Impact of CD133 positive stem cell proportion on survival in patients with glioblastoma multiforme
Impact of CD133 positive stem cell proportion on survival in patients with glioblastoma multiforme
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DOI：
10.2478/raon-2013-0055
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发表时间：
2013-12-01
影响因子：
2.4
通讯作者：
Jaal, Jana
中科院分区：
文献类型：
--
作者：
Kase, Marju;Minajeva, Ave;Jaal, Jana
背景。该研究的目的是评估CD133阳性（CD133+）癌症干细胞比例对多形性胶质母细胞瘤（GBM）患者治疗结果的影响。患者和方法。42例GBM患者术后接受放疗（+/-化疗）。手术切除的GBM组织切片免疫组织化学检测CD133表达。测定CD133+ GBM细胞比例（%）。CD133+ GBM干细胞比例由2名独立研究者确定，结果吻合较好（R = 0.8, p < 0.01）。此外，CD133表达水平与患者总生存率相关。CD133+细胞的比例因患者而异，从0.5%到82%不等。整个研究组CD133+细胞的平均和中位比例分别为33% +/- 24%（平均+/- SD）和28%。临床数据不支持干细胞比例较高与GBM侵袭性之间的关联。研究组的中位生存时间为10.0个月（95% CI 9.0-11.0）。存活时间明显依赖于CD133+细胞的比例（log rank检验，p = 0.02）。CD133+细胞比例低（<中位数）和高（>=中位数）患者的中位生存时间分别为9.0个月（95% CI 7.6-10.5）和12.0个月（95% CI 9.3-14.7）。在多变量分析中，CD133+细胞的比例成为延长总生存期的重要独立预测因子（HR 2.0, 95% CI 1.0-3.8, p = 0.04）。干细胞比例较高的患者，术后放疗后生存时间明显延长。GBM干细胞对分割放疗的潜在原因和可能的高敏感性有待进一步研究。
Background. The aim of the study was to assess the impact of CD133-positive (CD133+) cancer stem cell proportions on treatment results of glioblastoma multiforme (GBM) patients.Patients and methods. Patients with GBM (n = 42) received postoperative radiotherapy (+/- chemotherapy). Surgically excised GBM tissue sections were immunohistochemically examined for CD133 expression. The proportions of CD133+ GBM cells were determined (%). The proportion of CD133+ GBM stem cells was established by 2 independent researchers whose results were in good accordance (R = 0.8, p < 0.01). Additionally, CD133 expression levels were correlated with patients overall survival.Results. The proportion of CD133+ cells varied between patients, being from 0.5% to 82%. Mean and median proportions of CD133+ cells of the entire study group were 33% +/- 24% (mean +/- SD) and 28%, respectively. Clinical data do not support the association between higher proportion of stem cells and the aggressiveness of GBM. Median survival time of the study group was 10.0 months (95% CI 9.0-11.0). The survival time clearly depended on the proportion of CD133+ cells (log rank test, p = 0.02). Median survival times for patients with low (< median) and high (>= median) proportion of CD133+ cells were 9.0 months (95% CI 7.6-10.5) and 12.0 months (95% CI 9.3-14.7), respectively. In multivariate analysis, the proportion of CD133+ cells emerged as a significant independent predictor for longer overall survival (HR 2.0, 95% CI 1.0-3.8, p = 0.04).Conclusions. In patients with higher stem cell proportion, significantly longer survival times after postoperative radiotherapy were achieved. Underlying reasons and possible higher sensitivity of GBM stem cells to fractionated radiotherapy should be clarified in further studies.