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Association of CD44 Gene Polymorphism with Survival of NSCLC and Risk of Bone Metastasis

Yaosheng Liu, Haifeng Qing, Xiuyun Su, Cheng Wang, Zhou Li, Shubin Liu

Department of Orthopedics, The PLA 307th Hospital, Beijing, China (mainland)

Med Sci Monit 2015; 21:2694-2700

DOI: 10.12659/MSM.894357

Available online:

Published: 2015-09-10

BACKGROUND: Previous studies have reported CD44 expression played an important role in the development and progression of tumor. The aim of study was to investigate whether single nucleotide polymorphisms (SNPs) of CD44 gene were associated with risk of non-small cell lung cancer (NSCLC), survival and occurrence rate of bone metastasis in patients with NSCLC.
MATERIAL AND METHODS: A total of 234 patients with NSCLC between 2003 and 2010 were enrolled in this study and 468 healthy persons were used as controls. Two polymorphisms, rs13347 and rs187115, in the CD44 gene were genotyped using DNA from blood lymphocytes. For statistical analysis we used the chi-square test, Fisher’s exact test, Kaplan-Meier method, and log-rank test.
RESULTS: CD44 gene rs13347 polymorphism was not associated with NSCLC risk. For rs187115, the association with NSCLC risk was observed (P<0.001). Allele G carriers had significantly higher occurrence rates of bone metastasis (OR=0.4, 95%CI: 0.20–0.64, P<0.001) and more advanced tumor stage (OR=2.6, 95%CI: 1.50–4.45, P=0.001) compared to carriers of allele A. The survival rates for patients with AA genotype were significantly higher than for patients with the AG+GG genotypes (P<0.001). In multivariate analysis of survival in NSCLC patients, significant predictors were CD44 gene (AG+GG) (RR=0.48, 95%CI: 0.34–0.68, P<0.001), tumor stage (RR=0.45, 95%CI: 0. 0.31–0.65, P<0.001), and bone metastasis (RR=1.52, 95%CI: 1.05–2.21, P=0.027).
CONCLUSIONS: CD44 gene rs187115 polymorphism is a potential predictive marker of survival in NSCLC patients, and is significantly correlated with bone metastasis and tumor stage.

Keywords: Antigens, CD44 - genetics, Alleles, Bone Neoplasms - secondary, Carcinoma, Non-Small-Cell Lung - pathology, Genotype, Kaplan-Meier Estimate, Lung Neoplasms - pathology, Lymphocytes - cytology, Neoplasm Metastasis, Polymorphism, Single Nucleotide, Prognosis