CD44 splice variant expression in normal and malignant uterine cervical epithelium

CD44 expression was investigated immunohistochemically on paraffin sections obtained from 88 uterine cervical cancers and 31 normal cervices, using mo noclonal antibodies against CD44 variant epitopes v4, v5, v6, v7/8, v9 and the standard form of the CD44 protein. Normal epithelium showed expression of all CD44 splice variants, at least in traces, and it was located predomi nantly in basal and parabasal cells. In cervical carcinomas CD44 expression was widely heterogeneous. CD44 variant v9 staining was moderate or strong in 86% of the tumors, and it was significantly correlated with CD44 v6 stai ning. Also a significant correlation between expression of CD44 v4 and v6 o ccurred. Highly significant correlations between CD44 expression of variant s v4 and v6 and tumor stage as well as patients age were found. In addition , these variants were more frequently expressed in squamous cell carcinomas than in adenocarcinomas. However, in contrast to the recently reported, da ta, we were not able to confirm the hypothesis that CD44 v6 represents a pr ognostic indicator in cervical cancer. In FIGO stages III and IV,patients w ith CD44 variant v4 positive tumors had a significantly longer disease-free and overall survival than patients with CD44 variant v4 negative tumors, I n conclusion, our data indicate that CD44 v6 tissue expression cannot be co nsidered as a prognostic factor in cervical cancer. Regarding the unexpecte d outcome of patients with CD44 v4 positive tumors, further investigations are needed to elucidate the exact clinical value of this variant isoform.