Expression of CD44 and Its Correlation With Clinicopathological Factors in Oral and Oropharyngeal Carcinoma: A Retrospective Immunohistochemical Study.

BACKGROUND

CD44 is a cancer stem cell marker (CSC), which plays a crucial role in cell-to-cell and cell-to-matrix adhesion and is responsible for angiogenesis, invasion, and migration in oral and oropharyngeal cancer.

OBJECTIVES

The primary objective of the study was to assess the expression of CD44 in oral and oropharyngeal carcinoma using immunohistochemistry and compare the expression of CD44 in different histological grades of oral and oropharyngeal squamous cell carcinoma (OOSCC). The secondary objective was to correlate the prognosis with the expression.

MATERIAL AND METHODS

Based on the histopathological diagnosis, we retrieved OOSCC paraffin-embedded blocks from the archives of the Department of Pathology, Maharani Laxmi Bai Medical College, Jhansi (UP), India, reported from June 2023 to July 2024. We evaluated sections from 31 paraffin blocks of well-differentiated OOSCC, 33 moderately differentiated OOSCC, and six poorly differentiated OSCC for CD44 immunostaining. The immunohistochemical expression of CD44 was studied in these tissues and graded based on the intensity of staining. The difference in immune expression of CD44 between different grades was analyzed. The association of CD44 with all the variables was calculated and interpreted by applying the chi-square test and a p-value <0.05 was taken as significant All statistical analysis was performed and done via computer-based IBM SPSS Statistics for Windows, version 26.0 (released 2019, IBM Corp., Armonk, NY).

RESULTS

We found that all 70 cases of OOSCC showed immunopositivity with CD44 with varying staining intensities. In our study, 33 cases exhibited strong staining intensity, 31 cases were of moderate staining intensity, and six cases exhibited weak to poor staining intensity. Out of 31 well-differentiated of OOSCC, 29 case showed strong staining intensity and two cases showed moderate staining intensity. However, in 33 cases of moderately differentiated SCC, only four cases showed strong staining intensity, and none of the poorly differentiated OOSCC cases showed strong staining intensity. Our findings of grade versus staining intensity of CD44 expression by tumor cells in OOSCC came out to be statistically significant (p < 0.05).

CONCLUSION

The expression of CD44 was noted to decrease from well-differentiated to poorly differentiated OSCC.