EXPRESSION OF CD44 VARIANT-6 AND LYMPHATIC INVASION - IMPORTANCE TO LYMPH-NODE METASTASIS IN GASTRIC-CANCER

Lymph node metastasis is a critical prognostic factor for gastric canc er, In the present investigation me examined clinicopathologic factors influencing the metastatic processes to the lymph node and their prog nostic importance. A randomly selected group of 98 patients with adeno carcinomas of the stomach who underwent gastrectomy plus systematic ly mph node dissection at Osaka Police Hospital from 1991 to 1996 were an alyzed. Altogether 37 (38%) cancers were positive for CD44 variant 6 ( v6) staining, 31 (32%) were intermediately stained, and 30 (30%) were negative. CD44-v6 expression correlated well with lymph node metastasi s, Expression of CD44-v6 and lymphatic invasion were independent risk factors for metastatic lymph nodes. Among the patients with CD44-v6-po sitive and lymphatic invasion-positive cancers, 88% had lymph node met astasis, whereas only 13% of patients negative for both factors had ly mph node metastasis. Although CD44-v6 expression and lymphatic invasio n have been reported to be risk factors for recurrence and a poor prog nosis, in this investigation these factors were found not to be signif icant for hematogenous and lymphatic recurrences or overall survival r ates. Thus expression of CD44-v6 and lymphatic invasion may regulate l ymph node metastases from gastric cancer.