CD24 and tumor budding as a prognostic variable in carcinoma gall bladder: A pilot study.

BACKGROUND

CD24 is a small heavily glycosylated glycosylphosphotidylinositol-linked cell surface protein that is expressed in a variety of hematological and solid tumors. It is majorly involved in tumor development, proliferation, invasion, metastasis, and prevention of tumor cell death via various major and minor signalling pathways although it can also inhibit invasiveness via degrading BART mRNA.

AIM AND

OBJECTIVE

We aimed to evaluate CD24 expression in gall bladder carcinoma (GBC), via immunohistochemical (IHC) staining on paraffin-embedded histological tissue along with assessment of tumor budding.

MATERIAL AND

METHODS

87 patients were enrolled and CD24 IHC staining was evaluated using four degrees of positivity (negative, mild, moderate, and strong). The expression was then correlated with various clinicopathological parameters. Interpretation was tumor budding was done on the H and E slide. Hotspots were chosen and the total number of buds was reported in an area measuring 0.785 mm2 corresponding to 20× fields in the microscope.

RESULTS

CD24 positive expression was found in 77.5% of cases. Its positive expression correlated inversely with tumor stage, necrosis, and lymph vascular invasion establishing its usefulness as a prognostic marker. Tumor budding correlated with poor tumor differentiation and higher tumor grade and poorly differentiated cancer with higher budding responded well to chemotherapy.

CONCLUSION

Our study supports the importance of CD24 and tumor budding as prognostic markers and thus its usefulness in risk stratification in GBC. CD 24 positive subgroup of GBC cases may benefit from anti-CD24 mAb therapy and we also recommend that tumor budding may be included in the morphological synoptic reporting in gall bladder cancer.