Abstract
Stem cell markers are upregulated in various cancers and have potential as prognostic indicators. The objective of this study was to determine the expression of three stem cell markers, aldehyde dehydrogenase 1 (ALDH-1), B cell-specific Moloney murine leukemia virus integration site 1 (Bmi-1), and Nanog, in esophageal squamous cell carcinoma (ESCC) tissues. Immunohistochemistry was used to measure the expression of ALDH-1, Bmi-1, and Nanog in ESCC tissues from 41 patients who received pre-operative chemoradiation. We evaluated the relationship between expression of these markers, and clinicopathological features, tumor regression grade (TRG), and 5-year overall survival (OS). There were no significant associations of ALDH-1 or Bmi-1 expression with age, gender, clinical stage, and treatments (p>0.05). However, patients with Nanog-positive tumors were significantly older than those whose tumors were Nanog-negative (p = 0.033). TRG after treatment was significantly associated with expression of ALDH-1 (p = 0.001), Bmi-1 (p = 0.004), and Nanog (p<0.001). Although OS was significantly better in patients with low TRGs (p = 0.001), there were no significant correlations between ALDH-1, Bmi-1, or Nanog with OS. Expression of ALDH-1, Bmi-1, and Nanog correlated with TRG, but not OS. Further large studies are necessary to fully elucidate the prognostic value of these stem cell markers for ESCC patients.
Highlights
Esopahgeal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC) are the 2 major histological types of esophageal cancer [1]
tumor regression grade (TRG) was classified based on complete tumor response to therapy [19]
By the end of the study, 15 patients had died from ESCC, 9 patients died from complications associated with ESCC, and 2 patients died from unknown causes
Summary
Esopahgeal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC) are the 2 major histological types of esophageal cancer [1]. In China, ESCC is the fourth-leading cause of cancer-associated death [3]. Chemotherapy, and radiotherapy, the 5-year overall survival remains poor, in part because patients typically have advanced-stage cancer at diagnosis [4]. The levels of serum anti-p53 antibodies and C-reactive protein predict the response to therapy in patients with recurrent esophageal cancer [6]. The phosphorylation level of mammalian target of rapamycin (mTOR) is associated with response to chemoradiotherapy and overall disease-free survival in ESCC patients [7]. The EMT enhances cancer invasion and metastasis, in part because cells develop stem cell-like properties [8]
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