Purpose The invasive tumor front (ITF) and pattern of invasion (POI) are significant prognosticators in head and neck cancer squamous cell carcinoma (HNSCC); this study evaluates the expression of CSC marker, CD44 at the ITF and their combined prognostic potential. Methods POI, as scored by the invasive pattern grading score (IPGS), was correlated with CD44 expression in HNSCC cell line-derived xenografts. Immunohistochemical expression of CD44 was correlated with the ITF features in patients and their combined prognostic ability assessed by multivariate analysis, Kaplan–Meier plots, and Cox regression models. Results Assessment of cell line-derived in vivo models indicated that drug-resistant, CD44-enriched cell lines led to genera- tion of xenografts with aggressive POIs (IV) at the ITF. In patients (N = 173), a near significant association of CD44 with IPGS (p = 0.05) was observed. CD44 (p = 0.02), along with differentiation ( p = 0.04), and lymphoplasmocytic infiltration (LPI) (p = 0.03) were independent prognosticators of recurrence. Notably, IPGS and poorly differentiated tumors were high low predictors of recurrence in CD44 cohort (p < 0.05), while severe LPI was a good prognosticator only in CD44 cohort (p < 0.006). In the treatment naïve cohort, the prognostic efficacy was confined to the
Oral Cancer – Springer Journals
Published: Apr 16, 2018
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