Prognostic significance of CD44 and nm23 expression in patients with stageII and stage IIIA gastric carcinoma

Background and Objectives: Predicting the prognosis in gastric carcinoma pa tients with intermediate stages is difficult. We investigated the prognosti c impacts of CD44 and nm23 expression in a homogeneous group of patients wi th stage LI and IIIA gastric carcinoma who had undergone curative resection s. Methods: A total of 261 paraffin-embedded gastric carcinomas were stained w ith the monoclonal antibodies CD44 and nm23 using the labeled streptovidin biotin method. Results: The expression of CD44 and nm23 was detected, respectively, in 31. 0% (81/261) and 70.1% (183/261) of all tumors. There was no correlation bet ween CD44 expression and clinicopathological variables. However, nm23 was m ore frequently expressed in older patients with differentiated adenocarcino ma. A significant difference in 5-year survival rates was found between pat ients with CD44-positive (43.2%) and CD44-negative tumors (63.4%), (P = 0.0 018). However, there was no significant difference in 5-year survival rates between patients with nm23-positive (54.7%) and nm23-negative tumors (62.7 %) (P = 0.2734). Conclusions: CD44 expression was a significant adverse prognostic factor in gastric carcinoma and may be a predictor of metastatic potential of the pr imary tumor. By contrast, immunohistochemical detection of nm23 expression was not a predictor of outcome of patients with gastric carcinoma. J. Surg. Oncol. 1999:71:22-28. (C) 1999 Wiley-Liss, Inc.