Abstract
ABSTRACT INTRODUCTION: According to the cancer stem-cell theory, tumors originate from a small population of cancer stem cells, which lose the mechanism of self-regulation and begin to differentiate and proliferate indefinitely. The CD44+/CD24- phenotype may be considered a stem-cell marker in breast cancer. OBJECTIVE: To evaluate the correlation between CD44+/CD24- phenotype and different molecular subtypes of breast cancer in invasive ductal carcinoma samples. METHODS: The expression of CD44, CD44v6, and CD24 markers was investigated in 133 cases of invasive mammary carcinoma with immunohistochemistry. CD44+/CD24- phenotype was identified and correlated with the molecular subtypes and classical prognostic factors such as age, histological grade, tumor size, and lymph node status. RESULTS: Eighteen (14%) cases were positive for CD44+/CD24- (CD44+/CD24- or CD44v6+/CD24-) phenotype; among these, 11.1%, 27.8%, 38.9%, and 22.2% were luminal, luminal B-human epidermal growth factor receptor 2 (HER2), HER2, and triple-negative subtype, respectively. CD44+/ CD24- phenotype was more common in HER2 subgroup (p = 0.0197). CONCLUSION: CD44+/CD24- phenotype was correlated with molecular subtypes of breast cancer. The highest expression of CD44+/CD24- phenotype was reported in patients with HER2+ disease, a molecular subtype associated with more aggressive behavior and worse prognosis.
Highlights
According to the cancer stem-cell theory, tumors originate from a small population of cancer stem cells, which lose the mechanism of self-regulation and begin to differentiate and proliferate indefinitely
The highest expression of CD44+/CD24- phenotype was reported in patients with human epidermal growth factor receptor 2 (HER2)+ disease, a molecular subtype associated with more aggressive behavior and worse prognosis
The most significant finding of this study was the association between CD44+/CD24- phenotype and Breast cancer (BC) molecular subtypes (p = 0.02); HER2+ subtype is known for poor prognosis and showed the highest frequency
Summary
According to the cancer stem-cell theory, tumors originate from a small population of cancer stem cells, which lose the mechanism of self-regulation and begin to differentiate and proliferate indefinitely. Breast cancer (BC) is the most commonly diagnosed malignancy in women[1, 2] and the second most common cause of cancer death in females It is recognized as a heterogeneous and phenotypically diverse disease characterized by great variability in the recurrence pattern and survival outcomes observed among different BC subtypes. The initial gene expression arrays based on the measurement of gene cluster identified distinct molecular subtypes such as luminal A, luminal B, human epidermal growth factor receptor 2 (HER2)-enriched, and basal subtypes[3,4,5,6]. HER2 and basal subtypes display poor prognosis in terms of overall survival and disease-free survival[4,5,6] This analysis allowed the description of a tumor molecular portrait with different molecular subtypes harboring distinct prognosis[4, 5] and showing different responses to local and systemic therapy[7,8].
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