Abstract
Background:Breast Cancer (BC), is one of the most common malignancies around the world. CD44 expression correlates with cell proliferation, infiltration, angiogenesis, metastasis and prognosis in breast cancer but the exact mechanism of CD44 function is still not clear. The present study evaluates the expression of CD44 in primary HER2-positive breast cancer. The results can be used to determine the disease-free and overall survival of patients with breast cancer. Methods:We studied specimens from 100 patients with HER2-positive invasive breast cancer between March 2011 and June 2019. Immunohistochemical staining for CD44 was performed in all the specimens. Their CD44 association with clinicopathologic parameters and prognosis was evaluated. Results:The high CD44 was expression in 68(68%) of the patients and Low expression in 32(32%). CD44 expression was significantly associated with stage (p=0.007). There were no significant associations between the DFS, OS and other clinicopathologic parameters except for the stage, respectively (HR= 3.67, 95% CI =1.16-11.56, P = 0.03) (HR= 0.8.56, 95% CI =2.22-32.90, P = 0.002).20% of patients had died by the end of the follow-up. There were no significant association between DFS, OS and CD44 expression, respectively. (Log-rank p=0.13). (Log-rank p=0.10). Conclusion:The results from this study suggest that CD44 is clinically associated with stage of breast cancers. From the survival analysis, there was no statistical difference in overall survival and disease free survival with respect to CD44 expression. Further studies larger sample sizes are recommended for further investigation.
Highlights
Breast cancer stem cells are a small population of cells that have the classic features of cancer stem cells and are transformed by the accumulation of mutations in the tumor cells (Jemalet al., 2010).The initial detection of breast cancer stem cells takes place based on the observation of a combination of CD44 and CD24 (Boulbes et al, 2015)
Since Al-Hajj et al, (2003) revealed for the first time that the tumorigenic stem cells in breast cancer have the CD44+, the tumorigenic potential and invasive features of this phenotype have been confirmed repeatedly (Mylona et al, 2008; Abraham et al, 2005) Olsson et al, (2011), Sanchez et al, (2001), Found that there are no significant associations between the CD44 expression and tumor size, lymph node status and hormone receptor
In our study we did not find this association.According to the results obtained by Horiguchi et al, (2010), a higher expression of CD44 is significantly associated with a smaller tumor size, lack of axillary lymph node involvement and lower stages of breast cancer
Summary
The beginning of the 21st century has been marked by intensified research on molecular genetics, epigenetics and the metabolic factors of cancer progression and treatment of patients (Chekhun et al, 2017).Breast cancer is ranked the second most common malignancy(Jamel et al, 2010) ,the accounts for about 1.38 million new cases diagnosed every year (Ferlay et al, 2010).Breast cancer is a highly heterogeneous disease with distinct biological and clinical behaviors and responses to treatment that can be classified into different subtypes based on histopathology type as well as molecular profile (Zhang et al, 2012; Hu et al, 2006).Approximately 20-30% of breast cancer cases are HER2-positive owing to the over-expression and/or amplification of the HER2 gene (Dunnwald et al, 2007; Moasser et al, 2007). Recent observations showed that treatment with trastuzumab may directly affect BCSCs in HER2-positive breast cancer (Petrelli et al, 2012 ;Guo et al, 2015). Methods: We studied specimens from 100 patients with HER2-positive invasive breast cancer between March 2011 and June 2019. Immunohistochemical staining for CD44 was performed in all the specimens Their CD44 association with clinicopathologic parameters and prognosis was evaluated. There were no significant associations between the DFS, OS and other clinicopathologic parameters except for the stage, respectively (HR= 3.67, 95% CI =1.16-11.56, P = 0.03) (HR= 0.8.56, 95% CI =2.22-32.90, P = 0.002).20% of patients had died by the end of the follow-up. Conclusion: The results from this study suggest that CD44 is clinically associated with stage of breast cancers. Further studies larger sample sizes are recommended for further investigation
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
