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Doctors use information about each case of mesothelioma to help guide the treatment of each patient. Most commonly, doctors look at how far the mesothelioma has spread which is measured in the tumor-node-metastasis (TNM) stage and the type of tumor cell --epithelioid, biphasic, and sarcomatoid. However, even the same type of mesothelioma—epithelioid— can vary in its rate of growth or aggressiveness. Thus, other factors in mesothelioma must affect its aggressiveness.
Oncology surgeons and pathologists from Memorial Sloan Kettering Cancer Center in New York recently have found that an enzyme called CD10 can help uncover the aggressiveness of a specific mesothelioma, and, as a result, doctors can better predict mesothelioma's prognosis. CD10 is a neutral enzyme and can chew through the scaffold holding cells in place in the body.
Higher expression of CD10 in breast cancer, colon cancer (colorectal carcinoma),1 and prostate cancer2 correlates with the more aggressive type of tumors and a shorter survival. For example, high CD10 expression in the tumors is found more often in patients with metastatic disease—like patients with colon cancer in which some colon cancer cells migrated and seeded the liver.1 In contrast, high CD10 expression in bladder cancer predicted a more favorable outcome than those patients with CD10 negative bladder tumors.3 Thus, CD10 expression can affect distinct tissues in a different manner.3
No matter the type of mesothelioma, Kabota et al reported that mesotheliomas with high CD10 expression were more aggressive than those that didn’t express CD10.4 Their study was fairly rigorous: they examined 176 distinct mesotheliomas. The distinct types of mesothelioma varied in their number of CD10 positive tumors:
- 42% of nonpleomorphic epithelioid mesotheliomas had high CD10 expression;
- 57% of pleomorphic epithelioid mesotheliomas;
- 79% of biphasic mesotheliomas; and
- 93% of sarcomatoid mesotheliomas had high CD10 expression.
Patients with positive CD10 expression in their mesothelioma had significantly shorter survival length than patients with mesotheliomas with little or no CD10 expression.4
What could CD10 expression mean?
The exact meaning of CD10 expression in mesothelioma is unclear.
However, CD10 expression is higher in chemotherapy resistant head and neck cancer cells than in related chemotherapy sensitive tumor cells.5 Fukusumi et al provided evidence that CD10 expression was a marker of cancer stem cells. As discussed in an earlier post, cancer stem cells are the main drivers of tumors: they can grow continuously and make more tumor cells.
CD10 expression seems to be important not only for the growth of cancer stem cells but also for regulating the growth of stem cells for healthy tissues as well.6
Fujimoto Y, Nakanishi Y, Sekine S et al. CD10 expression in colorectal carcinoma correlates with liver metastasis. Dis Colon Rectum 2005;48(10):1883-1889.
Fleischmann A, Rocha C, Saxer-Sekulic N, Zlobec I, Sauter G, Thalmann GN. High CD10 expression in lymph node metastases from surgically treated prostate cancer independently predicts early death. Virchows Arch 2011;458(6):741-748.
Seiler R, von Gunten M, Thalmann GN, Fleischmann A. High CD10 expression predicts favorable outcome in surgically treated lymph node-positive bladder cancer patients. Hum Pathol 2012;43(2):269-275.
Kadota K, Villena-Vargas J, Nitadori JI et al. Tumoral CD10 Expression Correlates with Aggressive Histology and Prognosis in Patients with Malignant Pleural Mesothelioma. Ann Surg Oncol 2015.
Fukusumi T, Ishii H, Konno M et al. CD10 as a novel marker of therapeutic resistance and cancer stem cells in head and neck squamous cell carcinoma. Br J Cancer 2014;111(3):506-514.
Maguer-Satta V, Besancon R, Bachelard-Cascales E. Concise review: neutral endopeptidase (CD10): a multifaceted environment actor in stem cells, physiological mechanisms, and cancer. Stem Cells 2011;29(3):389-396.