Institute of Pathology,University Hospital of Basel, Basel, Switzerland.
Histopathology. 2009 Nov;55(5):564-75. doi: 10.1111/j.1365-2559.2009.03421.x.
To assess systematically the membranous expression of CD44v6 in colorectal cancer by immunohistochemistry to determine its prognostic impact, the differential expression between primary and metastatic tumours and expression differences between the tumour centre and invasive front.
Immunohistochemistry was performed for CD44v6 on two tissue microarrays. The first included 1279 colorectal tumours with full clinicopathological data. The second consisted of 50 matched primary and metastatic tumours sampled from the tumour centre and the invasive margin. A scoring system was tested by multiple observers. Receiver-operating characteristic curve analysis was used for cut-off point determination. Loss of membranous CD44v6 was associated with pT stage (P = 0.016; sensitivity 85.8%, specificity 20.1%), lymph node metastasis (P = 0.015; sensitivity 52.8%, specificity 55%), an infiltrating tumour margin (P < 0.001; sensitivity 71.4%, specificity 40%) and adverse prognosis (P = 0.011; hazard ratio 0.79, 95% confidence interval 0.7, 0.9), but was not an independent prognostic factor on multivariable analysis. Loss of expression occurred at the invasive front in both primary and metastatic lesions (P < 0.001).
This study outlines an approach to help standardize the immunohistochemical evaluation of CD44v6 and similar markers in colorectal cancer and highlights a significant role for loss of membranous CD44v6 expression in colorectal cancer progression and prognosis.
通过免疫组织化学评估结直肠癌中 CD44v6 的膜表达，以确定其预后影响、原发肿瘤和转移瘤之间的差异表达以及肿瘤中心和浸润前缘之间的表达差异。
对两个组织微阵列进行了 CD44v6 的免疫组织化学检测。第一个微阵列包含了 1279 例具有完整临床病理数据的结直肠肿瘤。第二个微阵列由 50 对原发和转移性肿瘤组成，取自肿瘤中心和浸润前缘。多个观察者对评分系统进行了测试。使用接收者操作特征曲线分析来确定截断点。膜 CD44v6 的缺失与 pT 分期（P=0.016；敏感性 85.8%，特异性 20.1%）、淋巴结转移（P=0.015；敏感性 52.8%，特异性 55%）、浸润性肿瘤边界（P<0.001；敏感性 71.4%，特异性 40%）和不良预后（P=0.011；危险比 0.79，95%置信区间 0.7，0.9）相关，但在多变量分析中不是独立的预后因素。在原发和转移性病变中，膜表达缺失都发生在浸润前缘（P<0.001）。
本研究概述了一种帮助标准化结直肠癌中 CD44v6 及类似标志物免疫组织化学评估的方法，并强调了膜 CD44v6 表达缺失在结直肠癌进展和预后中的重要作用。
