Abstract
Background and Aims: In colorectal cancer
patients’ mortality is largely influenced by spreading of tumour cells
from the primary tumour site and subsequent metastasis formation. CD44 is an
adhesion molecule and represents a highly variable family of isoforms. The
isoform CD44v6 has been associated with metastatic spread and poor prognosis in
animal models and several human cancers. Results of immunohistological studies
in primary colorectal cancer are mostly retrospective and contradictory. The
aim of our prospective study was to assess the controversial role of CD44v6 as
a prognostic factor in colorectal cancer.
Methods: In 93 patients we analysed tumour
CD44v6 expression in prospectively sampled stage I-IV colorectal
adenocarcinomas using RT-PCR and Southern blotting. The prognostic value of the
CD44v6 expression was assessed using univariate and multivariate analysis.
Results: CD44v6 expression was found in
47 % of the cases. CD44v6 expression failed to show any
association with the clinical or histological variables examined. CD44v6
expression did not correlate with survival in long-term follow-up. The most
important prognostic factor in this cohort was tumour stage.
Conclusions: Changes in CD446 expression
level do not predict tumour spread or patient survival in colorectal
cancer.
Zusammenfassung
Hintergrund und Ziele: Die Mortalität
bei Patienten mit kolorektalen Karzinomen wird im Wesentlichen durch
Metastasierung und Lokalrezidive bestimmt. Das Glykoprotein CD44
repräsentiert eine Familie von Zelladhäsionsmolekülen. Die
Isoform CD44v6 wird im Tiermodell für metastatisches Wachstum von
Tumorzellen verantwortlich gemacht und korreliert bei verschiedenen humanen
Tumorerkrankungen mit der Prognose der Patienten. Die Ergebnisse
immunhistologischer Untersuchungen zur Bedeutung der CD44v6-Expression bei
Patienten mit kolorektalen Karzinomen sind meist retrospektiv erhoben und
widersprüchlich. Wir untersuchten deshalb in einer prospektiven Studie die
Bedeutung von CD44v6 als Prognosefaktor bei Patienten mit kolorektalen
Karzinomen.
Methoden: Bei 93 Patienten mit
UICC-Grad-I-IV-Karzinomen wurde die Expression von CD44v6 mittels RT-PCR
und Southern-Blotting untersucht. Die prognostische Bedeutung der CD44v6-
Expression wurde mittels Univarianz- und Multivarianzanalyse
überprüft.
Ergebnisse: Die Expression von CD44v6
konnte in 47 % der Primärtumoren nachgewiesen werden. Dabei
zeigte sich keine Assoziation mit klinischen oder histologischen Variablen. Die
CD44v6-Expression korrelierte nicht mit dem Gesamtüberleben der Patienten
im Langzeitverlauf. Der wichtigste prognostische Faktor stellte das
Tumorstadium dar.
Schlussfolgerung: Veränderungen in der
Expression von CD44v6 beeinflussen nicht das Langzeitüberleben von
Patienten mit kolorektalen Karzinomen.
Key words
Colorectal
Cancer - CD44v6 - Prognosis
Schlüsselwörter
Kolorektales
Karzinom - CD44v6 - Prognosefaktor
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Andreas Stallmach, MD
Department of Internal Medicine II, Saarland University
66421 Homburg/Saar
Germany
Email: inasta@uniklinik-saarland.de