Department of Medical Oncology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Br J Cancer. 2014 Jan 21;110(2):430-4. doi: 10.1038/bjc.2013.767. Epub 2013 Dec 10.
About one in five patients with locally advanced rectal cancer (RC) suffers recurrence or distant metastasis after neoadjuvant therapy. We investigated how cancer stem cell markers change after neoadjuvant therapy and how these markers relate to recurrence.
Pretreatment biopsies and postoperative specimens were taken from 64 patients with locally advanced rectal adenocarcinoma who received preoperative radiochemotherapy (RCT) between sampling. Samples were tested immunohistochemically for CD44, LGR5, ALDH1 and CD166; scores were dichotomised as high or low. The median follow-up period was 36 months.
High expression of CD44, LGR5, ALDH and CD166 was found in 38%, 5%, 48% and 10%, respectively, before RCT and 86%, 33%, 71% and 52%, respectively, after RCT. CD44 (P=0.001), LGR5 (P=0.049) and CD166 (P=0.003) were significantly upregulated after RCT. Whereas no recurrence was seen during the follow-up in the low ALDH group, 40% of the high ALDH group suffered recurrence. In multivariate COX analysis, postoperative ALDH1 independently predicted poor prognosis in patients with RC who received RCT (P=0.0095).
Preoperative RCT upregulates expression of stem cell markers in patients with RC. High post-treatment ALDH1 expression predicts poor prognosis for these patients after neoadjuvant therapy.
约五分之一的局部进展期直肠癌（RC）患者在新辅助治疗后会出现复发或远处转移。我们研究了新辅助治疗后癌症干细胞标志物如何变化，以及这些标志物与复发的关系。
从 64 例接受术前放化疗（RCT）的局部进展期直肠腺癌患者中采集治疗前和术后标本。对标本进行 CD44、LGR5、ALDH1 和 CD166 的免疫组织化学检测；评分分为高或低。中位随访时间为 36 个月。
RCT 前 CD44、LGR5、ALDH 和 CD166 的高表达率分别为 38%、5%、48%和 10%，RCT 后分别为 86%、33%、71%和 52%。RCT 后 CD44（P=0.001）、LGR5（P=0.049）和 CD166（P=0.003）的表达明显上调。而在低 ALDH 组的随访期间没有复发，高 ALDH 组中有 40%的患者复发。在多变量 COX 分析中，术后 ALDH1 独立预测接受 RCT 的 RC 患者预后不良（P=0.0095）。
术前 RCT 上调 RC 患者的干细胞标志物表达。治疗后 ALDH1 高表达预示着这些患者新辅助治疗后的预后不良。
