CD44 Expression in Biopsy Specimens of Patients with Nasopharyngeal Carcinoma Is Associated with Prognosis

Abstract

Objectives: CD44 is a major cancer stem cell marker, and it has been reported to be associated with biological malignancy in several cancers. However, the potential oncogenic role of CD44 and its clinical/prognostic significance in nasopharyngeal carcinoma (NPC) are unclear. In this study, we evaluated the association of CD44, especially its variant isoforms V3 and V6, with prognostic factors in NPC patients. We examined CD44 expression by immunohistochemical analysis of biopsy specimens obtained from 42 NPC patients who underwent treatment. Methods: The subjects were 42 patients (35 men and 7 women; average age, 56.3 years) who received concurrent chemoradiotherapy (CCRT) consisting of chemotherapy (CBDCA or CDGP or DOC) and radiation therapy (60-66 Gy) as an initial treatment. Thereafter, the biopsy specimens from these patients were examined immunohistochemically to study the association between CD44 expression (V3, V6) and prognosis of NPC. Results: High CD44 (V3, V6) expression was significantly correlated with increased clinical incomplete response to CCRT at the primary site ( P = 0.008 in V3 and V6 by χ2-test) and poor disease-specific survival ( P = 0.0003 in V3 and P = 0.0029 in V6 by log-rank test). However, distant metastasis showed no association with CD44 expression. Conclusions: High expression of CD44 (V3, V6) is associated with poor prognosis in patients with NPC. Evaluation of CD44, especially the variant isoforms V3 and V6, may be useful for predicting tumor response to CCRT and prognosis of patients with NPC.