Abstract
INTRODUCTION: This study aimed to investigate the expression of cluster of differentiation 44 (CD44) in prostate adenocarcinoma (PAC) compared to benign prostatic hyperplasia (BPH) to address the need for biomarkers that can aid in grading classification and prognosis. METHODS: In this cross-sectional study, the CD44 expression in the tissue samples of the PAC and BPH was examined with hematoxylin and eosin and immunohistochemistry methods. The Gleason scores and grades and percentage of CD44 expression for specimens were determined. Data were analyzed using IBM SPSS version 23.0 software. RESULTS: This study included 80 PAC and 83 BPH samples. The mean expression of CD44 in PAC samples was significantly lower than in BPH samples (28.59 ± 14.84 vs. 47.82 ± 14.65, p < 0.001). A moderate to strong significant negative correlation was found between CD44 expression and total Gleason scores and Gleason grade groups (r: -0.743, p < 0.001; r: -0.732, p < 0.001, respectively). Ordinal logistic regression showed that lower CD44 expression was associated with higher odds of advanced disease (OR = 0.884, p < 0.001). CONCLUSION: This study highlights CD44 expression not only as a potential biomarker for PAC diagnosis but also potential guide to therapeutic decision-making. Patients exhibiting lower CD44 levels may require closer monitoring and more aggressive treatment strategies, while those with higher expression may be candidates for less intensive management. Overall, our findings advocate for further investigation into CD44 as a biomarker for prostate cancer aggressiveness, which could ultimately enhance personalized treatment approaches and improve the patient outcomes.