Aaltomaa S, Lipponen P, Ala-Opas M, Kosma V M
Department of Urology, Kuopio University Hospital, Finland.
Eur Urol. 2001 Feb;39(2):138-44. doi: 10.1159/000052428.
The adhesion molecule CD44 standard (CD44s), and its variant isoforms v3 and v6 are associated with cell-to-cell adhesion. The down-regulation of CD44 standard and its variant isoform CD44v6 is linked with early cancer cell dissemination, but the relationship between CD44v3 and malignant features of prostate cancer (PC) has not been established previously.
The expression of CD44s and its CD44v3 and CD44v6 isoforms was analysed by immunohistochemistry in 209 archival PC biopsy specimens to establish their prognostic value.
Down-regulation of CD44s and CD44v6 was related to high T classification, metastasis, high Gleason score, DNA aneuploidy, high S-phase fraction, high mitotic index, perineural growth and dense amount of tumour infiltrating lymphocytes (p < 0.03 for all). Down-regulation of CD44s and CD44v6 was related to poor survival in the entire cohort (p < 0.0001), in M0 tumours (p < 0.001) and in T1-2M0 tumours (p < 0.05). In needle biopsies and TURP specimens, the prognostic impact of the investigated parameters was similar. In the multivariate analysis, T classification (p = 0.0009), presence of metastases (p < 0.0001), Gleason score (p = 0.0060) and CD44v6 (p = 0.0220) expression were independent prognostic factors. In M0 tumours, T classification (p < 0.0001) and CD44v6 (p = 0.003) independently predicted survival.
Down-regulation of CD44s and its CD44v6 isoform is related to tumour malignancy and unfavourable prognosis in PC.
黏附分子CD44标准型（CD44s）及其变异体v3和v6与细胞间黏附有关。CD44标准型及其变异体CD44v6的下调与癌细胞早期播散相关，但CD44v3与前列腺癌（PC）恶性特征之间的关系此前尚未明确。
采用免疫组织化学方法分析209份存档的PC活检标本中CD44s及其CD44v3和CD44v6变异体的表达，以确定其预后价值。
CD44s和CD44v6的下调与高T分期、转移、高Gleason评分、DNA非整倍体、高S期分数、高有丝分裂指数、神经周围浸润及大量肿瘤浸润淋巴细胞相关（所有p<0.03）。CD44s和CD44v6的下调与整个队列的不良生存相关（p<0.0001），在M0肿瘤中（p<0.001）以及在T1-2M0肿瘤中（p<0.05）。在穿刺活检和经尿道前列腺切除术标本中，所研究参数的预后影响相似。多因素分析中，T分期（p=0.0009）、转移情况（p<0.0001）、Gleason评分（p=0.0060）和CD44v6表达（p=0.0220）是独立的预后因素。在M0肿瘤中，T分期（p<0.0001）和CD44v6（p=0.003）独立预测生存情况。
CD44s及其CD44v6变异体的下调与PC的肿瘤恶性程度及不良预后相关。
