CD44-9v and CD44-10v are potential molecular markers for squamous cell carcinoma of the vulva

OBJECTIVE: CD44 is a cell surface glycoprotein widely distributed in the ex tracellular matrix. CD44 isoforms arising from alternative mRNA splicing ar e implicated in tumor metastases. The aim of this study is to investigate t he expression of CD44s and two splice variants, CD44-9v and CD44-10v, in sq uamous cell carcinoma (SCC) of the vulva as well as its correlation with ly mph node (LN) metastases and disease-free survival. METHODS: Thirty-five SCC vulvar tumors were evaluated for CD44s, CD44-9v, a nd CD44-10v expression by immunocytochemistry. One nonmetastatic LN was stu died also. In cases with LN metastases, the metastic LN as well as a nonmet astatic LN from the same patient were evaluated. RESULTS: CD44s and CD44-9v were expressed in all epithelia- normal, dysplas tic, and SCC. However, intensity and distribution of expression of 9v isofo rms changed within the tissue containing invasive cancer. CD44-9v expressio n was downregulated in the most differentiated cells within the carcinoma, mainly in patients who had disease recurrence or eventually died of disease (P = .031). All metastatic tumor to LNs was immunoreactive also for CD44-9 v. CD44-10v expression, but not cytoplasmic expression, correlated with dis ease recurrence (P = .035). CONCLUSION: Our findings warrant larger multi-institutional studies to dete rmine the potential of CD44-9v and CD44-10v as molecular markers of disease recurrence in vulvar carcinoma. We propose to test the use of anti-CD44-9v monoclonal antibody for raadioimmunoimaging of occult LN metastases. Copyr ight (C) 2000 by the Society for Gynecologic Investigation.