Prognostic impact of CD44-positive cancer stem-like cells at the invasive front of gastric cancer.
Prognostic impact of CD44-positive cancer stem-like cells at the invasive front of gastric cancer.
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CD44 阳性癌症干细胞样细胞在胃癌侵袭性前沿的预后影响。
DOI：
10.1038/bjc.2016.401
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发表时间：
2017-01-17
影响因子：
8.8
通讯作者：
Tani M
中科院分区：
文献类型：
--
作者：
Kodama H;Murata S;Ishida M;Yamamoto H;Yamaguchi T;Kaida S;Miyake T;Takebayashi K;Kushima R;Tani M
侵袭性肿瘤前缘可提供预后信息。我们研究了胃癌（GC）侵袭性肿瘤前部肿瘤干细胞（CSCs）的存在与预后之间的关系。CD44是一种CSC标志物；因此，我们检测了123例切除的原发GCs中CD44标准（CD44s）、CD44变异-6 （CD44v6）和CD44变异-9 （CD44v9）的表达，并分析了侵袭性肿瘤前沿CSCs的临床意义。13例（10.6%）、79例（64.2%）和47例（38.2%）GCs为CD44s-、CD44v6-和cd44v9阳性。侵袭性肿瘤前缘cd44阳性表达患者的疾病特异性生存率明显低于阴性表达患者（CD44s: P<0.00001, CD44v6: P=0.013, CD44v9: P=0.0002）。侵袭性肿瘤前部的CD44s表达是可切除胃癌患者的独立预后因素（风险比=3.13；95%可信区间为1.09-9.01；P=0.035），与腹膜（P<0.001）、淋巴（P<0.001）和血液源性复发（P=0.008）显著相关。此外，浸润性肿瘤前端癌细胞中表达的CD44亚型的数量与患者预后相关。没有常规的临床病理因素与侵袭性肿瘤前部的CD44表达独立相关。侵袭性肿瘤前部的cd44阳性肿瘤干细胞表明生存率较差，可能是GC的独特生物学预后因素。
The invasive tumour front may provide prognostic information. We examined the relationship between the presence of cancer stem cells (CSCs) at the invasive tumour front and prognosis in gastric cancer (GC). CD44 is a CSC marker; accordingly, CD44 standard (CD44s), CD44 variant-6 (CD44v6), and CD44 variant-9 (CD44v9) expression were examined in 123 resected primary GCs and the clinical significance of CSCs at the invasive tumour front was analysed. Thirteen (10.6%), 79 (64.2%), and 47 (38.2%) GCs were CD44s-, CD44v6-, and CD44v9-positive, respectively. Patients with CD44-positive expression at the invasive tumour front had significantly poorer disease-specific survival than those with negative expression (CD44s: P<0.00001, CD44v6: P=0.013, CD44v9: P=0.0002). CD44s expression at the invasive tumour front was an independent prognostic factor in resectable GC patients (hazard ratio=3.13; 95% confidence interval, 1.09–9.01; P=0.035) and was significantly associated with peritoneal (P<0.001), lymphatic (P<0.001), and haematogenous recurrences (P=0.008). In addition, the number of CD44 isoforms expressed in cancer cells at the invasive tumour front was associated with patient prognosis. No conventional clinicopathological factors were independently associated with CD44 expression at the invasive tumour front. CD44-positive cancer stem-like cells at the invasive tumour front indicate poor survival and can be a unique biological prognostic factor for GC.