CD44 and EPCAM expression in pleomorphic adenoma and mucoepidermoid carcinoma: An immunohistochemical method

Abstract

Background: Recent studies have indicated that assessing the expression levels of cancer stem cell markers is critical in predicting the behavior of these neoplasms. This study aimed to evaluate and compare the expression levels of CD44 and epithelial cell adhesion molecule (EpCAM) markers in pleomorphic adenoma (PA) and mucoepidermoid carcinoma (MEC) using immunohistochemistry. Materials and Methods: In this cross-sectional descriptive-analytical study, 20 samples each of PA and MEC were selected from Kashani Hospital, Isfahan, Iran, based on inclusion and exclusion criteria. Specimens were prepared using immunohistochemical methods and analyzed under an optical microscope. Pathologists evaluated microscopic grade, staining intensity and percentage, and the staining intensity distribution (SID) index. Statistical analysis was conducted with SPSS (version 26), employing the Kolmogorov–Smirnov test, t-test, Chi-square, and Fisher’s exact test. Results: The mean frequency of stained cells for both CD44 (P = 0.39) and EpCAM (P = 0.40) markers showed no statistically significant differences between the PA and MEC groups. Similarly, the mean intensity of staining did not differ significantly for either CD44 (P = 0.40) or EpCAM (P = 0.18). The average SID index for the EpCAM marker in the MEC group was significantly higher than the PA group (P = 0.03) and for the EpCAM marker, there was a significant difference between the average SID index and all three variables of microscopic grade (P = 0.01), clinical stage (P = 0.00), and 3-year prognosis (P = 0.02). Conclusion: The use of EpCAM immunohistochemical marker may help to predict the behavior of salivary gland tumors and obtain better treatment measures for patients.

Keywords

• cd44
• epithelial cell adhesion molecule
• immunohistochemical
• mucoepidermoid carcinoma
• pleomorphic adenoma