Oguic Romano, Grskovic Antun, Spanjol Josip, Mikolasevic Ivana, Djordjevic Gordana
Department of Urology, University Hospital Rijeka, 51000 Rijeka, Croatia.
Clinical Institute of Oncology and Radiotherapy, University Hospital Centre Rijeka, 51000 Rijeka, Croatia.
Medicina (Kaunas). 2024 Dec 9;60(12):2032. doi: 10.3390/medicina60122032.
: Prostate cancer is one of the most commonly diagnosed cancers in the male population and the fifth leading cause of cancer death worldwide in men as of 2022. One of the potential biomarkers that can predict the progression of the disease is the transmembrane adhesion molecule CD44s. The aims of this study were to determine the expression of CD44s in prostate cancer in the central tumor mass and in the tumor periphery of the disease and to compare it with the clinicopathological parameters (PSA, Gleason score, surgical margins, and biochemical recurrence of the disease) in patients treated with radical prostatectomy. : The research was randomized retrospectively during the period from 2001 to 2006. Tissue microarrays of 121 archival acinar prostate carcinoma samples were immunohistochemically evaluated for CD44s expression. The immunoexpression was determined semiquantitatively, taking into account the percentage (0 (0-5%), 1 (6-24%), 2 (26-75%), and 3 (76-100%) and intensity of the membranous staining of the tumor cells (0 absent; 1 weak at 400×; 2 intermediates at 100×; 3 strong at 40×) and calculated to obtain a final score (0-3 were regarded as negative; 4-6 were regarded as positive). : For statistical purposes, we divided the tumors into two categories: Gleason grade group 1 makes up 80.7% and grade group 2, which includes all the remaining Gleason grade groups (out of 2-5), accounts for 19.3% of the tumors. Grade group 1 had the highest incidence of score 4 (positive expression). There were statistically significantly more positive expressions in those tumors with negative prostatectomy margins (chi square: = 0.001; Cramer V: 0.319). There was no correlation between CD44s expression and biochemical recurrence ( = 0.218), nor with the preoperative PSA values ( = 0.165). In the grade group 1 tumors, the CD44s immunoexpression and status of prostatectomy margin were statistically significantly related with negative margins ( = 0.028). An analysis of the expression of CD44s according to the localization in the central part of the tumor mass and on the periphery of the cancer in the group of tumors with a positive margin did not show a significant correlation because the sample was too small. Descriptively, it can be noted that the expression on the periphery was higher, and the central/peripheral expression ratio was higher in favor of the periphery. : Our results provide insight into the possible value of CD44s expression for predicting the behavior of prostate tumors and the justification of therapy after a prostatectomy. Also hypothetically, they indicate a protective role of CD44s in a group of well-differentiated tumors at the periphery of the tumor mass. Therefore, it is useful to study the CD44s molecule further in this sense.
前列腺癌是男性人群中最常被诊断出的癌症之一，截至2022年，它是全球男性癌症死亡的第五大主要原因。能够预测疾病进展的潜在生物标志物之一是跨膜粘附分子CD44s。本研究的目的是确定CD44s在前列腺癌中央肿瘤块和疾病肿瘤周边的表达情况，并将其与接受根治性前列腺切除术患者的临床病理参数（前列腺特异性抗原、 Gleason评分、手术切缘和疾病的生化复发）进行比较。
该研究在2001年至2006年期间进行回顾性随机研究。对121份存档的腺泡前列腺癌样本的组织微阵列进行免疫组织化学评估，以检测CD44s的表达。免疫表达采用半定量测定，考虑肿瘤细胞的膜染色百分比（0（0 - 5%）、1（6 - 24%）、2（26 - 75%）和3（76 - 100%））和强度（0无；1在400倍镜下为弱；2在100倍镜下为中等；3在40倍镜下为强），并计算得出最终分数（0 - 3分为阴性；4 - 6分为阳性）。
为了进行统计分析，我们将肿瘤分为两类：Gleason分级组1占80.7%，分级组2包括所有其余的Gleason分级组（2 - 5级），占肿瘤的19.3%。分级组1中得分4（阳性表达）的发生率最高。前列腺切除切缘阴性的肿瘤中阳性表达在统计学上显著更多（卡方值：= 0.001；克莱默V值：0.319）。CD44s表达与生化复发（= 0.218）以及术前前列腺特异性抗原值（= 0.165）之间均无相关性。在分级组1的肿瘤中，CD44s免疫表达与前列腺切除切缘状态在统计学上与阴性切缘显著相关（= 0.028）。在切缘阳性的肿瘤组中，根据肿瘤块中央和癌症周边的定位对CD44s表达进行分析，未显示出显著相关性，因为样本量太小。从描述性角度可以注意到，周边的表达更高，中央/周边表达比更高，更倾向于周边。
我们的研究结果为CD44s表达在预测前列腺肿瘤行为和前列腺切除术后治疗合理性方面的可能价值提供了见解。同样从假设角度来看，它们表明CD44s在肿瘤块周边一组高分化肿瘤中具有保护作用。因此，从这个意义上讲，进一步研究CD44s分子是有用的。
