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Introduction CD44, a multistructural and multifunctional transmembrane glycoprotein, is a promising cancer stem cell (CSC) marker that regulates the properties of CSCs, including self-renewal, tumor initiation, and metastasis, and confers resistance to chemotherapy and radiotherapy. The aim of the present study was to evaluate the gene and protein expression of CD44 and explore its prognostic value in head and neck squamous cell carcinoma (HNSCC). Methodology The present observational study employs computational tools for analysis. The Cancer Genome Atlas Head-Neck Squamous Cell Carcinoma dataset (520 primary HNSCC and 44 normal tissues) from the University of Alabama at Birmingham Cancer platform was used to study the association of CD44 mRNA transcript levels with various clinicopathological characteristics of HNSCC including age, gender, tumor grade, tumor stage, human papillomavirus (HPV) status, p53 mutation status, and overall survival. The CD44 protein expression in HNSCC and normal tissues was ascertained using the National Cancer Institute's Clinical Proteomic Tumor Analysis Consortium Head-and-Neck cancer dataset (108 primary HNSCC and 71 normal tissues). Results CD44 mRNA transcript and protein expression levels were significantly higher in HNSCC tissues than in normal tissues, and high CD44 expression was correlated with poor survival. CD44 was upregulated in Stage 1 and Grade 2 HNSCC compared with other stages and grades. Overexpression of CD44 was observed in HPV-negative and TP53-positive mutant status in HNSCC. Conclusion The pleiotropic roles of CD44 in tumorigenesis urge the need to explore its differential expression in HNSCC. The study concludes that CD44 can be a potential diagnostic and prognostic biomarker for HNSCC and offer new molecular targets for CD44-targeted therapy for cancer management.
RESUMO
INTRODUCTION: In India, it is estimated that 2.5 million people are currently living with Human Immunodeficiency virus infection (HIV) of which one million are women. Given the occurrence of oral lesions in our population, we studied the patter of these lesions with respect to the role played by gender. MATERIALS AND METHODS: 3729 consecutive patients seen over a period of 10 years (from 1998 to 2008) attending the YRG CARE (Center for AIDS Research and Education), at Chennai, India constituted the study group. The oral lesions were diagnosed and the findings were entered into a database and analysed using the SPSS package SPSS11. RESULTS: 3724 adult patients (71% males 29% females) were recruited in this study. 95% and 92% of males and females respectively acquired the infection through the heterosexual route. 69% of them presented with at least one oral lesion. There was a significant difference in the occurrence of oral candidiasis (OC) (18.8% males 10.3% females, P = 0.00) and oral hairy leukoplakia (OHL) (1.2% males 0.4% females, P = 0.023) between gender. The mean CD4 counts in males (n = 1908) was 284.48 ± 222.45 and in females (n = 1087) it was 394.51 ± 274.56. Males had 2.2 times higher risk of getting OC, 3.1 times higher risk of OHL and over all males had 1.58 times of having any oral lesion compared to females. Multivariate logistic regression that the odds of having OC (OR = 1.7, 95%CI 1.2-2.2, P = 0.001) and OHL (OR = 3.1, 95%CI 1.1-8.9; P = 0.03) were significantly higher for males than for females after controlling for duration of being HIV positive, CD4 count and HAART. 1412 patients had their spouses HIV status also as HIV positive and 769 patients had their spouse HIV status as negative. 858 patients were on HARRT (627 males and 231 females) The partial correlation analysis, done between gender and CD4 counts, when controlling for HAART was r = 0.2028 (P = 0.00). CONCLUSION: Our study confirms that males had a higher risk of oral lesions, especially OC and OHL, than females. The females in this study had a significantly higher mean CD4 counts than males. This different immunological status of the females compared to males should be taken in to consideration in the evaluation and management of HIV positive patients in our country.
