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However, the contribution of ovarian\n                    <jats:styled-content style=\"fixed-case\">CSC<\/jats:styled-content>\n                    s to peritoneal metastasis remains unresolved. The cell adhesion molecule\n                    <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>\n                    44 has been identified as a major marker for\n                    <jats:styled-content style=\"fixed-case\">CSC<\/jats:styled-content>\n                    s in solid tumors, including epithelial ovarian cancer.\n                    <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>\n                    44 exists as a standard form (\n                    <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>\n                    44s) and also as numerous variant isoforms (\n                    <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>\n                    44v) generated by alternative\n                    <jats:styled-content style=\"fixed-case\">mRNA<\/jats:styled-content>\n                    splicing. Here we show that disseminated ovarian tumors in the pelvic peritoneum contain highly enriched\n                    <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>\n                    44v6\u2010positive cancer cells, which drive tumor metastasis and are responsible for tumor resistance to chemotherapy. Clinically, an increased number of\n                    <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>\n                    44v6\u2010positive cancer cells in primary tumors was associated with a shortened overall survival in stage\n                    <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content>\n                    \u2013\n                    <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content>\n                    ovarian cancer patients. Furthermore, a subpopulation of\n                    <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>\n                    44v6\u2010positive cancer cells manifested the ability to initiate tumor metastasis in the pelvic peritoneum in an\n                    <jats:italic>in vivo<\/jats:italic>\n                    mouse model, suggesting that\n                    <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>\n                    44v6\u2010positive cells show the potential to serve as metastasis\u2010initiating cells. Thus, the peritoneal disseminated metastasis of epithelial ovarian cancer is initiated by the\n                    <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>\n                    44v6\u2010positive subpopulation, and\n                    <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>\n                    44v6 expression is a biomarker for the clinical outcome of advanced ovarian cancer patients. Given that a distinct subpopulation of\n                    <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>\n                    44v6\u2010positive cancer cells plays a critical role in peritoneal metastasis, definitive treatment should target this subpopulation of\n                    <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>\n                    44v6\u2010positive cells in epithelial ovarian cancer.\n                  <\/jats:p>","DOI":"10.1111\/cas.12765","type":"journal-article","created":{"date-parts":[[2015,8,6]],"date-time":"2015-08-06T10:37:24Z","timestamp":1438857444000},"page":"1421-1428","source":"Crossref","is-referenced-by-count":73,"title":["<scp>CD<\/scp>\n                    44 variant 6 is correlated with peritoneal dissemination and poor prognosis in patients with advanced epithelial ovarian cancer"],"prefix":"10.1111","volume":"106","author":[{"given":"Francisca","family":"Tjhay","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Faculty of Life Sciences Kumamoto University Kumamoto City Kumamoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Motohara","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Faculty of Life Sciences Kumamoto University Kumamoto City Kumamoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shingo","family":"Tayama","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Faculty of Life Sciences Kumamoto University Kumamoto City Kumamoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dashdemberel","family":"Narantuya","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Faculty of Life Sciences Kumamoto University Kumamoto 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