Evaluation of cd44v6 and hyaluronan in patients with breast cancer : correlation with other prognostic factors

Abstract EN

Background : Breast carcinoma is the most frequently occurring cancer in women worldwide and the second most common cause of malignancy-associated deaths.

Despite improvements in treatment modalities, there is still a high failure rate mainly due to tumor invasion and metastasis.

Aim : The current study was conducted to study hyaluronic acid(HA), a component of the extracellular matrix and its main receptor (CD44v6) and hyaluronidase enzymes in breast cancer patients and their role in tumor invasion and metastasis.

They were tested for their prognostic significance in correlation with various clinic pathological parameters and the outcome of patients as regards the metastatic potential and survival.

Methods : This study was carried out on a total of 70 female patients admitted to the department of Surgery, Medical Research Institute, Alex.

University from June 2005 to July 2009 allocated into 50 women with breast cancer enrolled for modified radical or simple mastectomy and 20 women with benign breast lesions subjected for excision biopsy.

The level of CD44v6, hyaluronan, and hyaluronidase enzymes were measured in the serum of the patients and correlated with the different clinic pathological parameters.

All patients were followed up for disease free and overall survival.

Results : Serum level of CD44v6 was higher in breast cancer patients than in benign group with insignificant statistical difference (P>0.05).

Significant correlation was noticed between CD44v6 and larger tumor size, higher grade, positive lymph node, positive ER receptors, positive vascular invasion, and stage of the disease( P < 0.05), while insignificant correlation with Progesterone receptor (PR) expression, age, and menstrual status of breast cancer patients.

Breast cancer patients had a higher serum level of hyaluronic acid than benign breast lesion group with significant statistical difference between both groups ( P < 0.05).

Significant correlation was noticed between hyaluronan and higher tumor grade, positive lymph node, positive ER receptor, vascular invasion positivity, and tumor stage ( P < 0.05), while insignificant relationship with PR receptor, age, menstrual status, or tumor size( P>0.05).Serum activity of hyauronidase enzymes ( HAE) was less in breast cancer patients than in benign group with significant statistical difference between both groups ( P < 0.05).

There was no significant association between HAE in breast cancer patients and any of the clinic pathological parameters ( P > 0.05).

Positive correlation was found between level of hyaluronan and CD44v6 with both disease free and overall survival while the correlation was negative for hyaluronidase enzymes.

Conclusions : The potent adhesion molecule CD44v6, hyaluronic acid (HA), and hyaluronidases (HAE) can be considered to be an additional potential predictors for the clinical course of breast cancer and they may be directly involved in the spreading of breast cancer.

Also, they may offer a potential target for new therapies