CD44 expression as a potential favorable marker for prognosis in mucoepidermoid carcinoma of salivary gland

Background: Cluster of differentiation 44 (CD44) is one of the markers of cancer stem cells belonging to the cell adhesion molecule family, which may play a role in tumorigenesis of mucoepidermoid carcinoma (MEC) of the salivary gland. The histological grade is one of the most important factors for prognosis. This study was aimed to investigate the association between CD44 expressions with histological grade in MEC of the salivary gland. Methods: In A cross-sectional study, 34 cases diagnosed with MEC in the Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia from 2012 to 2017 were included. Histological grade was classified into low-, moderate-, and high-grade. CD44 expression was done by immunohistochemistry staining and classified into weak and strong expressions. Results: Eighteen cases (52.9%) were high-grade, 3 cases (8.8%) were moderate, and 13 cases (38.2%) were low-grade. Perineural invasion was found in 7 cases (20.6%) and mostly in high-grade tumors. CD44 expression was significantly associated with histological grade (p = 0.002, OR=0.09, 95%CI=0.02-0.48). Strong CD44 expression was found more in low-grade MEC. Conclusions: This study suggests that strong CD44 expression may act as a potential favorable predictive factor for prognosis in the MEC of the salivary gland.