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Co‐expression of CD24 and CD44 in gastric carcinoma and its influence on clinicopathological parameters and prognosis

BACKGROUND: Studies have shown that the expression of CD24 and CD44 may be closely related to the disease progression, clinicopathological parameters and prognosis of gastric carcinoma. OBJECTIVE: To investigate the expression of CD24 and CD44 in gastric carcinoma and its influence on clinicopathological parameters and prognosis. METHODS: The clinical data of patients undergoing surgical resection of gastric carcinoma in Heze Municipal Hospital from April 2006 to April 2012 were collected. The expression of CD24 and CD44 protein in cancer tissues, paracancerous tissues and normal tissues from resected specimens was detected by immunohistochemistry. The relationship between the expressions of CD24 and CD44, clinicopathological parameters and prognosis of the patients was analyzed. RESULTS AND CONCLUSION: (1) Among 180 patients, the positive rate of CD24 was 57.5% (92/180), which was lowly expressed in 54 cases and highly expressed in 38 cases; the positive rate of CD44 was 49.3% (79/180), which was lowly expressed in 48 cases and highly expressed in 31 cases. The co‐expression rate was 24.3% (39/180) and the double negative rate was 30.0% (48/180). (2) Compared with cancer tissues, the positive rates of CD24 and CD44 in normal gastric tissues and paracancerous tissues were significantly lower (P < 0.001). (3) Univariate analysis showed that the co‐expression of CD24 and CD44 in gastric cancer tissues was related to the size of gastric carcinoma, T staging, N staging, vascular invasion (P < 0.05), but not related to age, sex, tumor site, WHO pathological classification, Lauren classification and M staging (P > 0.05). Multivariate analysis showed that T staging and N staging were independent risk factors affecting the expression of CD24 and CD44 in gastric cancer tissues. (4) Spearman rank correlation analysis showed no correlation between the expression intensity of CD24 and CD44 (r=0.020, P=0.795). (5) Seventeen of 180 cases were lost to follow‐up, and the loss rate was 9.4%. Eighty‐seven patients died within 5 years. Twenty‐one of 53 patients in CD24 single‐positive group died, and 23 of 40 patients in CD44 single‐positive group died. Thirteen of 48 patients in double‐negative group died, and 30 of 39 patients in double positive group died. Log‐rank test results showed that the survival rate of the four groups was significantly different (&khgr;2=21.72, P < 0.001), and the CD24(+) CD44(+) group had the worst prognosis. To conclude, CD24 and CD44 have higher positive rates in gastric carcinoma, which are closely related with the staging of patients. Moreover, the co‐expression of CD24 and CD44 strongly indicates a poor prognosis.