Expression and significance of CD44 and p-AKT in pancreatic head cancer
Xiaoping et al. World Journal of Surgical Oncology
Expression and significance of CD44 and p-AKT in pancreatic head cancer
Li Xiaoping 0 2
Zhang Xiaowei 0 1
Zheng Leizhen 2
Guo Weijian 1
0 Equal contributors
1 Department of Oncology, Cancer Hospital, Fudan University , Shanghai 200032 , China
2 Department of Oncology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University , Shanghai 200092 , China
Background: CD44 and phosphorylated AKT (p-AKT) is a potentially interesting prognostic marker and therapeutic target in pancreatic cancer. The expression of CD44 and p-AKT has been reported to correlate with poor prognosis of pancreatic cancer in most literatures. The purpose of this study is to investigate the roles of CD44 and p-AKT in pancreatic head cancer and their correlation with the prognosis of pancreatic head cancer patients. Methods: Forty-eight pancreatic head cancer samples were collected dating from Jan. 2010 to Dec. 2012. Immunohistochemistry was applied to test the expression of CD44 and p-AKT in pancreatic head cancer. The clinical data of the patients were collected including their gender, age, the histology and location, lymph node metastasis, and so on. The correlation between the CD44 expression and the clinicopathological factors of patients with pancreatic head cancer was analyzed by the software SPSS 13.0. Results: The positive rates of CD44 and p-AKT expression in the samples were 64.6 and 29.2 %, respectively. There was a significant difference between the CD44 expression and the pancreatic cancer' T staging, tumor node metastasis (TNM) staging, lymph node metastasis (P < 0.05). The Cox proportional hazard model showed that CD44 and lymph node metastasis were independent prognostic factors. Conclusions: CD44 was related to the distant metastasis and aggressive malignant behaviors of pancreatic head cancer.
CD44; p-AKT; Pancreatic head cancer; Metastasis; Prognosis
Background
Pancreatic cancer is a digestive tract malignant tumor with
poor prognosis because of difficult diagnosis and rapid
development, most of them located in the head of pancreas
[
1
]. Most pancreatic head cancer patients have
peripancreatic nerve invasion and lymph node metastasis during
diagnosis, and 1-year survival rate is less than 20 % [
2
]. It
is necessary to explore the biological index for the early
diagnosis and prediction of pancreatic head cancer which
present as aggressive and recurrent malignancies.
Tumor invasion and metastasis involves the interaction
of multiple factors. Cancer stem cells (CSC), a
subpopulation of tumor cells, are responsible for tumor initiation,
growth, metastasis, and resistance to chemotherapy [
3
].
Some cell surface markers have been reported as CSC
markers in pancreatic cancers, such as CD44, CD133,
ALDH1, and ABCG2, and high expression of these markers
is usually considered an indicator of poor prognosis [
4
].
CD44, an important marker for CSC, is a membrane
glycoprotein involved in cell–cell and cell–extracellular matrix
adhesion as well as cell migration, differentiation, and
survival. CD44 may be involved in invasion and metastasis by
regulating different signal transduction pathways, including
phosphorylated AKT (p-AKT) [
5
]. p-AKT phosphorylates
multiple proteins implicated in cellular processes leading to
induction of cell survival and inhibition of apoptosis. This
effect could be mediated by CD44. Previous studies
demonstrated that anti-CD44 mAb induces apoptosis by
suppressing the PI3K/Akt cell survival pathway [
6
].
Most scholars believe that the CD44 gene can be used
as a new tumor marker, which greatly facilitates the early
diagnosis of malignant tumor recurrence and metastasis
[
7, 8
]. Several studies have reported overexpression of
CD44 in subsets of pancreatic adenocarcinomas in 37–
80 % of the tumors investigated [9]. However, most of
them focused on all sites of the pancreas. There is
relatively few data on CD44 expression in pancreatic head
adenocarcinomas.
In this study,CD44 and p-AKT were selected as
markers. Here, we used immunohistochemical (IHC)
method to detect the expression of CD44 and p-AKT in
the pancreatic head cancer tissues. The aim of the present
study was to examine the prognostic relevance of CD44
expression in pancreatic head adenocarcinomas.
Methods
Patients and specimens
Forty-eight pancreatic head cancer samples were collected
dating from Jan. 2010 to Dec. 2012. The clinical data of
the patients were collected including their gender, age, the
histology and location, lymph node metastasis, and so on.
Standard demographic, clinicopathological, and
tumorspecific data were collected retrospectively from hospital
records, and the disease stages of the patients were
classified according to the 2010 AJCC pancreatic cancer tumor
node metastasis (TNM) staging system [
10
]. For the use
of these clinical materials for research purposes, informed
consent and approval from the Institute Research Ethics
Committee w (...truncated)