Abstract
BackgroundCancer stem cells (CSCs) have been reported to play an important role in chemoradiation resistance. Although the association of CSC markers with clinicopathological outcomes after neoadjuvant chemoradiotherapy (NACRT) has been reported in various types of cancers, there have been no such reports for pancreatic cancer. Here we examined the sequential changes in CSC marker expressions after NACRT in patients with pancreatic adenocarcinoma (PA) and the impact of these changes on the prognosis.MethodsWe used immunohistochemistry to evaluate the expressions of the CSC markers epithelial cell adhesion molecule (EpCAM), CD24, CD44, CD133, CXCR4 and Aldehyde dehydrogenase 1 (ALDH1) in resected specimens obtained from 28 PA patients, and we compared these expressions with the patients’ clinicopathological parameters and survival data.ResultsThe expression frequencies of CD44 and ALDH1 were significantly higher in the NACRT group (n = 17) compared to the non-NACRT group (n = 11), but the CD133 expression was significantly lower in the NACRT group. In the NACRT group, the expression of CD133 was inversely correlated with that of ALDH1, and CD133+/ALDH1- expression was associated with an unfavorable patient outcome.ConclusionThis is the first report showing that NACRT may influence the expression frequencies of CD44, CD133 and ALDH1 in PA patients. Moreover, CD133 and ALDH1 expressions may be useful predictors of prognosis in PA patients who have received NACRT.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2407-14-687) contains supplementary material, which is available to authorized users.
Highlights
Cancer stem cells (CSCs) have been reported to play an important role in chemoradiation resistance
In the present study we investigated the properties of pancreatic CSCs to compare the expressions of CSC markers in the tumours of pancreatic adenocarcinoma (PA) patients according to whether they received neoadjuvant chemoradiotherapy (NACRT), and to analyze the associations between the expressions of the CSC markers and the clinicopathological characteristics of the NACRT group to determine the clinical implications of the CSC marker expressions
Regarding the chemoradiation resistance to pancreatic CSCs, we have demonstrated that the frequencies of CD44- and Aldehyde dehydrogenase 1 (ALDH1)-positive cases are increased in the NACRT group
Summary
Cancer stem cells (CSCs) have been reported to play an important role in chemoradiation resistance. The association of CSC markers with clinicopathological outcomes after neoadjuvant chemoradiotherapy (NACRT) has been reported in various types of cancers, there have been no such reports for pancreatic cancer. We examined the sequential changes in CSC marker expressions after NACRT in patients with pancreatic adenocarcinoma (PA) and the impact of these changes on the prognosis. NACRT has several positive aspects such as an increased resectability rate with clear margins and decreased rates of metastatic lymph nodes and local relapse, and NACRT resulted in a significant improvement of the 5-year survival rate in curative cases [6,7]. Many patients with pancreatic cancer do not respond to NACRT, and little is known about the potential biological markers that may be associated with response to NACRT
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