Abstract 3346: CD44 is an independent predictor of lymph node metastasis in differentiated thyroid cancer

Abstract Background: Differentiated Thyroid Carcinoma (DTC), a common endocrine malignancy, has witnessed a significant rise in global incidence over the past few decades. Despite its indolent nature and favorable prognosis, the clinical course of DTC varies extensively, with lymph node metastasis being an important risk factor in prognosis. CD44 has been shown to be associated with prognosis in various cancers. However, its role in DTC is not well explored. Methods: A total of 1703 DTC cases of Middle Eastern ethnicity were included in the study. CD44 expression was evaluated by immunohistochemistry using tissue microarray to analyze the clinico-pathological associations. Univariate and multivariate logistic regression analysis was used to determine the predictors of lymph node metastasis. Results: CD44 over-expression was noted in 69.7% (1187/1703) of DTC cases and was significantly associated with younger age (< 55 years; p < 0.0001), multifocality (p < 0.0001), lymphovascular invasion (p = 0.0007) and lymph node metastasis (p < 0.0001). Interestingly, on multivariate logistic regression analysis, CD44 was found to be an independent predictor of lymph node metastasis (Hazard ratio = 1.79; 95% confidence interval = 1.40 - 2.30; p < 0.0001). Conclusion: Our study showed that CD44 expression was an independent predictive biomarker of lymph node metastasis in Middle Eastern patients with DTC. Detection of CD44 expression could help identify patients at risk for developing lymph node metastasis and help in individualization of clinical management for DTC patients. Citation Format: Syed Zeeshan Qadri, Abdul K. Siraj, Sandeep K. Parvathareddy, Nabil Siraj, Padmanaban Annaiyappanaidu, Khawla S. Al-Kuraya. CD44 is an independent predictor of lymph node metastasis in differentiated thyroid cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 3346.