Clinicopathologic significance of putative stem cell marker, CD44 and CD133, in human gastric carcinoma

J Surg Oncol. 2013 Jun;107(8):799-806. doi: 10.1002/jso.23337. Epub 2013 Apr 22.

Abstract

Background and objectives: CD44 and CD133 have been reported as putative stem cell markers. However, the clinicopathologic significance of CD44 and CD133 expression in patients with gastric carcinoma (GC) has not been clearly elucidated.

Methods: Immunohistochemistry (IHC) was performed to investigate the CD44 and CD133 expression in gastric carcinomas and normal mucosal tissues. Receiver operating characteristic (ROC) curve analysis, spearman's rank correlation, Kaplan-Meier plots, and Cox proportional hazards regression model were used to analyze the data.

Results: The highly expressed CD44 and CD133 were observed in 27/152 (17.7%) and 64/152 (42.1%) of GCs and in 4/60 (6.7%) and 15/60 (25.0%) normal gastric mucosal tissues, respectively (P < 0.05, Fisher's exact test). High expression of CD44 was significantly correlated with tumor poorer differentiation, presence of distant metastasis, advanced TNM stage, and tumor relapse; and high expression of CD133 was positively associated with tumor invasion depth, presence of distant metastasis and advanced TNM stage. More importantly, high-expressed CD44 and CD133 were both associated with shorter survival as evidenced by univariate and multivariate analysis.

Conclusions: Our study introduces high expression of CD44 and CD133 as adverse independent prognostic factors in GC patients. The combined CD44 and CD133 expression may become a useful tool for identifying patients with different clinical outcomes.

MeSH terms

  • AC133 Antigen
  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Antigens, CD / analysis*
  • Biomarkers, Tumor / analysis*
  • Female
  • Gene Expression Regulation, Neoplastic
  • Glycoproteins / analysis*
  • Humans
  • Hyaluronan Receptors / analysis*
  • Immunohistochemistry
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Staging
  • Neoplastic Stem Cells*
  • Peptides / analysis*
  • Phenotype
  • Prognosis
  • ROC Curve
  • Stomach Neoplasms / chemistry*
  • Stomach Neoplasms / pathology*

Substances

  • AC133 Antigen
  • Antigens, CD
  • Biomarkers, Tumor
  • CD44 protein, human
  • Glycoproteins
  • Hyaluronan Receptors
  • PROM1 protein, human
  • Peptides