CD44 AS A DIFFERENTIATION MARKER AND METASTASIS PROMOTER IN GYNECOLOGICAL MALIGNANCIES

CD44 has been established as a major player in the development and met astatic spread of various human malignancies due to its adhesional pro perties, However, the concept of CD44 as a universal metastasis promot er has been brought into question by the fact that the expression of C D44 isoforms lacks prognostic value in several malignancies, e.g. ovar ian cancer, endometrial cancer, and breast cancer, Furthermore, CD44 i soform expression has been shown to be downregulated after malignant t ransformation of certain cell types (58) (59), It may be speculated th at the role of CD44 as a metastasis mediator in hormonally regulated m alignancies, e.g,, breast and ovarian cancer, is impaired by hormonal interference with the biological functions of CD44. On the other hand, CD44 expression is not correlated with hormonal phenotypes in neuroen docrine tumours and has been shown to be independent of estrogen and p rogesterone receptor status in breast cancer (60) (61), In the field o f gynecological oncology, CD44 is most likely to be at the center of s cientific attention in cervical cancer, Assessment of CD44 isoform exp ression could be of clinical value in deciding about adjuvant therapy resulting in more individualized therapy management, According to the data available today, the CD44 isoform CD44v6 is the most promising ca ndidate to become an additional prognostic marker in surgically treate d cervical cancer.