Abstract
CD44 is a marker of cancer stem-like cells in renal cell carcinoma (RCC). However, the prognostic value of CD44 in RCC remains controversial. This study evaluated the correlation of CD44 expression with the clinicopathological features of RCC through a meta-analysis. We systematically searched PubMed, ISI Web of Science and Embase for relevant studies until February 2015. We collected and analysed data on clinical stage, Fuhrman grade, microvascular invasion, recurrence, five-year overall survival (OS), disease-specific survival (DSS) and disease-free survival (DFS). Twenty studies involving 1672 patients satisfied the inclusion criteria. Results showed that high CD44 expression in RCC was a poor prognostic marker for five-year OS (RR = 0.69, 95% CI 0.60–0.78) in a fixed-effects model and for five-year DSS (RR = 0.46, 95% CI 0.27–0.80) and five-year DFS (RR = 0.63, 95% CI 0.43–0.93) in a random-effects model. CD44 expression also correlated with Furhman grade (RR = 0.61, 95% CI 0.48–0.77), tumour recurrence (RR = 7.42, 95% CI 3.74–14.70) and MVI (Microvascular invasion) (RR = 3.63, 95% CI 1.97–6.71). This meta-analysis suggests that CD44 is a prognostic marker in RCC. High CD44 expression correlates with high Fuhrman grade, recurrence, MVI and poor prognosis.
Highlights
CD44 standard form (CD44s) receptor is a transmembrane glycoprotein with different variant isoforms because of the alternative splicing of variable exons[13]
Molecular markers remain lacking for Renal cell carcinoma (RCC) diagnosis and prognosis prediction
CD44 participates in the extravasation and migration of tumour cells
Summary
CD44 receptor is a transmembrane glycoprotein with different variant isoforms because of the alternative splicing of variable exons[13]. This receptor is located on chromosome 11p13 and consists of at least 20 exons[14]. The CD44 standard form (CD44s) is the main receptor for hyaluronate[15]. CD44s remains the most reported isoform in RCC. Many studies demonstrated that CD44 exerts a negative prognostic value in RCC, but some studies disclosed that CD44 elicits no effect on the survival of RCC patients[17,18]. We performed a meta-analysis to determine the prognostic value of CD44 in RCC. The correlation between CD44 expression and other clinical features was analysed
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