The impact of CD44 immunoreactivity on survival of patients with colorectal cancer

Background: CD44, a cell hyaluronic acid transmembrane glycoprotein 
implicated in cell growth, differentiation, survival as well as the metastatic 
behavior of some cancer cells. Its expression is upregulated in subpopulations of 
cancer cells and is identified as a molecular marker for cancer stem cells (CSC). 
Methodology: This retrospective study investigated CD44 immunoreactivity in 
85 cancer colon patient’s specimens at diagnosis obtained from the pathology 
department, South Egypt Cancer Institute. All specimens were stained by Anti 
CD44 antibody. Patients were followed up for 3 years.
Aim: The study aims at inspecting CD44 immunoreactivity in the epithelium of 
colorectal cancer specimens and at detecting its association with the patients’ 
survival function by calculating disease free survival and overall survival of 
patients. 
Results: In our current study there was a statistically significant association 
between low epithelial expression of CD44 marker (H score ≤ 150) and 3-year 
OS (p=0.009) as well as a statistically significant association between low CD44 
epithelial expression and 2-year DFS (P=0.041). In multivariate analysis the 
high epithelial expression of CD44 is the only independent factor for early 
recurrence (HR:9.393, P=0.031) concluding that high epithelial expression of 
CD44 is a bad prognostic factor and the likelihood of death is 9 times more with 
CD44 overexpression.
Conclusion: CD44 positivity in non-metastatic colorectal cancer specimens at 
diagnosis is associated with worse overall survival of patients and more 
likelihood of progression or death