Abstract
Background:CD133 is a commonly used cancer stem cell (CSC) marker in breast cancer. However, the association between CD133 expression, with clinicopathological features and prognosis in breast cancer, is poorly understood in the Indian subcontinent. This study was designed to explore the expression of CD 133 in breast carcinoma and to know its association between CD133 and clinicopathological characteristics. Methods:A total of fifty seven cases were included in the study. All the clinicopathological parameters were collected from Department of Pathology archives. Slides, blocks, clinical information, tumor size and axillary lymph node status were obtained from medical records and the pathology reports. Immunohistochemistry was done using CD 133 antibodies. Both Cytoplasmic and membranous staining was taken a positive. Scoring was done based on percentage of positive cells and intensity of staining. MS Excel, SPSS version 22 (IBM SPSS Statistics, Somers NY, USA) was used to analyze data.p value < 0.05 was considered as statistically significant. Results:Statistically significant association between the CD 133 expression and nodal metastasis, tumor stage and Nottingham prognostic index was analysed. There was no statistical correlation between CD 133 expression age, tumor grade and tumor size. The disease free survival showed the mean disease free survival of CD 133 positivity cases was 16months. And the patients who were negative for CD 133 expression had mean survival of 30 months. By the Kaplan Mayer graph it was evident that the more the CD 133 expression the lesser was the disease free survival of the patients. Conclusion: CD 133 expression was seen in 77.08% cases and was associated with tumor stage, lymph node metastasis, poor Nottingham prognostic index and worse disease free survival. An increasing trend of association was seen between CD 133 expression and Age, Tumor Size and Tumor grade.
Highlights
Breast carcinoma is the most common malignant tumour in women worldwide
Metastasis to nodes was seen in 44/57 cases where axillary lymph node dissection was made
It has been considered that the tumor is composed of tumor cells and cancer stem cell (CSC) - rare subpopulation of cells in solid tumors with the capability of self-renewal, differentiation potential and initiating tumors (Reya et al, 2001)
Summary
Breast carcinoma is the most common malignant tumour in women worldwide. In India breast carcinoma is leading cause of malignancy in females with age adjusted rate of 25.8 per 100,000 women and mortality of 12.7 per 100,000 women with higher incidence in Urban area as compared to Rural population (Bray et al, 2018; Malvia et al, 2017). Amongst newer set of prognostic markers, evidence demonstrates that cancer stem cells (CSCs) play an important role in tumor initiation, occurrence and metastasis. Various markers such as CD34, CD38, CD44, CD133, and ALDH are used to identify these stem cells. The expression of CD133 and its relation with histopathological parameters has yielded conflicting results which may be attributed to different research methodologies and differences between study populations (Mukhopadhyay et al, 2013; Zhan et al, 2017; Kim et al, 2015; Margaret et al, 2013). Conclusion: CD 133 expression was seen in 77.08% cases and was associated with tumor stage, lymph node metastasis, poor Nottingham prognostic index and worse disease free survival. An increasing trend of association was seen between CD 133 expression and Age, Tumor Size and Tumor grade
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