e93692.

22. Kosunen A, Pirinen R, Ropponen K, et al. CD44 expression and its relationship with MMP-9, clinicopathological factors and survival in oral squamous cell carcinoma.Oral oncology2007;43(1):51-9.

23. Okamoto M, Nishimine M, Kishi M, et al. Prediction of delayed neck metastasis in patients with stage I/II squamous cell carcinoma of the tongue. Journal of Oral Pathology & Medicine. 2002; 31(4):227-33.

24. Lin JT, Chang TH, Chang CS, et al. Prognostic value of pretreatment CD44 mRNA in peripheral blood of patients with locally advanced head and neck cancer. Oral oncology. 2010;46(5):e29-33.