Department of Breast Disease, Peking Union Medical College Hospital, Peking Union Medical College, Beijing, China.
J Exp Clin Cancer Res. 2012 Jul 4;31(1):59. doi: 10.1186/1756-9966-31-59.
Invasive ductal carcinoma is the most common type of breast malignancy, with varying molecular features and resistance to treatment. Although CD44+/CD24- cells are believed to act as breast cancer stem cells and to be linked to poor prognosis in some patients, the association between these cells and tumor recurrence or metastasis in all or some types of invasive ductal carcinoma is unclear.
A total of 147 randomly selected primary and secondary invasive ductal carcinoma samples were assayed for expression of CD44, CD24, ER, PR, and Her2. The association between the proportions of CD44+/CD24- tumor cells and the clinico-pathological features of these patients was evaluated.
CD44+/CD24- tumor cells were detected in 70.1% of the tumors, with a median proportion of 5.8%. The proportion of CD44+/CD24- tumor cells was significantly associated with lymph node involvement (P = 0.026) and PR status (P = 0.038), and was correlated with strong PR status in patients with recurrent or metastatic tumors (P = 0.046) and with basal-like features (p = 0.05). The median disease-free survival (DFS) of patients with and without CD44(+)/CD24(-/low) tumor cells were 22.9 ± 2.2 months and 35.9 ± 3.8 months, and the median overall survival (OS) of patients with and without CD44(+)/CD24(-/low) tumor cells were 39.3 ± 2.6 months and 54.0 ± 3.5 months, respectively, and with both univariate and multivariate analyses showing that the proportion of CD44(+)/CD24(-/low) tumor cells was strongly correlated with DFS and OS.
The prevalence of CD44+/CD24- tumor cells varied greatly in invasive ductal carcinomas, with the occurrence of this phenotype high in primary tumors with high PR status and in secondary tumors. Moreover, this phenotype was significantly associated with shorter cumulative DFS and OS. Thus, the CD44(+)/CD24(-) phenotype may be an important factor for malignant relapse following surgical resection and chemotherapy in patients with invasive ductal carcinoma.
浸润性导管癌是最常见的乳腺癌类型，具有不同的分子特征和治疗耐药性。虽然 CD44+/CD24-细胞被认为是乳腺癌干细胞，并与一些患者的预后不良有关，但这些细胞与所有或某些类型浸润性导管癌的肿瘤复发或转移之间的关系尚不清楚。
共检测了 147 例随机选择的原发性和继发性浸润性导管癌样本中 CD44、CD24、ER、PR 和 Her2 的表达情况。评估了肿瘤细胞中 CD44+/CD24-肿瘤细胞的比例与这些患者的临床病理特征之间的关系。
在 70.1%的肿瘤中检测到 CD44+/CD24-肿瘤细胞，中位数比例为 5.8%。肿瘤细胞中 CD44+/CD24-肿瘤细胞的比例与淋巴结受累（P=0.026）和 PR 状态（P=0.038）显著相关，与复发性或转移性肿瘤中 PR 状态较强（P=0.046）和基底样特征（p=0.05）相关。有和无 CD44(+)/CD24(-/低)肿瘤细胞的患者的中位无病生存（DFS）分别为 22.9±2.2 个月和 35.9±3.8 个月，有和无 CD44(+)/CD24(-/低)肿瘤细胞的患者的中位总生存（OS）分别为 39.3±2.6 个月和 54.0±3.5 个月，单因素和多因素分析均显示 CD44(+)/CD24(-/低)肿瘤细胞比例与 DFS 和 OS 密切相关。
浸润性导管癌中 CD44+/CD24-肿瘤细胞的发生率差异很大，高 PR 状态的原发性肿瘤和继发性肿瘤中这种表型的发生率较高。此外，这种表型与较短的累积 DFS 和 OS 显著相关。因此，CD44(+)/CD24(-)表型可能是浸润性导管癌患者手术切除和化疗后恶性复发的一个重要因素。
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