Simultaneous bilateral breast carcinoma: Histopathological characteristics and CD44/catenin-cadherin profile

AIMS: Family history of breast carcinoma, multicentric tumor foci in one breast, and in situ lobular carcinoma increase the risk of bilateral breast cancer (BBC), synchronous or metachronous. Synchronous tumors are designated as simultaneous breast carcinoma if they appear at the same time. The CD44 family and cadherin/catenin immunophenotype of this group of BBCs has not yet been evaluated. The aim of this study was to compare clinicopathological characteristics and immunohistochemical profiles of simultaneous BBC and corresponding lymph node metastases in eight patients. METHODS AND RESULTS: In toto 15 primary and 9 metastatic tumors were evaluated. The expression of CD44 variant isoforms, beta-catenin, E, P and N-cadherin were evaluated by immunohistochemistry. Rare types of breast carcinoma were frequent in this group of patients. There were 6 pleomorphic lobular, 5 invasive ductal of usual type, 3 atypical medullary carcinomas, 2 mucinous and one invasive micropapillary carcinoma. The expression CD44v6 was most frequent, followed by CD44v3-10, CD44v5, and CD44v3. CD44v4 was generally not expressed. E-cadherin was expressed in 80% primary tumors, 40% expressed N-cadherin, and 66% expressed P-cadherin. CONCLUSIONS: Generally, simultaneous carcinomas had different morphology and different immunophenotype. Each primary tumor was more similar to its corresponding metastatic tumor than to the contralateral primary tumor.     

CD44v6: a target for antibody-based cancer therapy

The human CD44 gene encodes type 1 transmembrane glycoproteins involved in cell-cell and cell-matrix interactions. The structural heterogeneity of the gene products is caused primarily by alternative splicing of at least 10 out of 20 exons. Certain CD44 variant isoforms, in particular those containing CD44 variant domain 6 (CD44v6), have been implicated in tumourigenesis, tumour cell invasion and metastasis. Here we will give an overview of immunohistochemically determined CD44v6 expression in human malignancies (primary epithelial and nonepithelial tumours as well as metastases) and normal tissues, and review several examples of the clinical use of CD44v6-specific antibodies. In nonmalignant tissues, CD44v6 expression is essentially restricted to a subset of epithelia. Intense and homogeneous expression of CD44v6 was reported for the majority of squamous cell carcinomas and a proportion of adenocarcinomas of differing origin, but was rarely seen in nonepithelial tumours. This expression pattern has made CD44v6 an attractive target for antibody-guided therapy of various types of epithelium-derived cancers.Abbreviations CD44 type 1 transmembrane glycoprotein, cell surface receptor for hyaluronate - CD44s (CD44H) standard form of CD44 - CD44v6 splice variant exon 6 of CD44 - CTC common toxicity criteria - 2F10, VFF4, VFF7, VFF18 (BIWA 1), U36, V6B3, HB-256, Var 3.1 monoclonal antibodies targeting the CD44v6 antigen - SCC squamous cell carcinoma     

非小细胞肺癌中E-钙粘素和CD44v6的表达及其意义

为了探讨E-钙粘素(E-cadherin,E-cad)和白细胞分化抗原变异型6(CD44v6)在非小细胞肺癌(NSCLC)中的表达及临床意义,采用免疫组织化学(SP法)对65例NSCLC和20例癌旁组织中E-cad和CD44v6的表达进行研究。结果显示E-cad在肺癌组织中的阳性表达率(32.31%)显著低于癌旁组织(75.00%)(P<0.01),且与NSCLC的TNM分期、淋巴结转移呈负相关(P<0.05),与分化程度呈正相关(P<0.01),而与组织分型无关(P>0.05);CD44v6的阳性表达率与组织分型和分化程度无关(P>0.05),而与TNM分期和淋巴结转移呈正相关(P<0.05,<0.01)。两者在NSCLC中的表达显著相关(P<0.05)。因此检测E-cad和CD44v6的共同表达将是指导临床治疗及估计预后的有意义指标,可应用于临床预后的综合评价。     

胃癌中CD44v6 表达及与微血管密度和生物学行为的关系

目的:探讨CD44v6在胃癌中的表达及其与微血管密度(microvessel density,MVD)和生物学行为的关系。方法:采用免疫组化法检测80例胃癌组织CD44v6、CD34的表达,以CD34标记肿瘤微血管,并在显微镜下计数微血管密度(MVD)。结果:CD44v6在胃癌组织中的表达与肿瘤浸润深度、临床分期、淋巴结转移相关(P<0.05),CD44v6强阳性表达组中MVD明显高于CD44v6阴性表达组(P<0.05)。结论:CD44v6的表达和MVD计数是反映胃癌生物学特性的良好的指标,对判断胃癌的浸润转移具有一定的临床意义。     

宫颈癌中骨桥蛋白和CD44v6的表达及临床意义

目的探讨骨桥蛋白(OPN)和CD44v6在宫颈浸润癌中的表达及其意义。方法应用免疫组化SP法检测OPN和CD44v6在10例慢性宫颈炎、30例宫颈上皮内瘤样变及50例宫颈浸润癌组织中的表达。结果OPN在以上组织中的阳性表达率分别为10.00%(1/10)、36.67%和60.00%,慢性宫颈炎与宫颈浸润癌之间的表达差异有显著性(P<0.01);CD44v6阳性表达率分别为10.00%(1/10)、43.33%和68.00%,慢性宫颈炎与宫颈浸润癌之间的表达差异有显著性(P<0.01)。宫颈浸润癌组织中OPN和CD44v6表达均与患者年龄、肿瘤病理分级、组织学类型无关(P>0.05),而与淋巴结转移有关(P<0.05)。OPN与CD44v6的表达之间有显著正相关性(r=0.829,P<0.01)。结论OPN、CD44v6可能参与了宫颈癌的发生、发展和转移过程,联合检测它们的表达可作为判断宫颈癌的预后和术后复发的评估指标。     

E-cadherin和CD44V6在食管上皮癌变过程及癌组织中的表达

研究不同类型的食管上皮增生和癌组织的 E- cadherin (E- cad)和 CD44 V6的表达 ,并探讨其与食管癌发生和发展的关系。应用免疫组织化学 SABC法 ,观察 10例正常、 3例消化性溃疡、 2 5例单纯性增生、 15例不典型增生的食管粘膜上皮 ,5例食管原位癌与 5 4例浸润癌组织中的 E- cad和 CD44 V6蛋白的表达情况。结果显示正常食管鳞状上皮和高分化肿瘤细胞膜和细胞浆 E- cad和 CD44 V6染色 ,非典型增生、低分化肿瘤细胞两种蛋白抗体表达减弱或呈阴性。E- cad和 CD44 V6的表达与癌组织的组织学分级、类型和淋巴结转移有关 (P<0 .0 1,P<0 .0 5 ) ,与癌组织的浸润深度无关 (P>0 .0 5 )。提示E- cad和 CD44 V6表达减弱是癌组织低分化和高度恶性的生物学标志 ,但其与淋巴结转移的关系有待进一步研究     

CD44v6、MMP-9、VEGF在胃癌的表达及临床意义

目的:检测胃癌组织中CD44v6、MMP-9、VEGF表达情况及其与胃癌临床病理因素的关系,并探讨其表达与胃裸区侵犯的临床意义。方法:采用免疫组化方法测定60例胃癌组织CD44v6、MMP-9、VEGF表达情况,并结合患者的临床病理资料进行分析。结果:CD44v6、MMP-9、VEGF的表达与胃癌的TNM分期、浸润深度、淋巴结转移有关。胃裸区受侵组与未受侵组胃癌组织的CD44v6、MMP-9、VEGF的表达无明显差异。结论:CD44v6、MMP-9、VEGF的表达与胃癌的浸润转移密切相关,胃裸区是否受侵与胃癌组织的CD44v6、MMP-9、VEGF的表达无关,胃裸区这一解剖结构可能是胃癌预后较差的原因。     

PSMA、CD44v6在前列腺癌组织中的表达及相关性研究

目的探讨PSMA、CD44v6在前列腺癌中的表达及其与临床特征的关系,为临床预测前列腺癌的转移潜能及预后、指导治疗提供客观有效的指标。方法采用免疫组化S-P法检测PSMA、CD44v6在前列腺癌、前列腺增生及正常前列腺组织中的表达情况。结果PSMA在前列腺癌组织与前列腺增生组织中的表达无显著性差异;肿瘤分化程度低及有淋巴结转移者PSMA表达明显高于分化程度高及无淋巴结转移者。CD44v6在正常前列腺组织及前列腺增生组织中无表达,在前列腺癌组织中的表达较高,并且分化程度低及有淋巴结转移者CD44v6表达明显高于分化程度高及无淋巴结转移者。结论前列腺癌组织中PSMA与CD44v6的表达与肿瘤分化程度、淋巴结转移有关,且两者的表达在前列腺癌组织中具有相关性。     

Brain metastasis is predetermined in early stages of cutaneous melanoma by CD44v6 expression through epigenetic regulation of the spliceosome

Melanoma brain metastasis (MBM) is frequent and has a very poor prognosis with no current predictive factors or therapeutic molecular targets. Our study unravels the molecular alterations of cell‐surface glycoprotein CD44 variants during melanoma progression to MBM. High expression of CD44 splicing variant 6 (CD44v6) in primary melanoma (PRM) and regional lymph node metastases from AJCC Stage IIIC patients significantly predicts MBM development. The expression of CD44v6 also enhances the migration of MBM cells by hyaluronic acid and hepatocyte growth factor exposure. Additionally, CD44v6‐positive MBM migration is reduced by blocking with a CD44v6‐specific monoclonal antibody or knocking down CD44v6 by siRNA. ESRP1 and ESRP2 splicing factors correlate with CD44v6 expression in PRM, and ESRP1 knockdown significantly decreases CD44v6 expression. However, an epigenetic silencing of ESRP1 is observed in metastatic melanoma, specifically in MBM. In advanced melanomas, CD44v6 expression correlates with PTBP1 and U2AF2 splicing factors, and PTBP1 knockdown significantly decreases CD44v6 expression. Overall, these findings open a new avenue for understanding the high affinity of melanoma to progress to MBM, suggesting CD44v6 as a potential MBM‐specific factor with theranostic utility for stratifying patients.     

E-cadherin 在鼻咽癌组织中的表达及临床意义*

摘要目的：检测鼻咽癌组织中上皮细胞钙黏蛋白（E-cadherin）的表达情况,探讨E-cad 与肿瘤侵袭、转移的关系。方法：收集临床 确诊的存档鼻咽低分化鳞癌石蜡标本40例,鼻炎标本20 例。将每个标本的4 长切片分别进行HE染色、免疫组化PV 二步法及 阴性对照。HE 确认病理类型,结合临床资病例料进行TNM分期,根据PV 二步法染色结果检测E-cadherin 的表达,所得结果用 SPSS17.0 进行统计学检验。结果：E-cadherin 在鼻咽癌组织对比中呈不同程度的降低（P=0.002）,与性别、年龄无明显相关,与T 分 期（P=0.023）、淋巴结转移（P=0.001）、TNM 分期（P=0.000）显著相关。结论：1：E-cadherin 在鼻咽癌组和对照组的表达有显著的差 别,可能参与了鼻咽癌的发生发展。2：E-cadherin 的表达与肿瘤的淋巴结转移和病理分期有相关性,但与年龄和性别无相关性。 E-cadherin 的表达缺失是肿瘤远处转移的重要指标。3：E-cadherin 表达水平可能作为肿瘤侵袭,预测鼻咽癌颈部淋巴结隐匿性转 移的潜在肿瘤标志物。     

E-cadherin在鼻咽癌组织中的表达及临床意义

目的：检测鼻咽癌组织中上皮细胞钙黏蛋白（E-cadherin）的表达情况,探讨E-cad与肿瘤侵袭、转移的关系。方法：收集临床确诊的存档鼻咽低分化鳞癌石蜡标本40例,鼻炎标本20例。将每个标本的4长切片分别进行HE染色、免疫组化PV二步法及阴性对照。HE确认病理类型,结合临床资病例料进行TNM分期,根据PV二步法染色结果检测E-cadherin的表达,所得结果用SPSSl7．0进行统计学检验。结果：E-cadherin在鼻咽癌组织对比中呈不同程度的降低（P=0．002）,与性别、年龄无明显相关,与T分期（P=0．023）、淋巴结转移（P=0．001）、TNM分期（P=0．000）显著相关。结论：1：E-cadherin在鼻咽癌组和对照组的表达有显著的差别,可能参与了鼻咽癌的发生发展。2：E-cadherin的表达与肿瘤的淋巴结转移和病理分期有相关性,但与年龄和性别无相关性。E-cadherin的表达缺失是肿瘤远处转移的重要指标。3：E-cadherin表达水平可能作为肿瘤侵袭,预测鼻咽癌颈部淋巴结隐匿性转移的潜在肿瘤标志物。     

胃癌CD44v6 mRNA及其蛋白表达与临床病理特征的关系

目的探讨细胞粘附分子CD44v6 mRNA及其蛋白表达与胃癌临床病理学行为和患者预后的关系. 方法应用高敏感性催化信号放大系统(catalyzed signal amplification,CSA)原位杂交和免疫组化技术,对17例早期胃癌、21例中期胃癌和57例晚期胃癌组织进行CD44v6 mRNA及其蛋白检测,并结合肿瘤的病理学行为和临床随访资料进行分析.结果在胃癌中,CD44v6 mRNA及其蛋白的表达阳性率分别为85.3%和82.1%.CD44v6 mRNA及其蛋白表达阳性率在晚期胃癌明显高于早、中期胃癌(P<0.05).CD44v6 mRNA表达与蛋白表达水平具有一致性,均与胃癌浆膜浸润,淋巴结转移和患者预后呈正相关(P<0.05).结论 CD44v6 mRNA及其蛋白异常表达与胃癌的临床病理生物学行为密切相关,特别是与胃癌细胞的转移潜能和胃癌患者的不良预后密切相关.CD44v6蛋白水平的表达可以间接反映其mRNA转录水平,并可作为预测胃癌转移潜能和患者预后的一个新的生物学指标.     

大肠癌组织及癌旁组织中c—myc，COX-2和CD44v6基因表达量差异的检测

目的：通过检测大肠癌组织和癌旁组织中c-myc,COX-2以及CD44v6的表达水平,探讨这三种基因在大肠癌发生和发展中的意义。方法：应用实时荧光定量PCR技术检测了10例大肠癌组织和相应癌旁组织中c-myc,COX-2以及CD44v6基因表达水平的差异,并探讨了各基因在癌纽织中的表达水平与大肠癌临床病理指标之间的关系。结果：c-myc,COX-2以及CD44v6在大肠癌组织和癌旁组织中的表达均有非常显著性差异（P〈0．01）;癌组织中COX-2和CD44v6的表达与淋巴结转移、分化程度及Dukes分期有关（P〈0．05）。结论：c—myc,COX-2和CD44v6的异常表达均与大肠癌密切相关,三者从不同方面对大肠癌的发生和发展起到了重要作用,可作为早期诊断和预后的参考指标。     

CD44s and CD44v6 expression in head and neck epithelia

Background

CD44 splice variants are long-known as being associated with cell transformation. Recently, the standard form of CD44 (CD44s) was shown to be part of the signature of cancer stem cells (CSCs) in colon, breast, and in head and neck squamous cell carcinomas (HNSCC). This is somewhat in contradiction to previous reports on the expression of CD44s in HNSCC. The aim of the present study was to clarify the actual pattern of CD44 expression in head and neck epithelia.

Methods

Expression of CD44s and CD44v6 was analysed by immunohistochemistry with specific antibodies in primary head and neck tissues. Scoring of all specimens followed a two-parameters system, which implemented percentages of positive cells and staining intensities from − to +++ (score = %×intensity; resulting max. score 300). In addition, cell surface expression of CD44s and CD44v6 was assessed in lymphocytes and HNSCC.

Results

In normal epithelia CD44s and CD44v6 were expressed in 60–95% and 50–80% of cells and yielded mean scores with a standard error of a mean (SEM) of 249.5±14.5 and 198±11.13, respectively. In oral leukoplakia and in moderately differentiated carcinomas CD44s and CD44v6 levels were slightly increased (278.9±7.16 and 242±11.7; 291.8±5.88 and 287.3±6.88). Carcinomas in situ displayed unchanged levels of both proteins whereas poorly differentiated carcinomas consistently expressed diminished CD44s and CD44v6 levels. Lymphocytes and HNSCC lines strongly expressed CD44s but not CD44v6.

Conclusion

CD44s and CD44v6 expression does not distinguish normal from benign or malignant epithelia of the head and neck. CD44s and CD44v6 were abundantly present in the great majority of cells in head and neck tissues, including carcinomas. Hence, the value of CD44s as a marker for the definition of a small subset of cells (i.e. less than 10%) representing head and neck cancer stem cells may need revision.     

CD44v10 expression in the mouse and functional activity in delayed type hypersensitivity

We have described recently that expression of CD44 exon v10 (CD44v10) is down-regulated upon metastasis of squamous cell carcinoma, whereas it is up-regulated in skin metastases of malignant melanoma. The striking regulation of CD44v10 prompted us to generate a murine CD44v10-specific monoclonal antibody to define expression and possible functions of this particular CD44 variant isoform. In the mouse, expression of exon v10 was restricted to basal layers of the epidermis and squamous epithelium of the oral cavity, the esophagus, the omasum, glandular epithelium of the submandibular and the uterine gland, as well as subpopulations of bone marrow cells and activated lymphocytes. Expression started late during development, e.g., was not observed before day 16 of gestation and there was no evidence for developmental regulation of CD44v10 expression. Functional in vivo studies revealed that anti-CD44v10 had no effect on wound healing but inhibited edema and granuloma formation in delayed type hypersensitivity (DTH). Furthermore, lymphocyte-monocyte interactions could be inhibited by anti-CD44v10. Because a CD44v10 transfected tumour line did not show any distinct pattern of cell-matrix or cell-cell adhesion, the data point toward an involvement of CD44v10 in cell migration, possibly by acting as a target structure for cytokines/chemokines provided by the contacted partner cell. J. Cell. Physiol. 171:305–317, 1997. © 1997 Wiley-Liss, Inc.     

Expression of A and H blood-group and of CD44 antigens during chemical rat colonic carcinogenesis

Using an experimental model of rat colon adenocarcinoma, we have recently shown that the presence of H blood-group antigen on variants of the CD44 adhesion molecule carrying amino acids encoded by exon v6 (CD44v6), increased the cells' tumorigenicity. In the present study, colon adenocarcinomas were induced by 1,2-dimethylhydrazine treatment in rats. Using immunohistochemistry, biopsies of normal, precancerous and carcinomatous colon mucosa were evaluated for expression A and H blood group antigens and CD44s and CD44v6 antigens. Normal rat colon showed strong and homogeneous expression of blood-group antigen A, but weak expression of H antigen. Several weeks before the appearance of tumours, dysplastic glands were strongly stained with anti-H reagents, while their A antigen was lost. Expression of CD44v6 was weak and restricted to some cells at the bottom of normal crypts. No obvious change was observed before appearance of severe dysplasia. In carcinomas, a strong but irregular expression of A, H and CD44v6 antigens was observed. In moderately differentiated carcinomas, A and H antigens were present at the apical surface of cells, whereas CD44v6 was found at the basolateral side. Only carcinomatous cells with loss of polarity, found in poorly differentiated cancers or infiltrated in the muscularis mucosae, were found to coexpress blood-group H or A and CD44v6 antigens at their surface. This revised version was published online in November 2006 with corrections to the Cover Date.     

Immunohistochemical assessment of the tumour-associated epitopes CD44v6 and E48 in tumour-free lymph nodes from patients with squamous cell carcinoma in the head-neck region.

We examined immunohistochemically 370 tumour-free lymph nodes from 41 patients with a head and neck squamous cell carcinoma (HNSCC) to clarify whether the tumour-associated epitopes CD44v6 and E48 are suitable for adjuvant postoperative immunotherapy. All the positively immunostained cells found were single cells. CD44v6+ cells were found in 55% of the lymph nodes, with their numbers increasing in pN>0-patients (62%). Only pN>0-patients had abundant to massive CD44v6+ cells. A comparison with mononuclear cells in lymphatic tissue from control patients suggested a similarity with activated T-cells. In the 41 cancer patients there were significantly fewer lymph nodes with E48+ cells (11%), but the number of E48+ cells increased in pN> 1-patients (29%) with predominantly abundant E48+ cells. We conclude from the comparison with the epithelial marker EMA that the E48+ single cells are epithelial in origin. Only a specific E48 peptide sequence appears suitable for adjuvant immunotherapy in patients with head-neck tumours.     

A human homologue of the rat metastasis-associated variant of CD44 is expressed in colorectal carcinomas and adenomatous polyps

A recently described splice variant of CD44 expressed in metastasizing cell lines of rat tumors has been shown to confer metastatic potential to a non-metastasizing rat pancreatic carcinoma cell line and to non- metastasizing sarcoma cells. Homologues of this variant as well as several other CD44 splice variants are also expressed at the RNA level in human carcinoma cell lines from lung, breast, and colon, and in immortalized keratinocytes. Using antibodies raised against a bacterial fusion protein encoded by variant CD44 sequences, we studied the expression of variant CD44 glycoproteins in normal human tissues and in colorectal neoplasia. Expression of CD44 variant proteins in normal human tissues was readily found on several epithelial tissues including the squamous epithelia of the epidermis, tonsils, and pharynx, and the glandular epithelium of the pancreatic ducts, but was largely absent from other epithelia and from most non-epithelial cells and tissues. In human colorectal neoplasia CD44 variant proteins, including homologues of those which confer metastatic ability to rat tumors, were found on all invasive carcinomas and carcinoma metastases. Interestingly, focal expression was also observed in adenomatous polyps, expression being related to areas of dysplasia. The distribution of the CD44 variants in human tissues suggests that they play a role in a few restricted differentiation pathways and that in colorectal tumors one of these pathways has been reactivated. The finding that metastasis-related variants are already expressed at a relatively early stage in colorectal carcinogenesis and tumor progression, i.e., in adenomatous polyps, suggests the existence of a yet unknown selective advantage linked to CD44 variant expression. The continued expression in metastases would be compatible with a role in the metastatic process.     

Demonstration of a Melanoma-Specific CD44 Alternative Splicing Pattern That Remains Qualitatively Stable,but Shows Quantitative Changes during Tumour Progression

The role of CD44 in the progression of human melanoma has mostly been characterised by qualitative changes in expression of its individual variable exons. These exons however, may be expressed to form a number of molecules, the alternative splice variants of CD44, which may be structurally and functionally different. Using real-time PCR measurements with variable exon specific primers we have determined that all are expressed in human melanoma. To permit comparison between different tumours we identified a stable CD44 variable exon (CD44v) expression pattern, or CD44 ‘fingerprint’. This was found to remain unchanged in melanoma cell lines cultured in different matrix environments. To evaluate evolution of this fingerprint during tumour progression we established a scid mouse model, in which the pure expression pattern of metastatic primary tumours, circulating cells and metastases, non-metastatic primary tumours and lung colonies could be studied. Our analyses demonstrated, that although the melanoma CD44 fingerprint is qualitatively stable, quantitative changes are observed suggesting a possible role in tumour progression.     

E-cadherin negatively regulates CD44-hyaluronan interaction and CD44-mediated tumor invasion and branching morphogenesis

CD44 is a principal cell-surface receptor for hyaluronan (HA). Up-regulation of CD44 is often associated with morphogenesis and tumor invasion. On the contrary, reduction of cell-cell adhesion due to down-regulation of E-cadherin is associated with the invasive and metastatic phenotype of carcinomas. In our current study, we investigated the functional relationship between CD44 and E-cadherin. We established an inverse correlation between CD44 and E-cadherin indicating that the cells expressing higher levels of E-cadherin display weaker binding affinity between CD44 and HA. By using TA3 murine mammary carcinoma (TA3) cells, which display CD44-dependent HA binding, branching morphogenesis, and invasion, we demonstrated an inverse functional relationship between CD44 and E-cadherin by transfecting exogenous E-cadherin into the cells. Our results showed that increased expression of E-cadherin in TA3 cells, but not ICAM-1, weakens the binding between CD44 and HA and blocks spreading of the cells on HA substratum and CD44-mediated branching morphogenesis and tumor cell invasion. The results reported here demonstrated for the first time that E-cadherin negatively regulated CD44-HA interaction and CD44 function and suggested that balanced function of CD44 and E-cadherin may be essential for normal epithelial cell functions, and imbalanced up-regulation of CD44 function and/or down-regulation of E-cadherin function likely contributes to tumor progression.