CD44 EXPRESSION IN PROSTATIC ADENOCARCINOMA: CORRELATION WITH GLEASON GRADES

Abstract

Objective: CD44, a cell-surface adhesion protein, is a marker of stem cells and is involved in the structural maintenance of prostate gland basal cells. It plays an important role in prostate carcinogenesis; however, research results till date have been inconsistent. The current study was conducted to evaluate the expression level of CD44 among carcinomas with different Gleason growth patterns and hyperplastic glands.

Material and Methods: Eighty archival tissue samples from patients with either prostate carcinoma of differing Gleason patterns or benign prostate hyperplasia from the pathology archives of the Kırıkkale University, Faculty of Medicine, from 2011 to 2018 were included. Immunoreaction to CD44 antibodies was evaluated by calculating positively stained cell percentage and staining intensity. Mean values and significance were determined using the Kruskal–Wallis test. p<0.05 was considered significant.

Results: CD44 staining was more diffuse and intense in most of benign hyperplastic tissues compared to carcinoma cases (p values ranged from <0.01 to 0.005). Expression level gradually decreased with increasing severity of histologic pattern. Pattern 3 tumor showed higher percentage of positively stained cells than pattern 4 (p<0.01) There was no positivity with CD44 in grade 5 tumours. Also, in pattern 4 only few cells reacted with CD44. There was no statistically significant difference in the staining score between pattern 4 and 5 (p=0.278).

Conclusion: We conclude that once cancerous properties have been established, cells tend to lose the ability of CD44 expression. CD 44 expression in low grade carcinomas suggest that CD 44 maintains the tumor in a differentiated, gland forming state so it may not act as a cancer stem cell marker in prostate carcinogenesis.

Keywords

• Prostate Carcinogenesis
• Stem cells
• Prostatic Hyperplasia
• Keratins

Prostat Adenokarsinomunda CD44 Ekspresyonu: Gleason Derecesi ile Korelasyon

Abstract

Amaç: Bir yüzey adezyon proteini olan CD44, kök hücre belirteci olup prostat glandlarının bazal hücrelerinin yapısal bütünlüğünü korumada görev alır. Prostat karsinogenezisinde de önemli bir rolü olduğu düşünülse de şu ana dek yapılan çalışmalarda elde edilen sonuçlar belirsizdir. Bu çalışma, farklı Gleason büyüme patternlerine sahip tümörlerde ve hiperplastik glandlarda CD44 ekspresyonunu değerlendirmek amacı ile yapılmıştır. 

Gereç ve Yöntemler: Kırıkkale Üniversitesi, Tıp Fakültesi patoloji arşivine ait, 2011 ile 2018 yılları arasında tanı almış, farklı Gleason derecelerine sahip prostat karsinomlu ve benign prostat hiperplazili 80 olgu, çalışmaya dahil edilmiştir. CD44 ile olan immünreaksiyon, pozitif boyanan hücrelerin yüzdesi ile boyanma yoğunluğunun çarpımı olarak değerlendirilmiştir. Ortalama değerler ve anlamlılık Kruskal-Wallis testi kullanılarak belirlenmiş; p<0.05 anlamlı kabul edilmiştir. 

Bulgular: Benign hiperplazi olgularında CD44 boyanması, karsinom olgularına göre daha diffüz ve yoğun idi (p değerleri <0.01-0.005). Ekspresyon seviyesi, histolojik derece arttıkça kademeli olarak düşüş gösterdi. Pattern 3 tümörler, pattern 4 tümörlerden daha yüksek oranda pozitif hücre sayısına sahipti (p<0.01). Pattern 5 tümörlerde CD44 ile boyanma olmadı. Pattern 4 tümörlerde ise az sayıda hücrede pozitiflik görüldü. Pattern 4 ve 5 arasında, CD44 boyanması bakımından anlamlı farklılık gözlenmedi ((p=0.278).

Sonuç: Bu çalışmada, bir kez kanseröz özellikler kazanıldıktan sonra hücrelerin CD44 ekspresyonu kabiliyetini yitirme eğiliminde olduğu sonucuna vardık. Düşük dereceli kanserlerdeki CD44 ekspresyonunun, tümör dokusunu diferansiye ve gland oluşturabilen durumda kalmasını sağladığını, bu nedenle CD44’ün prostat karsinogenezisinde bir tümör kök hücre marker’ı gibi davranmayabileceğini düşündük.

Keywords

• Prostat karsinogenezis
• Kök Hücreler
• Prostatik Hiperplazi
• Keratinler

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