Correlation between CD44 and Human Epidermal Growth Factor Receptor 2 Expression with Distant Metastasis on Women Non-Luminal Breast Cancer

Abstract

Background:  HER2 shows a link in the regulation of CD44+/CD24 expression. CD44 overexpression is associated with cancer cell progression and metastasis. The study aims to evaluate whether to determine the relationship between CD44 and HER2 expression and distant metastasis in breast cancer.

Methods: This study was cross-sectional with breast cancer patients. We performed clinicopathology data collection, which involved age and grading. Then, we performed immunohistochemistry panel examination of ER, PR, Her2, and Ki-67. Immunohistochemical examination to assess CD44 and HER2 expression used Mouse anti-CD44 monoclonal antibody and Rabbit Anti-Human c-erbB-2 oncoprotein monoclonal antibody. Staining intensity and percentage of positive nuclei were recorded after manually segmenting the tumor from the stroma.

Results: There were 60 subjects in this study. CD44 overexpression was positively associated with HER2 overexpression (p=0.011). The results of the odds ratio calculation show that subjects with the HER2 subtype are 4.6 times more likely to experience CD44 overexpression than those with the triple-negative subtype. Overexpression of CD44 was positively associated with the occurrence of distant metastases in breast cancer (p=0.007). The results of the odds ratio calculation show that subjects with CD44 overexpression are six times more likely to experience distant metastases than subjects with low CD44 expression. Statistically, there was no significant difference between CD44 expression and HER2 expression on the incidence of distant metastasis in breast cancer.

Conclusion: These results suggest that CD44 overexpression is associated with the occurrence of distant metastases in breast cancer.