ArticleScientific reports2025
CD44 and phosphorylated ERK1/2 coexpression predicts distant metastasis in colorectal cancer based on a study of 1137 Saudi patients.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Cluster of differentiation 44 (CD44) is a transmembrane glycoprotein implicated in tumor progression and metastasis, while phosphorylated ERK1/2 (p-ERK1/2) plays central role in MAPK pathway-driven oncogenic signaling. We investigated the expression and clinical relevance of CD44 in colorectal cancer (CRC) and explored its synergistic interaction with p-ERK1/2 in predicting metastatic risk. Immunohistochemistry (IHC) for CD44 and p-ERK1/2 was performed in tissue microarray from 1,137 primary CRC cases. Associations with clinicopathological parameters and survival outcomes were analyzed using Chi-square tests, Kaplan-Meier curves and logistic regression models. CD44 was over expressed in 47.7% (542/1,137) cases and was significantly associated with lymph node metastasis (p = 0.0042), stage III disease (p = 0.0045), high-grade tumors (p = 0.0111), deficient mismatch repair status (p = 0.0007), high Ki-67 (p = 0.0051) and p-ERK1/2 expressions (p = 0.0012). However, CD44 alone did not predict survival outcomes (overall survival and disease-free survival). Co-expression of CD44 and p-ERK1/2 was observed in 284 cases (25.3%) and was significantly associated with stage III/IV disease (p = 0.0022), lymph node involvement (p = 0.0117) and metachronous distant metastasis (p = 0.0404). Co-expression emerged as an independent predictor of distant metastasis in multivariate analysis (Odds ratio = 1.73; 95% confidence interval = 1.11-2.69; p = 0.0149). CD44 and p-ERK1/2 co-expression defines a high-risk subset of CRC patients with increased metastatic potential. These findings highlight a clinically relevant biomarker axis that may aid in prognostic stratification and future therapeutic targeting.
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