Yang Lang, Xu Jun-Feng, Kang Qian, Li Ai-Qin, Jin Peng, Wang Xin, He Yu-Qi, Li Na, Cheng Tao, Sheng Jian-Qiu
Department of Gastroenterology, PLA Army General Hospital, Beijing, China.
GraduateCollege, PLA General Hospital, Beijing, China.
PLoS One. 2017 Jan 3;12(1):e0169124. doi: 10.1371/journal.pone.0169124. eCollection 2017.
Cancer stem cells (CSCs) are thought to be the "root" of cancer. Although stemness-related factors ALDH1A1 and Sox2 have been used as markers to identify gastric CSCs, the expression pattern and significance of these factors in gastric cancer have not been sufficiently demonstrated. In this study, the expressions of ALDH1A1 and Sox2 were detected by immunohistochemistry in 122 gastric cancer specimens. And the correlation between Sox2 or ALDH1A1 expression and clinicopathological parameters and overall survival data were analyzed. The positive rate of ALDH1A1 expression was 60%, but there was no significant difference between survival rates of ALDH1A1-positive and ALDH1A1-negative patients. Sox2 was expressed in 42% of specimens and was associated with poor prognosis of patients (P = 0.015). Stratified analysis showed that Sox2 expression correlated with shorter lifespan only in patients with cardiac gastric cancers (P = 0.002) or stage I or II gastric cancers (P = 0.002); but not in patients with non-cardiac cancers (P = 0.556) or stage III or IV gastric cancers (P = 0.121). Analysis on a database cohort validated the correlation between Sox2 expression and poor prognosis in stage II cancer. Also, expression of Sox2 was associated with lymphnode metastasis in patients with cardiac gastric cancer (P = 0.037). A multivariate analysis revealed that Sox2 was an independent prognostic factor in cardiac gastric cancer. Our results indicate that predictive value of Sox2 in gastric cancer is associated with cardiac cancer location and with early cancer stages (I and II).
癌症干细胞（CSCs）被认为是癌症的“根源”。尽管与干性相关的因子醛脱氢酶1A1（ALDH1A1）和性别决定区Y框蛋白2（Sox2）已被用作鉴定胃CSCs的标志物，但这些因子在胃癌中的表达模式和意义尚未得到充分证实。在本研究中，采用免疫组织化学法检测了122例胃癌标本中ALDH1A1和Sox2的表达情况。并分析了Sox2或ALDH1A1表达与临床病理参数及总生存数据之间的相关性。ALDH1A1表达的阳性率为60%，但ALDH1A1阳性和阴性患者的生存率之间无显著差异。Sox2在42%的标本中表达，且与患者的不良预后相关（P = 0.015）。分层分析显示，Sox2表达仅在贲门胃癌患者（P = 0.002）或Ⅰ期或Ⅱ期胃癌患者（P = 0.002）中与较短的生存期相关；而在非贲门癌患者（P = 0.556）或Ⅲ期或Ⅳ期胃癌患者（P = 0.121）中则无此相关性。对数据库队列的分析验证了Sox2表达与Ⅱ期癌症患者不良预后之间的相关性。此外，Sox2的表达与贲门胃癌患者的淋巴结转移相关（P = 0.037）。多因素分析显示，Sox2是贲门胃癌的独立预后因素。我们的结果表明，Sox2在胃癌中的预测价值与癌症位置为贲门以及癌症早期阶段（Ⅰ期和Ⅱ期）相关。
