Tumoral CD10 expression correlates with aggressive histology and prognosis in patients with malignant pleural mesothelioma

Our plain-English summary of Tumoral CD10 expression correlates with aggressive histology and prognosis in patients with malignant pleural mesothelioma, by K. Kadota, J. Villena-Vargas, J. Nitadori, et al (Annals of Surgical Oncology, 2015).

The study

• Authors: K. Kadota, J. Villena-Vargas, J. Nitadori, C.S. Sima, D.R. Jones, W.D. Travis, P.S. Adusumilli
• Journal: Annals of Surgical Oncology
• Published: 2015;22(9):3136-43
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Currently, tumor-node-metastasis stage and histologic type are the established prognostic factors for malignant pleural mesothelioma, whereas no prognostic markers have been established for clinical practice. We investigated the prognostic value of CD10, a metalloproteinase that can promote cancer aggressiveness through enzymatic degradation and intracellular signaling crosstalk, in malignant pleural mesothelioma.

Methods: CD10 immunostaining was performed for 176 cases of malignant pleural mesothelioma (epithelioid, 148; biphasic, 14; sarcomatoid, 14), and its expression was dichotomized as negative (no staining) or positive (any staining). Epithelioid tumors were classified as pleomorphic subtype when cytologic pleomorphism was ≥10 % of the tumor. Overall survival (OS) was analyzed by log-rank tests and Cox proportional hazard models.

Results: Tumoral CD10 expression was identified in 42 % of epithelioid non-pleomorphic tumors, 57 % of epithelioid pleomorphic tumors, 79 % of biphasic tumors, and 93 % of sarcomatoid tumors (p < 0.001). Positive CD10 expression was correlated with higher mitotic count (p = 0.002). Overall survival for patients with positive CD10 expression was significantly shorter than that for patients with negative CD10 expression in all patients (p = 0.001) and in patients with epithelioid tumor (p = 0.04). On multivariate analysis, CD10 expression was an independent prognostic factor for all patients (hazard ratio 1.48; p = 0.019).

Conclusions: Tumoral CD10 expression correlated with aggressive histologic types and higher mitotic activity and is an independent prognostic factor for patients with malignant pleural mesothelioma.

In plain English

This retrospective study from Memorial Sloan Kettering Cancer Center examined whether a tumor protein called CD10 was linked to tumor type and survival in malignant pleural mesothelioma. Asbestos exposure was not studied. Tumor samples from 176 patients diagnosed between 1989 and 2009 (148 epithelioid, 14 biphasic, 14 sarcomatoid) were stained for CD10. CD10 was present in 42% of epithelioid non-pleomorphic, 57% of epithelioid pleomorphic, 79% of biphasic and 93% of sarcomatoid tumors. CD10-positive tumors had more dividing cells. Among all patients, median survival after surgery was 9.8 months for the 90 with CD10-positive tumors and 16.9 months for the 86 with CD10-negative tumors. After adjustment for stage and other factors, CD10 positivity was linked to a higher risk of death (hazard ratio 1.48, 95% confidence interval 1.07 to 2.04). For epithelioid tumors alone, the adjusted result (hazard ratio 1.41) was not statistically significant (p = 0.052). The authors concluded that CD10 is an independent predictor of survival. They noted that the cohort was mixed in stage and that small tissue samples might have missed some CD10-positive tumors.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Retrospective single-institution study of stored tumor tissue, using CD10 staining on tissue microarrays and survival analysis
• Who was studied: 176 patients with malignant pleural mesothelioma diagnosed at Memorial Sloan Kettering Cancer Center, New York, between 1989 and 2009, with tumor tissue adequate for testing: 148 epithelioid, 14 biphasic and 14 sarcomatoid
• Exposure: Asbestos exposure was not examined. The factor studied was expression of the protein CD10 in tumor tissue, scored as negative (no staining) or positive (any staining).
• Main results:
  • CD10 was positive in 42% (53/125) of epithelioid non-pleomorphic tumors, 57% (13/23) of epithelioid pleomorphic tumors, 79% (11/14) of biphasic tumors and 93% (13/14) of sarcomatoid tumors
  • Mitotic counts (mitoses per 10 high-power fields) were higher in CD10-positive tumors than in CD10-negative tumors: median 6 (range 0 to 42) vs 3 (range 0 to 64), p = 0.002
  • All 176 patients: median overall survival was 9.8 months for those with CD10-positive tumors (n = 90) vs 16.9 months for those with CD10-negative tumors (n = 86), p = 0.001
  • All 176 patients, multivariate analysis adjusting for stage, lymphatic invasion, vascular invasion and histologic type: CD10-positive vs negative hazard ratio 1.48 (95% CI 1.07 to 2.04), p = 0.019
  • Epithelioid patients (148): CD10 was positive in 45% (66/148). Median overall survival was 14.5 months for CD10-positive (n = 66) vs 17.4 months for CD10-negative (n = 82), p = 0.04
  • Epithelioid patients, multivariate analysis: CD10-positive vs negative hazard ratio 1.41 (95% CI 0.99 to 2.00), p = 0.052, which the authors described as a trend rather than a statistically significant result
  • Early-stage (stage I to II) epithelioid patients (46): median overall survival was 16.3 months with CD10-positive tumors (n = 21) vs 36.4 months with CD10-negative tumors (n = 25), p = 0.008
  • CD10 in the tumor-related stroma (23% of cases) and CD10-positive granulocytes were not associated with clinical or pathological factors, including overall survival
• The authors' conclusion: The authors concluded that in malignant pleural mesothelioma, CD10 expression correlates with aggressive histologic types and high mitotic activity and is an independent predictor of patient survival
• Limitations the authors state:
  • The cohort was heterogeneous in terms of TNM stage
  • Because small tissue microarray cores were used, some tumors scored CD10-negative might have been focally positive if whole tissue blocks had been stained
  • The early-stage survival result came from a small number of patients

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Histology, Prognosis, Pleural Mesothelioma, Metastasis, Epithelioid, Biphasic Mesothelioma, Sarcomatoid, Pleomorphic.

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