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©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Nov 7, 2008; 14(41): 6376-6381
Published online Nov 7, 2008. doi: 10.3748/wjg.14.6376
Expression of cell adhesion molecule CD44 in gastric adenocarcinoma and its prognostic importance
Kamran Ghaffarzadehgan, Mostafa Jafarzadeh, Hamid Reza Raziee, Hamid Reza Sima, Ehsan Esmaili-Shandiz, Hanieh Hosseinnezhad, Ali Taghizadeh-Kermani, Omeed Moaven, Maryam Bahrani
Kamran Ghaffarzadehgan, Department of Pathology, Mashhad University Cancer Research Center, Omid Oncology Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
Mostafa Jafarzadeh, Ehsan Esmaili-Shandiz, Hanieh Hosseinnezhad, Omeed Moaven, Maryam Bahrani, Gastric Cancer Research Group, Mashhad University of Medical Sciences, Mashhad, Iran
Hamid Reza Raziee, Ali Taghizadeh Kermani, Department of Radiation Oncology, Mashhad University Cancer Research Center, Omid Oncology Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
Hamid Reza Sima, Department of Internal Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Medicine, The Mount Sinai Medical Center, New York, NY 10029, United States
Hanieh Hosseinnezhad, Young Researchers’ Club, Medical School of Islamic Azad University of Mashhad, Mashhad, Iran
Author contributions: Sima HR, Ghaffarzadehgan K, Raziee HR, Esmaili-Shandiz E and Jafarzadeh M designed the research; Ghaffarzadehgan K, Sima HR, Raziee HR, Hosseinnezhad H, Taghizadeh-Kermani A and Moaven O performed the research; Raziee HR, Bahrani M, and Jafarzadeh M analyzed the data; Jafarzadeh M, Raziee HR and Hosseinnezhad H organized the figures and patient data; Esmaili-Shandiz E, Hosseinnezhad H, Moaven O helped organize the paper; Ghaffarzadehgan K, Jafarzadeh M, Raziee HR and Sima HR wrote and corrected the paper.
Supported by A research grant offered by Mashhad University of Medical Sciences, No. 85017
Correspondence to: Mostafa Jafarzadeh, MD, Gastric Cancer Research Group, Mashhad University of Medical Sciences, 51, Jami Street, Sajad Blvd, PO Box 91865-335, Mashhad, Iran. mostafa.jafarzadeh@gmail.com
Telephone: +98-915-1106494 Fax: +98-511-6065742
Received: July 17, 2008
Revised: September 16, 2008
Accepted: September 23, 2008
Published online: November 7, 2008
AIM: To evaluate the relation of cluster of differentiation 44 (CD44) expression with clinicopathological features of gastric adenocarcinoma, and also its effect on prognosis with an emphasis on the differences between intestinal and diffuse types.
METHODS: From 2000 to 2006, 100 patients with gastric adenocarcinoma, who had undergone total or subtotal gastrectomy without any prior treatment, were studied. Haematoxylin & eosin (HE) staining was used for histological evaluation, including the type (Lauren’s classification) and grading of the tumor. The expression of CD44 in the gastric adenocarcinoma mucosa and the adjacent mucosa were determined by immunohistochemistry. The survival analysis was obtained using the Kaplan-Meier test.
RESULTS: Of 100 patients, 74 (74%) patients were male. The tumors were categorized as intestinal type (78%) or diffuse type (22%). Sixty-five percent of patients were CD44-positive. CD44 expression was not detected in normal gastric mucosa. Rather, CD44 was more commonly expressed in the intestinal subtype (P = 0.002). A significant relation was seen between the grade of tumor and the expression of CD44 (P = 0.014). The survival analysis showed a poor prognosis of patients with CD44-positive tumors (P = 0.008); and this was more prominent in the intestinal (P = 0.001) rather than diffuse type.
CONCLUSION: Cell adhesion molecule CD44 is highly expressed in gastric adenocarcinoma. CD44 expression is correlated with a poor prognosis in patients with the intestinal type of gastric adenocarcinoma. CD44 can, therefore, be utilized as a prognostic marker for this group of patients.
