Kim Hye Min, Koo Ja Seung
Department of Pathology, Yonsei University College of Medicine, Seoul, South Korea.
Front Endocrinol (Lausanne). 2019 Aug 2;10:523. doi: 10.3389/fendo.2019.00523. eCollection 2019.
Cancer stem cell (CSC) markers have prognostic significance in various cancers, but their clinical significance in papillary thyroid carcinoma (PTC) has not been demonstrated. In this study, CSC markers expressed in PTC and their relationships with prognosis were evaluated. We constructed tissue microarrays for 386 PTC cases, divided it into 42 low risk cases and 344 intermediate risk cases according to the American Thyroid Association 2009 Risk Stratification System. Immunohistochemical staining of CSC markers (CD15, CD24, CD44, CD166, and ALDH1A1) was performed, and the proportion of stained cells and immunostaining intensity were evaluated to determine positive marker expression. The relationships between CSC marker expression and other clinicopathological parameters or survival were analyzed. CD15 expression was higher in PTC with intermediate risk than in PTC with low risk (29.4 vs. 11.9%, = 0.017). According to a multivariate analysis, CD15, CD44, CD166, and ALDH1A1 positivity were independently associated with a shorter progression-free survival (PFS) (odds ratio [OR]: 1.929, 2.960, 7.485, and 3.736; = 0.016, = 0.026, < 0.001, and = 0.006, respectively). Higher N and cancer stage were the only other clinical factors associated with a shorter PFS (OR: 2.953 and 1.898, = 0.011 and = 0.034). Overexpression of CSC markers in PTC was associated with shorter PFS during follow-up. Immunohistochemical staining of CSC markers may provide useful information for predicting patient outcomes.
癌症干细胞（CSC）标志物在多种癌症中具有预后意义，但其在甲状腺乳头状癌（PTC）中的临床意义尚未得到证实。在本研究中，对PTC中表达的CSC标志物及其与预后的关系进行了评估。我们构建了386例PTC病例的组织芯片，并根据美国甲状腺协会2009年风险分层系统将其分为42例低风险病例和344例中风险病例。对CSC标志物（CD15、CD24、CD44、CD166和ALDH1A1）进行免疫组织化学染色，评估染色细胞比例和免疫染色强度以确定标志物阳性表达。分析了CSC标志物表达与其他临床病理参数或生存率之间的关系。中风险PTC中CD15表达高于低风险PTC（29.4%对11.9%，P = 0.017）。根据多变量分析，CD15、CD44、CD166和ALDH1A1阳性与无进展生存期（PFS）较短独立相关（优势比[OR]：1.929、2.960、7.485和3.736；P分别为0.016、0.026、<0.001和0.006）。较高的N分期和癌症分期是与较短PFS相关的仅有的其他临床因素（OR：2.953和1.898，P = 0.011和P = 0.034）。PTC中CSC标志物的过表达与随访期间较短的PFS相关。CSC标志物的免疫组织化学染色可为预测患者预后提供有用信息。
