CD44 EXPRESSION IN UTERINE CERVICAL INTRAEPITHELIAL NEOPLASIA AND SQUAMOUS-CELL CARCINOMA - AN IMMUNOHISTOCHEMICAL STUDY

CD44 is an integral membrane glycoprotein, functioning as the receptor for hyaluronic acid. CD44 is expressed on epithelial, mesenchymal, ly mphoid, and glial cells. CD44 distribution, pattern of staining, and i soform types are altered in neoplastic conditions, including cervical dysplasia and carcinoma. We have studied CD44 expression by immunohist ochemistry in 49 patients with cervical intraepithelial neoplasia (CIN ) I, II, III invasive squamous cell carcinoma of the uterine cervix an d controls. Only membranous staining was considered positive. Diffuse membranous staining was observed in all controls and CIN I cases, but only in 7/10, 3/10, and 4/9 cases of CIN II, CIN In and squamous cell carcinoma, respectively. The remaining cases showed either complete la ck of staining, only focal membranous staining or only diffuse inconsi stent (weak/cytoplasmic/fragmented) staining. Three invasive carcinoma s showed both areas of membranous staining and areas of inconsistent s taining in the same section. No correlation was observed between tumor grade and CD44 pattern of staining. Human papillomavirus (HPV) was fo und in 24/29 high-grade intraepithelial lesions and carcinomas. HPV ex pression did not correlate with CD44 staining. In conclusion, CD44 exp ression was found to be reduced in more than 50% of high-grade intraep ithelial neoplastic lesions and invasive carcinomas. This might be ass ociated with the loss of cellular adhesion characteristics of pre-inva sive and invasive lesions. HPV presence did not seem to influence CD44 expression.