Frequency of cells expressing CD44, a head and neck cancer stem cell marker: correlation with tumor aggressiveness

Head Neck. 2012 Jan;34(1):42-9. doi: 10.1002/hed.21699. Epub 2011 Feb 14.


Background: We previously identified by flow cytometry a Lineage-CD44+ (Lin-CD44+) subpopulation of cells with cancer stem cell properties in head and neck squamous cell carcinoma (HNSCC). We now correlate clinical and histologic factors with Lin-CD44+ cell frequency.

Methods: The study included 31 patients with HNSCC, of whom 87% had stage IV disease. The frequency of Lin-CD44+ cells and the success of xenografting patient tumors in mice were correlated with clinical and pathologic data.

Results: The mean frequency of Lin-CD44+ cells was 25% (0.4%-81%). It was 36% in patients who had recurrence versus 15% for those without recurrence (p = .04). Successful xenograft implantation occurred in 53%. Seventy-five percent of patients with successful xenografts had recurrence versus 21% of patients with unsuccessful xenografts (p = .003).

Conclusions: Successful xenograft implantation and a high frequency of Lin-CD44+ cells correlate with known poor prognostic factors such as advanced T classification and recurrence. These findings may support the stem cell concept in HNSCC.

MeSH terms

  • Adult
  • Animals
  • Biomarkers
  • Biomarkers, Tumor / analysis*
  • Carcinoma, Squamous Cell / pathology*
  • Follow-Up Studies
  • Head and Neck Neoplasms / pathology*
  • Humans
  • Hyaluronan Receptors / analysis*
  • Mice
  • Middle Aged
  • Neoplasm Staging
  • Neoplastic Stem Cells / pathology*
  • Transplantation, Heterologous


  • Biomarkers
  • Biomarkers, Tumor
  • CD44 protein, human
  • Hyaluronan Receptors