Head and Neck Pathology

, Volume 7, Issue 2, pp 122–128 | Cite as

CD44 Expression in Intraoral Salivary Ductal Papillomas and Oral Papillary Squamous Cell Carcinoma

  • Sarah G. Fitzpatrick
  • Lindsay J. Montague
  • Donald M. Cohen
  • Indraneel Bhattacharyya
Original Paper

Abstract

CD44 is a transmembrane adhesion molecule which has been previously shown to be useful in the differentiation of benign papillary lesions from invasive carcinoma in several different areas including sinonasal mucosa and breast tissue. CD44 expression has previously been shown to be lost in invasive carcinoma and retained in benign papillary lesions in both of the above locations. In addition, studies have evaluated oral mucosal lesions for CD44 expression and found a loss with invasive squamous cell carcinoma when compared to normal epithelium, hyperplasia, and squamous papillomas, which stained particularly strongly. To the best of our knowledge, no study has evaluated CD44 expression when comparing salivary ductal papillomas in comparison to oral papillary SCCA. In this study 18 cases of intraductal papilloma were compared to 19 cases of oral papillary SCCA. Within the ductal papilloma group, all cases stained either absent (6 %), weakly (33 %), or moderately (61 %) with 76 % expressing the stain diffusely and 24 % focally. In comparison, the papillary squamous cell carcinoma cases expressed the CD44 moderately (26 %) or strongly (74 %) with 100 % showing diffuse staining. Thus, the CD44 expression was contrary to expectation based on previous studies, which we hypothesize is due to the extremely well differentiated nature of papillary SCCA which expressed CD44 staining compatible with levels previously reported with oral squamous papillomas than invasive carcinoma.

Keywords

CD44 Salivary ductal papillomas Papillary squamous cell carcinoma Immunohistochemistry 

References

  1. 1.
    Ingle R, Jennings TA, Goodman ML, Pilch BZ, Bergman S, Ross JS. CD44 expression in sinonasal inverted papillomas and associated squamous cell carcinoma. Am J Clin Pathol. 1998;109:309–14.PubMedGoogle Scholar
  2. 2.
    Saddik M, Lai R. CD44s as a surrogate marker for distinguishing intraductal papilloma from papillary carcinoma of the breast. J Clin Pathol. 1999;52:862–4.PubMedCrossRefGoogle Scholar
  3. 3.
    Troxell ML, Masek M, Sibley RK. Immunohistochemical staining of papillary breast lesions. Appl Immunohistochem Mol Morphol. 2007;15:145–53.PubMedCrossRefGoogle Scholar
  4. 4.
    Tse GMK, Tan P-H, Ma TKF, Kilks CB, Poon CSP, Law BKB. CD44s is useful in the differentiation of benign and malignant papillary lesions of the breast. J Clin Pathol. 2005;58:1185–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Bahar R, Kunishi M, Kayada Y, Yoshiga K. CD44 variant 6 (CD44v6) expression as a progression marker in benign, premalignant, and malignant oral epithelial tissues. Int J Oral Maxillofac Surg. 1997;26:443–6.PubMedCrossRefGoogle Scholar
  6. 6.
    Ellis GL, Auclair PL. Benign epithelial neoplasms. In: Silverberg SG, Sobin LH, editors. AFIP atlas of tumor pathology: tumors of the salivary glands. Washington, DC: American Registry of Pathology; 2008. p. 49–171.Google Scholar
  7. 7.
    Gomes APN, Sobral APV, Loducca SVL, de Araujo VC. Sialadenoma papilliferum: immunohistochemical study. Int J Oral Maxillofac Surg. 2004;33:621–4.PubMedCrossRefGoogle Scholar
  8. 8.
    Ubaidat MA, Robinson RA, Belding PJ, Merryman DJ. Sialadenoma papilliferum of the hard palate: report of 2 cases and immunohistochemical evaluation. Arch Pathol Lab Med. 2001;125:1595–7.PubMedGoogle Scholar
  9. 9.
    de Sousa SO, Sesso A, de Araujo NS, de Araujo VC. Inverted ductal papilloma of minor salivary gland origin: a report of 19 cases and a review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;92:68–77.CrossRefGoogle Scholar
  10. 10.
    Koutlas IG, Jessurun J, Iamaroon A. Immunohistochemical evaluation and in situ hybridization in a case of oral inverted ductal papilloma. J Oral Maxillofac Surg. 1994;52:503–6.PubMedCrossRefGoogle Scholar
  11. 11.
    Ishikawa T, Imada S, Ijuhin N. Intraductal papilloma of the anterior lingual salivary gland: case report and immunohistochemical study. Int J Oral Maxillofac Surg. 1993;22(2):116–7.PubMedCrossRefGoogle Scholar
  12. 12.
    Tomonao A, Kishino M, Masuda T, Isomura ET, Tanaka S, Namikawa M, Iida S. Intraductal papilloma arising from sublingual minor salivary gland: case report and immunohistochemical study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107:e34–7.PubMedGoogle Scholar
  13. 13.
    Suarez PA, Adler-Storthz K, Luna MA, El-Naggar AK, Abdul-Karim FW, Batsakis JG. Papillary squamous cell carcinomas of the upper aerodigestive tract: a clinicopathologic and molecular study. Head Neck. 2000;22(4):360–8.PubMedCrossRefGoogle Scholar
  14. 14.
    Russell JO, Hoschar AP, Scharpf J. Papillary squamous cell carcinoma of the head and neck: a clinicopathologic series. Am J Otolaryngol. 2011;32(6):557–63.PubMedCrossRefGoogle Scholar
  15. 15.
    Colby C, Klein AM. Papillary squamous cell carcinoma of the larynx. Ear Nose Throat J. 2011;90(8):E13–5.PubMedGoogle Scholar
  16. 16.
    Zoller M. CD44: can a cancer-initiating cell profit from an abundantly expressed molecule? Nature. 2011;11:254–67.Google Scholar
  17. 17.
    Ioachim HL, Medeiros LT, editors. Flow cytometry. In: Ioachim’s lymph node pathology. Philadelphia, PA: Lippincott Williams and Wilkins; 2009. p. 48–58.Google Scholar
  18. 18.
    Schniederjan SD, Li S, Saxe DF, Lechowicz MJ, Lee KL, Terry PD, Mann KP. A novel flow cytometric antibody panel for distinguishing Burkitt lymphoma from CD10+ diffuse large B-cell lymphoma. Am J Clin Pathol. 2010;133:718–26.PubMedCrossRefGoogle Scholar
  19. 19.
    McKenney JK, Desai S, Cohen C, Amin MB. Discriminatory immunohistochemical staining of urothelial carcinoma in situ and non-neoplastic urothelium: an analysis of cytokeratin 20, p53, and CD44 antigens. Am J Surg Pathol. 2001;25(8):1074–8.PubMedCrossRefGoogle Scholar
  20. 20.
    Esteban F, Bravo JJ, Gonzales-Moles MA, Bravo M, Ruiz-Avila I, Gil-Montoya JA. Adhesion molecule CD44 as a prognostic factor in laryngeal cancer. Anticancer Res. 2005;25:1115–22.PubMedGoogle Scholar
  21. 21.
    Gonzales-Moles MA, Bravo M, Ruiz-Avila I, Esteban F, Rodriguez-Archilla A, Gonzales-Moles S, Arias B. Adhesion molecule CD44 as a prognostic factor in tongue cancer. Anticancer Res. 2003;23(6D):5197–202.Google Scholar
  22. 22.
    Ahmed MA, Aleskandarany MA, Rakha EA, Moustafa RZ, Benhasouna A, Nolan C, Green AR, Ilyas M, Ellis IO. A CD44(−)/CD24(+) phenotype is poor prognostic marker in early invasive breast cancer. Breast Cancer Res Treat. 2011 Nov 27. Epub ahead of print.Google Scholar
  23. 23.
    Sillanpaa S, Anttila MA, Voutilainen K, Tammi RH, Tammi MI, Saarikoski SV, Kosma VM. CD44 expression indicates favorable prognosis in epithelial ovarian cancer. Clin Cancer Res. 2003;9(14):5318–24.PubMedGoogle Scholar
  24. 24.
    Aaltomaa S, Lipponen P, Ala-Opas M, Kosma V-M. Expression and prognostic value of CD44 standard and variant v3 and v6 isoforms in prostate cancer. Eur Urol. 2001;39:138–44.PubMedCrossRefGoogle Scholar
  25. 25.
    Stavropoulos NE, Filliadis I, Ioachim E, Michael M, Mermiga E, Hastazeris K, Nseyo UO. CD44 standard form expression as a predictor of progression in high risk superficial bladder tumors. Int Urol Nephrol. 2001;33(3):479–83.PubMedCrossRefGoogle Scholar
  26. 26.
    Sviatoha V, Tani E, Kleina R, Sperga M, Skoog L. Immunohistochemical analysis of the S100A1, S100B, CD44 and Bcl-2 antigens and the rate of cell proliferation assessed by Ki-67 antibody in benign and malignant melanocytic tumors. Melanoma Res. 2010;20(2):118–25.PubMedCrossRefGoogle Scholar
  27. 27.
    Montgomery E, Abraham SC, Fisher C, Robinette Deasel M, Amr SS, Sheikh SS, House M, Lilliemoe K, Choti M, Brock M, Ephron DT, Zahuruk M, Chadburn A. CD44 loss in gastric stromal tumors as a prognostic marker. Am J Surg Pathol. 2004;28:168–77.PubMedCrossRefGoogle Scholar
  28. 28.
    Coppola D, Clarke M, Landreneau R, Weyant RJ, Cooper D, Yousem SA. Bcl-2, p53, CD44, and CD44v6 isoform expression in neuroendocrine tumors of the lung. Mod Pathol. 1996;9(5):484–90.PubMedGoogle Scholar
  29. 29.
    Jalkanen S, Joensuu H, Soderstrom K-O, Klemi P. Lymphocyte homing and clinical behavior of non-Hodgkin’s lymphoma. J Clin Invest. 1991;87:1835–40.PubMedCrossRefGoogle Scholar
  30. 30.
    Eisterer W, Bechter O, Hilbe W, van Driel M, Lokhorst HM, Thaler J, Bloem AC, Gunthert U, Stauder R. CD44 isoforms are differentially regulated in plasma cell dyscrasias and CD44v9 represents a new independent prognostic parameter in multiple myeloma. Leuk Res. 2001;25(12):1051–7.PubMedCrossRefGoogle Scholar
  31. 31.
    Herold-Mende C, Seiter S, Born AI, Patzelt E, Schupp M, Zoller J, Bosch FX, Zoller M. Expression of CD44 splice variants in squamous epithelia and squamous cell carcinomas of the head and neck. J Pathol. 1996;179:66–73.PubMedCrossRefGoogle Scholar
  32. 32.
    Chrissman JD, Kessis T, Shah KV, Fu YS, Stoler MH, Zarbo RJ, Weiss MA. Squamous papillary neoplasia of the adult upper aerodigestive tract. Hum Pathol. 1988;19:1387–96.CrossRefGoogle Scholar
  33. 33.
    Thompson LDR, Wenig BM, Heffner DK, Gnepp DR. Exophytic and papillary squamous cell carcinomas of the larynx: a clinicopathologic series of 104 cases. Otolaryngol Head Neck Surg. 1999;120:718–24.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Sarah G. Fitzpatrick
    • 1
  • Lindsay J. Montague
    • 2
  • Donald M. Cohen
    • 2
  • Indraneel Bhattacharyya
    • 2
  1. 1.Department of Oral PathologyCase Western Reserve University School of Dental MedicineClevelandUSA
  2. 2.Division of Oral Pathology, Department of Oral and Maxillofacial Diagnostic Sciences, JHMHCUniversity of Florida College of DentistryGainesvilleUSA

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