EXPRESSION AND PROGNOSTIC VALUE OF CD44 ISOFORMS IN TRANSITIONAL CELL CARCINOMA OF RENAL PELVIS AND URETER

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Abstract
We retrospectively evaluated the expression and prognostic value of CD44 isoforms in transitional cell carcinoma of the renal pelvis and ureter. Using a labeled streptavidin-biotin-peroxidase method we performed immunohistochemical staining of archival tissue specimens from 62 men and 26 women with a mean age of 66.5 years who had transitional cell carcinoma of the renal pelvis and ureter. The expression of CD44 standard (CD44s) and splice variant 6 (CD44v6) proteins was significantly decreased in relation to histological grade and pathological stage, while expression of the CD44 splice variant 3 (CD44v3) protein was decreased in relation to histological grade. The prognosis was more favorable in patients with greater versus less than 25% CD44s positive cells. CD44v3 and CD44v6 proteins had no prognostic value. Multivariate analysis indicated that only pathological stage has an independent prognostic value. The expression of CD44 isoforms is closely associated with tumor differentiation and progression. However, it is not an independent marker and has no statistical significance greater than that of stage.