Background: Small cell lung cancer (SCLC) is a highly aggressive malignancy characterized by rapid growth, early metastasis and acquired therapeutic resistance, and the prognosis is extremely poor. Studies have proved that the stem cell marker CD44 is correlated with tumor recurrence and treatment resistance, however, there are limited reports yet concerning on the CD44 expression and its clinical prognostic significance in SCLC patients. The purpose of this study is to investigate the expression of CD44 in tumor tissues as well as serum of SCLC patients and explore its correlation with the clinical characteristics, therapeutic effect and prognosis.
Methods: The tumor tissues and serum samples of 47 newly diagnosed SCLC patients were collected. Immunohistochemistry and enzyme-linked immunosorbent assay were applied to detect CD44. The relationship between CD44 level and the clinical characteristics as well as prognosis of the patients was analyzed.
Results: The stem cell marker CD44 was detectable both in serum sample and tumor tissue of SCLC patients. The positive rate of CD44 in tumor tissue was significantly higher in patients with performance status (PS) 2 than that of patients with PS 0-1 (85.71% vs 30%, P=0.017). Patients were divided in to different groups according to the treatment efficacy. The CD44 immunohistochemical score and serum level in the disease progression group were significantly higher than those in the disease control group, and the differences were statistically significant (P=0.006, P=0.034), Univariate analysis depicted that the progression-free survival (PFS) of CD44 positive patients was significantly shorter than that of CD44 negative patients (5.23 mon vs 9.03 mon, P=0.036).
Conclusions: The positive expression of CD44 in tumor tissues of pre-treatment SCLC patients is correlated with poor PFS. The clinical significance of CD44 is worthy to be further studied.
【中文题目：小细胞肺癌肿瘤组织及血清CD44表达及 临床预后意义】 【中文摘要：背景与目的 小细胞肺癌（small cell lung cancer, SCLC）是一种以增殖迅速、易早期远处转移和获得性治疗耐药为特征的高侵袭性恶性肿瘤，临床预后极差。研究发现干细胞标志物CD44与肿瘤复发转移及治疗抵抗有关，而有关CD44在SCLC患者中的表达及其临床预后意义研究不多。本研究拟通过检测SCLC患者肿瘤组织和血清中CD44的表达水平，初步探索其与患者临床特征的关系并评估其判断预后的临床价值。方法 将本院47例初治SCLC患者肿瘤组织和血清标本配对，分别应用免疫组化法（immunohistochemistry, IHC）和酶联免疫吸附试验方法（enzyme-linked immunosorbent assay, ELISA）对CD44进行检测，分析其与患者临床特征及预后的关系。结果 SCLC患者肿瘤组织和血清中均可检测到干细胞标志物CD44的表达，体能状态（performance status, PS）2分的患者肿瘤组织CD44阳性率明显高于PS 0分-1分的患者（85.71% vs 30%, P=0.017），根据化疗疗效对患者进行分组，疾病进展组肿瘤组织CD44免疫组化得分及血清CD44浓度均明显高于疾病控制组且差异均达到统计学意义（P=0.006, P=0.034），单因素分析肿瘤组织CD44阳性患者无进展生存期（progression-free survival, PFS）较CD44阴性患者PFS明显缩短（5.23个月 vs 9.03个月，P=0.036）。结论 初治SCLC患者肿瘤组织中CD44的表达水平与PFS相关，CD44在SCLC中的临床意义值得进一步深入研究。】 【中文关键词：肺肿瘤；干细胞标志物；CD44；预后】.
Keywords: CD44; Lung neoplasms; Prognosis; Stem cell marker.