CD44 Marker Expression in Colorectal Carcinoma
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Date
2021
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Ievads. Pētījumi norāda, ka vēža cilmes šūnu (CSC) jēdzienam ir būtiska nozīme onkoģenēzes procesā. Glikoproteīna marķiera CD44 ekspresija šobrīd tiek izmantota, lai noteiktu CSC klātbūtni koloroktālā vēža (CRC) gadījumā. Jaunākie pētījumi iezīmē CD44 lomu attiecībā uz vēža agresīvu augšanu, audzēja šūnu proliferāciju un metastātisku audzēja izplatību. CD44 kā antivielu mērķa identificēšana, ir parādījusi daudzsološus rezultātus, lai samazinātu ļaundabīgos procesus neoplazmā.
Mērķis. CD44 marķiera ekspresijas novērtēšana dažādās CRC zonās un tās saistība ar dažādiem audzēja parametriem.
Materiāli un metodes. Retrospektīvajā pētījumā tika iekļauti 40 CRC gadījumi, kas bija iekrāsoti ar CSC marķieri CD44. Audzēja veidu un izplatību (pTN) novērtēja pēc PVO klasifikācijas. Pētījumā tika atzīmēta invāzija limfvados un nervu struktūrās. CD44 marķiera ekspresija CRC galvenajā audzēja masā (MTM) un invāzijas vietā (IS), tika kvalitatīvi novērtēta 5 redzes laukos. Ekspresiju raksturoja relatīvā apjoma (RE),% un intensitātes I skalā 0-3 (0: nav, 1: vāja, 2: mērena, 3: spēcīga), reizinājuma (RExI) summa. Iegūtie dati tika analizēti, izmantojot IBM SPSS 25.0. Tika izmantotas aprakstošās statistikas metodes. Rezultāti tika uzskatīti par statistiski nozīmīgiem, ja p <0,05.
Rezultāti. Pētījumā tika iekļauti 40 CRC gadījumi, un lielākā daļa gadījumu bija pT3 un pT4 stadijas CRC. Metastāzes limfmezglos (pN +) tika atrastas 42,5% (95% TI: 28,5 - 57,8) gadījumu. Kopumā invāzija limfavados tika konstatēta 35,0% (22,1–50,5), un perineirāla invāzija 27,5% (16,1–42,8) no gadījumiem. Paraugu analīze atklāja vidējo CD44 marķiera ekspresiju 2,47 (2,30 - 2,55) MTM un 1,93 (1,82 - 2,05) IS. Tika pierādīts, ka pozitīva korelācija starp MTM un IS ir statistiski nozīmīga (Spīrmana tests (ρ) = 0,44, p = 0,04). Starpība (∆) CD44 izteiksmē starp MTM un IS uzrādīja vidējo vērtību 0,54 (0,44–0,66). Netika konstatēta statistiski nozīmīga vidējās atšķirības vērtība attiecībā uz pT (p = 0,07), pN (p = 0,37) un audzēja pakāpi (p = 0,69). 45% (30–60) no gadījumiem tika uzrādīts vismaz viens pozitīvs invāzijas parametrs. Statistiski nozīmīgu vidējo aritmētisko vērtību uzrādīja, salīdzinājums starp gadījumiem, kur tika konstatēta invāzija limfvados (p = 0,02), bet statistiski nenozīmīga atšķirība bija attiecībā uz venozo (p> 0,05), perineirālo (p> 0,05), intraneirālo (p> 0,05) invāziju. Attiecībā uz pTN un invāziju audu struktūrās (p> 0,05), statistiski nenozīmīgu rezultātu uzrādīja CD44 augsta (> M = 2,47) un zema (<M = 2,47) ekspresija MTM. Tomēr augsta (> M = 1,93) un zema (<M = 1,93) CD44 ekspresija IS parādīja statistiski nozīmīgu rezultātu attiecībā uz gadījumiem, kad bija vismaz viena invāzija, un gadījumiem bez invāzijas (p = 0,03).
Secinājums. MTM uzrādīja ievērojami augstāku vidējo CD44 ekspresiju nekā IS. CD44 varētu būt prognozējoša loma audzēja invāzijai un CRC izplatībai limfātiskajā sistēmā. Potenciālā terapeitiskā vērtība ir jānovērtē turpmākajos pētījumos.
Introduction. Studies suggest that the concept of cancer stem cells (CSCs) is essential in the process of oncogenesis. The expression of glycoprotein marker CD44 is currently used to detect these CSCs in colorectal carcinoma (CRC). Recent research marks CD44 role in aggressive cancer growth, tumour cell proliferation and metastatic spread. Identifying CD44 as target for antibodies has shown promising results in the reduction of malignant activity in a neoplasm. Aim. Evaluation of CD44 marker expression in different CRC areas and its relation to different tumour parameters. Materials and methods. The retrospective study included 40 CRC cases, stained with CSC marker CD44. The tumour type and spread (pTN) was assessed by WHO classification. Invasion into lymphatic vessels and nerve structures were noted. CD44 marker expression in CRC in main tumour mass (MTM) and invasion site (IS) was qualitatively evaluated in 5 vision fields. Expression was characterized by relative extent (RE), % and intensity I in a 0–3 scale (0: absent, 1: weak, 2: moderate, 3: strong) as the sum of RExI. Obtained data were analyzed using IBM SPSS 25.0. Descriptive statistical methods were used. Results were considered statistical significant, if p < 0.05. Results. Study included 40 cases of CRC and main part of cases were pT3 and pT4 CRC. Metastasis in lymph nodes (pN+) were present in 42.5 % (95 % CI: 28.5 – 57.8) of cases. Overall, invasion into lymph vessels were found in 35.0 % (22.1–50.5), perineural invasion in 27.5 % (16.1 – 42.8) of cases. Sample analysis revealed a mean CD44 marker expression of 2.47 (2.30 – 2.55) in MTM and 1.93 (1.82 – 2.05) at IS. Positive correlation between MTM and IS was proved to be statistical significant (Spearman test (ρ) = 0.44, p = 0.04). Difference (∆) in CD44 expression between MTM and IS displayed a mean of 0.54 (0.44–0.66). There was no statistically significant difference of mean ∆ regarding pT (p = 0.07), pN (p = 0.37) and tumour grade (p = 0.69). 45 % (30–60) of cases showed at least one positive parameter for invasion. Mean ∆ had statistically significant result comparing cases with lymph vessel invasion (p = 0.02), but there was no statistically significant difference regarding venous (p > 0.05), perineural (p > 0.05), intraneural (p > 0.05) invasions. CD44 high (> M = 2.47) and low (< M = 2.47) expression in MTM showed no statistically significant result regarding pTN and invasion into tissue structures (p > 0.05). However, high (> M = 1.93) and low (< M = 1.93) CD44 expression in IS showed statistically significant result regarding cases with at least one invasion and cases without any invasion (p = 0.03). Conclusion. MTM showed significantly higher mean CD44 expression than the IS. CD44 might have a predictive role in tumour invasion and lymphatic spread of CRC. Potential therapeutic value needs to be evaluated in further research.
Introduction. Studies suggest that the concept of cancer stem cells (CSCs) is essential in the process of oncogenesis. The expression of glycoprotein marker CD44 is currently used to detect these CSCs in colorectal carcinoma (CRC). Recent research marks CD44 role in aggressive cancer growth, tumour cell proliferation and metastatic spread. Identifying CD44 as target for antibodies has shown promising results in the reduction of malignant activity in a neoplasm. Aim. Evaluation of CD44 marker expression in different CRC areas and its relation to different tumour parameters. Materials and methods. The retrospective study included 40 CRC cases, stained with CSC marker CD44. The tumour type and spread (pTN) was assessed by WHO classification. Invasion into lymphatic vessels and nerve structures were noted. CD44 marker expression in CRC in main tumour mass (MTM) and invasion site (IS) was qualitatively evaluated in 5 vision fields. Expression was characterized by relative extent (RE), % and intensity I in a 0–3 scale (0: absent, 1: weak, 2: moderate, 3: strong) as the sum of RExI. Obtained data were analyzed using IBM SPSS 25.0. Descriptive statistical methods were used. Results were considered statistical significant, if p < 0.05. Results. Study included 40 cases of CRC and main part of cases were pT3 and pT4 CRC. Metastasis in lymph nodes (pN+) were present in 42.5 % (95 % CI: 28.5 – 57.8) of cases. Overall, invasion into lymph vessels were found in 35.0 % (22.1–50.5), perineural invasion in 27.5 % (16.1 – 42.8) of cases. Sample analysis revealed a mean CD44 marker expression of 2.47 (2.30 – 2.55) in MTM and 1.93 (1.82 – 2.05) at IS. Positive correlation between MTM and IS was proved to be statistical significant (Spearman test (ρ) = 0.44, p = 0.04). Difference (∆) in CD44 expression between MTM and IS displayed a mean of 0.54 (0.44–0.66). There was no statistically significant difference of mean ∆ regarding pT (p = 0.07), pN (p = 0.37) and tumour grade (p = 0.69). 45 % (30–60) of cases showed at least one positive parameter for invasion. Mean ∆ had statistically significant result comparing cases with lymph vessel invasion (p = 0.02), but there was no statistically significant difference regarding venous (p > 0.05), perineural (p > 0.05), intraneural (p > 0.05) invasions. CD44 high (> M = 2.47) and low (< M = 2.47) expression in MTM showed no statistically significant result regarding pTN and invasion into tissue structures (p > 0.05). However, high (> M = 1.93) and low (< M = 1.93) CD44 expression in IS showed statistically significant result regarding cases with at least one invasion and cases without any invasion (p = 0.03). Conclusion. MTM showed significantly higher mean CD44 expression than the IS. CD44 might have a predictive role in tumour invasion and lymphatic spread of CRC. Potential therapeutic value needs to be evaluated in further research.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
CD44, kolorektālais vēzis, CD44, colorectal cancer