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Open Access Highly Accessed Research article

Prognostic significance of CD44s expression in resected non-small cell lung cancer

Yoon Ho Ko1, Hye Sung Won1, Eun Kyoung Jeon1, Sook Hee Hong2, Sang Young Roh2, Young Seon Hong2, Jae Ho Byun3, Chan-Kwon Jung4 and Jin Hyoung Kang2*

Author Affiliations

1 Division of Oncology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, Catholic University, Uijeongbu -si, Gyeonggi-do, South Korea

2 Division of Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, Catholic University, Seoul, South Korea

3 Division of Oncology, Department of Internal Medicine, Incheon St. Mary's Hospital, Catholic University, Seoul, South Korea

4 Department of Hospital Pathology, Seoul St. Mary's hospital, Catholic University, Seoul, South Korea

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BMC Cancer 2011, 11:340  doi:10.1186/1471-2407-11-340

Published: 7 August 2011

Abstract

Background

CD44s is a cell adhesion molecule known to mediate cellular adhesion to the extracellular matrix, a prerequisite for tumor cell migration. CD44s plays an important role in invasion and metastasis of various cancers. In the present study, we sought to determine whether CD44s is involved in clinical outcomes of patients with resected non-small cell lung cancer (NSCLC).

Methods

Using immunohistochemical staining, we investigated CD44s protein expression using tissue array specimens from 159 patients with resected NSCLC (adenocarcinoma (AC; n = 82) and squamous cell carcinoma (SCC; n = 77). Additionally, the immunoreactivity of cyclooxygenase (COX)-2 was also studied. The clinicopathological implications of these molecules were analyzed statistically.

Results

High CD44s expression was detected more frequently in NSCLC patients with SCC (66/72; 91.7%) than in those with AC histology (P < 0.001). Additionally, high CD44s expression was significant correlated with more advanced regional lymph node metastasis (P = 0.021). In multivariate analysis of survival in NSCLC patients with AC histology, significant predictors were lymph node metastasis status (P < 0.001), high-grade tumor differentiation (P = 0.046), and high CD44s expression (P = 0.014). For NSCLC patients with SCC histology, the significant predictor was a more advanced tumor stage (P = 0.015). No significant association was found between CD44s and clinical outcome (P = 0.311).

Conclusions

High CD44s expression was a negative prognostic marker with significance in patients with resected NSCLC, particularly those with AC histology, and was independent of tumor stage.

Keywords:
non-small cell lung cancer; CD44s; immunohistochemistry; prognosis