Predictive value of CD24 and CD44 for neoadjuvant chemotherapy response and prognosis in primary breast cancer patients

Purpose: We investigated the significance of CD24and CD44 expression for predicting responses tochemotherapy and prognosis in primary breastcancer patients.Patients and Methods: Diagnosis of breast cancerwas confirmed by core needle biopsy, andimmunohistochemical studies were performed.Preoperatively, patients received anthracyclinecontainingchemotherapy. Expression of CD44 andCD24 was assessed immunohistochemically andthe relationship with chemotherapy response andwith prognosis was analyzed.Results : Between 2001 and 2004, 139 womenwere enrolled in this study. In the correlationanalysis, CD24 expression was negativelyassociated with pathological response tochemotherapy (p=0.0003). A machine learningtechnique with an alternating decision tree(ADTree) showed that four logical rules areinvolved in predicting the response depending onthe combination of CD24, HER2, tumor stage,CD44, progesterone receptor, and patient age. Inthe survival analysis, patients having CD44 (++)showed a significantly favorable prognosis ascompared with others (p=0.0002). A multivariateanalysis showed that CD44 expression had anindependent prognostic value (p