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乳腺癌组织CD44+CD24-/LowESA+Lin-干细胞比例及影响因素分析

Study on the Correlation Factors on CD44+CD24-/LowESA+Lin- Cell Ratio in Breast Cancer

  • 摘要: 目的 研究乳腺浸润性导管癌组织CD44+CD24-/LowESA+Lin-乳腺癌干细胞比例及其相关影响因素。方法 收集四川大学华西医院甲状腺乳腺外科2011年4月至2011年12月经病理诊断为浸润性导管癌的新鲜标本40例进行流式细胞学检测,分析患者年龄、肿瘤大小、临床分期、组织学分级、腋窝Ⅰ-Ⅱ水平淋巴结转移状况、免疫组化指标 〔雌激素受体(ER)、孕激素受体(PR)、上皮因子生长受体-2(C-erbB-2)、Ki-67〕等与CD44+CD24-/LowESA+Lin-乳腺癌干细胞比例的关系。结果 在乳腺浸润性导管癌组织中,CD44+CD24-/LowESA+Lin-乳腺癌干细胞全部为阳性表达 (干细胞比例0.5%~16.8%),平均值为4.38%,其中,低表达 (≤4.38%)20例,高表达 (>4.38%)20例。单因素分析显示CD44+CD24-/LowESA+Lin-细胞比例与患者的年龄、肿瘤大小、临床分期、组织学分级、腋窝淋巴结转移状态、ER、PR以及C-erbB-2均无相关性。而以32.0%为界,把Ki-67分为高表达组 (>32.0%)和低表达组 (≤32.0%),两组间干细胞比例差异有统计学意义 (P=0.008)。多因素logistic回归发现,Ki-67表达强度是CD44+CD24-/LowESA+Lin- 表达比例的独立影响因素 (P=0.012,OR=6.926, 95%可信区间1.529~31.377)。结论 乳腺癌组织中,Ki-67表达强度是CD44+CD24-/LowESA+Lin- 表达比例的独立影响因素。但干细胞比例与临床疗效和预后的关系仍需进一步研究。

     

    Abstract: Objective?To explore the related factors on CD44+CD24-/LowESA+Lin- cell (breast caner stem cell) ratio in breast cancer patients. Methods?Flow cytometry was used to analyze CD44+CD24-/LowESA+Lin- cell ratio in fresh tumor tissues of 40 breast cancer patients administered between March of 2011 and January of 2012 in West China Hospital, Sichuan University, China. Nine individual variables, such as age, clinical stage, histological grade, axillary lymph nodes metastases, immunohistochemisty (IHC) of estrogen receptor (ER), progesterone receptor (PR), C-erbB-2, and Ki-67 were selected to study their correlation with CD44+CD24-/LowESA+Lin- cell ratio. Results?CD44+CD24-/LowESA+Lin- cells were expressed in all breast cancer tissues (median ratio: 4.38%, ranging from 0.5% to 16.8%), in which 20 patients (50.0%) showed low expression less than or equal to 4.38%, whereas, 20 patients (50.0%) demonstrated high expression greater than 4.38%. By univariant analysis, no statistical correlation was observed between CD44+CD24-/LowESA+Lin- cell ratio and the factors like age, tumor size, clinical stage, histological stage, axillary nodes metastasis metastasic, ER, PR. However, when Ki-67 was divided into high expression group (>32.0%) and low expression group (≤32.0%), statistical difference in CD44+CD24-/LowESA+Lin- cell ratio between the two groups was observed (P=0.008). By multivariate logistic analysis, only Ki-67 expression was the independent factor of breast cancer stem cell expression (P=0.012, OR=6.926, (95%CI,1.529-31.377). Conclusion?In fresh breast cancer tissues, Ki-67 expression was the independent impact factor on CD44+CD24-/LowESA+Lin- cell ratio. Further investigation should be made to explore the correlation of breast cancer stem cell ratio with therapeutic effect and prognosis.

     

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