J Pathol Transl Med.  2016 Nov;50(6):459-468. 10.4132/jptm.2016.10.02.

CD9 Expression in Colorectal Carcinomas and Its Prognostic Significance

• Kim KJ
• Kwon HJ
• Kim MC
• Bae YK

• KMID: 2361994
• DOI: http://doi.org/10.4132/jptm.2016.10.02

Abstract

BACKGROUND
CD9, a member of the tetraspanin superfamily, is a tumor suppressor in many malignancies. The aim of this study was to evaluate the immunohistochemical expression of CD9 in colorectal carcinomas (CRCs) and determine clinicopathological and prognostic significance of its expression.
METHODS
The CD9 expression status of 305 CRCs was evaluated using a semi-quantitative scoring system in tumor cells (T-CD9) and immune cells (I-CD9) by classifying the results as high and low expression.
RESULTS
High T-CD9 (T-CD9 [+]) expression was detected in 175 samples (57.6%) and high I-CD9 (I-CD9 [+]) expression was detected in 265 samples (86.9%). Using Kaplan-Meier survival analysis, the T-CD9 (+) group showed a tendency for better disease-free survival (DFS) (p = .057). In left-sided tumors, DFS was significantly longer in the T-CD9 (+) group (p = .021) but no statistical significance was observed with right-sided tumors (p = .453). I-CD9 (+) CRCs significantly correlated with well/moderately differentiation (p = .014). In Kaplan-Meier analysis, the I-CD9 (+) group had a tendency towards worse DFS compared to the I-CD9 (-) group (p = .156). In combined survival analysis of T-CD9 and I-CD9, we found that the longest DFS was among patients in the T-CD9 (+)/I-CD9 (-) group, whereas the T-CD9 (-)/I-CD9 (+) group showed the shortest DFS (p = .054).
CONCLUSIONS
High expression of T-CD9 was associated with a favorable DFS, especially in left-sided CRCs. Combined evaluation of T-CD9 and I-CD9 is required to determine the comprehensive prognostic effect of CD9 in CRCs.

Keyword

Colorectal neoplasms; CD9 antigens; Tetraspanin; Prognosis

MeSH Terms

Antigens, CD9
Colorectal Neoplasms*
Disease-Free Survival
Humans
Kaplan-Meier Estimate
Prognosis
Antigens, CD9

Figure

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  Fig. 1. Immunohistochemical expression of CD9 in non-neoplastic colorectal mucosa (A) and tumor cells exhibiting intensity score 0 (B), intensity score 1 (C), and intensity score 3 (D).

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  Fig. 2. Immunohistochemical expression of CD9 in immune cells in colorectal carcinomas. Representative case exhibiting score 0 (A), score 1 (B), score 2 (C), and score 3 (D).

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  Fig. 3. Kaplan-Meier survival analysis with log-rank test of CD9 expression. (A) Survival curves of the T-CD9 (−) versus T-CD9 (+) in all cases. (B) Survival curves of the T-CD9 (−) versus T-CD9 (+) in left-sided tumors. (C) Survival curves of the T-CD9 (−) versus T-CD9 (+) in right-sided tumors. (D) Survival curves of the I-CD9 (−) versus I-CD9 (+) in all cases. (E) Survival curves of the I-CD9 (−) versus I-CD9 (+) in left-sided tumors. (F) Survival curves of the I-CD9 (−) versus I-CD9 (+) in right-sided tumors. T-CD9, CD9 expression in tumor cells; I-CD9, CD9 expression in immune cells.

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  Fig. 4. Kaplan-Meier survival analysis with log-rank test of combined T-CD9 and I-CD9 expression. (A) Survival curves of the I versus II versus III in all cases. (B) Survival curves of the I versus II versus III in left-sided tumors. (C) Survival curves of the I versus II versus III in right-sided tumors. “I”, T-CD9 (−)/I-CD9 (+); “II”, T-CD9 (+)/I-CD9 (+) and T-CD9 (−)/I-CD9 (−); “III”, T-CD9 (+)/I-CD9 (−). T-CD9, CD9 expression in tumor cells; I-CD9, CD9 expression in immune cells.

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