Abstract
Background: Cancer stem cells, also known as tumor-initiating cells, are suggested to be responsible for drug resistance and cancer development due in part to their ability to self-renew themselves and differentiate into heterogeneous lineages of cancer cells. Objective: This study was designed to investigate the role of cancer stem cells in pancreatic cancer. Methods: A retrospective clinicopathological analysis was undertaken in 112 patients diagnosed with pancreatic ductal adenocarcinoma between 2005 and 2010, and immunohistochemistry was performed with antibodies against CD133, CD24, and OCT4. Positive nuclear, cytoplasmic or membrane staining for each antibody was rated on staining intensity, being classified into low/moderate or strong staining groups. Results were analyzed relative to each patient’s clinicopathological parameters. Results: There was an established relationship between the staining of the markers with some variables associated with worse prognosis, being the three markers present in most tumor cells and associated with tumor progression. We suppose that cancer stem cells are present from the beginning of tumor initiation and are intrinsically related to tumor development. Although the presence of stem cells has been associated with molecular biology of various tumors, their expression in pancreatic cancer has not yet been clinically reported. Conclusion: The presence of stem cells and their role in pancreatic cancer tumorigenesis may be considered as valuable prognostic factors, although the mechanism involved needs further investigation. Increasing insights into role of cancer stem cells and carcinogenesis can ultimately generate new ideas for molecularly based diagnostic and therapeutic approaches.
Highlights
Despite progress in cancer diagnosis and treatment over the past decades, it remains one of the most common causes of death worldwide
A retrospective clinicopathological analysis was undertaken in 112 patients diagnosed with pancreatic ductal adenocarcinoma between 2005 and 2010, and immunohistochemistry was performed with antibodies against CD133, CD24, and OCT4
The molecular biology of pancreatic cancer is directly related to its rapid progression and low therapeutic response
Summary
Despite progress in cancer diagnosis and treatment over the past decades, it remains one of the most common causes of death worldwide. Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive disease usually diagnosed in an advanced stage and for which few effective therapies are available. It is a neoplasm whose incidence is almost equal to its mortality. Despite advances in surgical techniques, which today are considered the only curative option, the average 5-year survival rate is less than 5% (1-3%) (BARBOSA et al, 2018; SOTO et al, 2006) It is considered the neoplasia with the worst prognosis out of more than 60 types of cancers, a fact evidenced by its incidence rate almost equaling the mortality rate (SAKORAFAS et al, 2000). Increasing insights into role of cancer stem cells and carcinogenesis can generate new ideas for molecularly based diagnostic and therapeutic approaches
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