Sung Woo Jung, Park Ki-Sung, Kwak Sang Gyu, Hyun Dae-Sung, Jang Jae Seok, Park Kwan-Kyu
Department of Pathology, Catholic University of Daegu College of Medicine Daegu, Republic of Korea.
Department of Thoracic and Cardiovascular Surgery, Catholic University of Daegu College of Medicine Daegu, Republic of Korea.
Int J Clin Exp Pathol. 2015 Aug 1;8(8):8997-9009. eCollection 2015.
Adenocarcinoma is the most common histologic type of non-small cell lung carcinomas. The existence of lung cancer stem cells (CSCs) and epithelial-mesenchymal transition (EMT) in human tissue is controversy. The aim of this study is to investigate the expression and clinical significance of CSCs and EMT markers and evaluate the correlation between the two in lung adenocarcinoma. A total of 97 cases comprise the tissue microarray from surgical resection for primary lung adenocarcinoma. Immunohistochemistry for ALDH1 and CD44 as CSC markers and E-cadherin, vimentin, fibronectin, SMA as EMT markers was performed. High ALDH1A1 expression was statistically associated with female gender (P=0.001), smoker (P=0.012), and high pT stages (P=0.046). High CD44 expression was statistically associated with female gender (P=0.008), non-smoker (P=0.000), and no pleural invasion (P=0.039). High expression of ALDH1 was associated with good overall survival (P=0.021). High expression of CD44 was correlated with both good overall survival (P=0.024) and disease-free survival (P=0.000). Vimentin expression was associated with pT stage (P=0.001) and pleural invasion (P=0.028). E-cadherin, fibronectin and SMA were not associated with clinicopathologic correlation and all EMT markers were not correlated with survival of lung adenocarcinoma. CSC markers expression was not related to EMT. Our results showed that the expression of CSCs was associated with a good prognosis in lung adenocarcinoma. The prognostic significance of EMT markers was skeptical in this study. There is a need for more research about CSC, EMT, and the relation between these two in human lung adenocarcinoma.
腺癌是非小细胞肺癌最常见的组织学类型。人体组织中肺癌干细胞（CSCs）和上皮-间质转化（EMT）的存在存在争议。本研究旨在探讨CSCs和EMT标志物的表达及其临床意义，并评估二者在肺腺癌中的相关性。共有97例原发性肺腺癌手术切除组织构成组织芯片。采用免疫组织化学方法检测CSC标志物ALDH1和CD44以及EMT标志物E-钙黏蛋白、波形蛋白、纤连蛋白、平滑肌肌动蛋白（SMA）。ALDH1A1高表达与女性性别（P=0.001）、吸烟（P=0.012）及高pT分期（P=0.046）具有统计学相关性。CD44高表达与女性性别（P=0.008）、不吸烟（P=0.000）及无胸膜侵犯（P=0.039）具有统计学相关性。ALDH1高表达与总生存期良好（P=0.021）相关。CD44高表达与总生存期良好（P=0.024）及无病生存期（P=0.000）均相关。波形蛋白表达与pT分期（P=0.001）及胸膜侵犯（P=0.028）相关。E-钙黏蛋白、纤连蛋白和SMA与临床病理特征无相关性，所有EMT标志物与肺腺癌生存均无相关性。CSC标志物表达与EMT无关。我们的结果显示，CSCs的表达与肺腺癌的良好预后相关。本研究中EMT标志物的预后意义存疑。需要对人肺腺癌中的CSC、EMT及其二者之间的关系进行更多研究。
