Prognostic value of CD44 expression in penile squamous cell carcinoma: a pilot study
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ORIGINAL PAPER
Prognostic value of CD44 expression in penile squamous cell carcinoma: a pilot study Daniele Minardi & Guendalina Lucarini & Alessandra Filosa & Antonio Zizzi & Oriana Simonetti & Anna Maria Offidani & Gianluca d’Anzeo & Roberto Di Primio & Rodolfo Montironi & Giovanni Muzzonigro
Accepted: 6 August 2012 / Published online: 13 September 2012 # International Society for Cellular Oncology 2012
Abstract Background Several studies have reported on the prognostic value of molecular markers for metastasis risk and survival in penile squamous cell carcinoma (SCC) patients. The usefulness of CD44 expression as such a marker has been studied in different tumors, but not in penile SCC. Our aim was to determine whether CD44 expression may serve as a prognostic marker for lymph node metastasis and survival in penile SCC patients.
Daniele Minardi and Guendalina Lucarini contributed equally to this work D. Minardi : G. d’Anzeo : G. Muzzonigro Institute of Maternal and Children’s Sciences, Urology, Polytechnic University of the Marches Region, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy G. Lucarini : R. Di Primio Department of Molecular and Clinical Sciences, Polytechnic University of the Marches Region, Ancona, Italy A. Filosa : A. Zizzi : R. Montironi Institute of Pathological Anatomy, Polytechnic University of the Marches Region, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy O. Simonetti : A. M. Offidani Institute of Dermatology, Polytechnic University of the Marches Region, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Ancona, Italy D. Minardi (*) Clinica Urologica, Università Politecnica delle Marche, A.O. Ospedali Riuniti, Via Conca 71, 60020 Ancona, Italy e-mail: [email protected]
Methods CD44 immunoistochemical expression was investigated in tissue specimens from 39 patients with penile SCC. CD44 cell positivity, staining intensity and distribution were analyzed and correlated with tumor stage, grade, lymph node status and disease-specific survival. Results CD44 expression was detected in epithelial cells of both intratumoral and normal tissues with different intensities and staining distributions. In normal tissues CD44 protein was mainly detected in cell membranes, whereas in the tumor compartments it was found in both the cell membranes and the cytoplasm. The intensities and percentages of CD44 expressing cells did not correlate with tumor stage and/or grade. Seventy-three percent of the patients with lymph node metastasis showed high intensities of CD44 staining, as compared to 44% of the patients without lymph node metastasis (P00.03). Lymph node-positive patients showed both cytoplasmic and membranous CD44 expression. High CD44 expression was found to be significantly correlated with a decreased 5 year overall survival (P00.01). Conclusions CD44 levels and patterns of expression can be considered as markers for penile SCC aggressiveness and, in addition, may serve as predictive markers for lymph node metastasis, also in patients with clinically negat
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