High CD44 immunoexpression correlates with poor overall survival: Assessing the role of cancer stem cell markers in oral squamous cell carcinoma patients from the high-risk population of Pakistan

Authors

Yumna Mirza, Aga Khan UniversityFollow
Syed Adnan Ali, Aga Khan UniversityFollow
Hasnain Ahmed Farooqui, Aga Khan UniversityFollow
Hammad A. Kayani, Shaheed Zulfikar Ali Bhutto Institute of Science and Technology
Romana Idress, Aga Khan UniversityFollow
Mohammad Sohail Awan, Aga Khan UniversityFollow

Document Type

Article

Department

Surgery; Otolaryngology, Head and Neck Surgery

Abstract

Oral squamous cell carcinoma (OSCC) is a top-ranked cancer in the Pakistani population, and patient survival has remained unchanged at ∼50% for several decades. Recent advances have claimed that a subset of tumour cells, called cancer stem cells (CSCs), are responsible for tumour progression, treatment resistance, and metastasis, which leads to a poor prognosis. This study investigated the impact of CSC markers expression on overall survival (OS) and disease-free survival (DFS) of OSCC patients. Materials and Methods. Immunohistochemistry was used to evaluate CD44, CD133, L1CAM, and SOX2 expression in a well-characterized cohort of 100 Pakistani patients with primary treatment naïve OSCC. The immunoreactivity for each marker was correlated with patient clinicopathologic characteristics, oral cancer risk chewing habits, and survival. The minimum follow-up time for all patients was five years, and survival estimates were calculated using the Kaplan-Meier method and Cox proportional hazards model. Results. In this cohort of 100 patients, there were 57 males and 43 females. The median OS and DFS time durations observed were 64 and 52.5 months, respectively. Positive expression for CD44, CD133, L1CAM, and SOX2 was observed in 33%, 23%, 41%, and 63% of patients. High CD44 expression correlated with decreased OS (P=0.047) but did not influence DFS. However, CD133, L1CAM, and SOX2 had no effect on either OS or DFS. Tonsils, nodal involvement, and AJCC stage were independent predictors of worse OS and DFS both. Conclusion. Of the CSC markers investigated here, only CD44 was a predictor for poor OS. CD44 was also associated with advanced AJCC and T stages. Interestingly, CD133 was significantly lower in patients who habitually consumed oral cancer risk factors.

Comments

Issue, and pagination are not provided by the author/publisher

Publication (Name of Journal)

International journal of surgical oncology

Recommended Citation

Mirza, Y., Ali, S. A., Farooqui, H. A., Kayani, H. A., Idress, R., Awan, M. (2022). High CD44 immunoexpression correlates with poor overall survival: Assessing the role of cancer stem cell markers in oral squamous cell carcinoma patients from the high-risk population of Pakistan. International journal of surgical oncology, 2022.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_surg_surg/891

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This work is licensed under a Creative Commons Attribution 4.0 International License.