Abstract
BackgroundThe aim of this study was to elucidate the value of putative cancer stem cell markers Musashi-1, ALDH1, Sox2, and CD49f in predicting the prognosis in cervical squamous cell carcinoma (CSCC).MethodsReal-time PCR and immunohistochemistry staining was performed to examine Musashi-1, ALDH1, Sox2, and CD49f expression in archived specimens of CSCC patients with postoperative chemotherapy. Kaplan–Meier analysis and Cox proportional hazards model were used to assess the prognostic impact of CSC markers for overall survival (OS) and recurrent-free survival (RFS).ResultsThe Real-time PCR data showed that the expression of all markers were increased in CSCC tissues compared with in paired normal cervical tissues (P < 0.05). The IHC result showed that high expression of Msi1, ALDH1, Sox2, and CD49f was found in 25.7 %, 43.0 %, 62.0 % and 29.0 % CSCC samples, respectively. Moreover, high expression of Msi1 (P = 0.033 and P = 0.003, respectively), ALDH1 (P = 0.015 and P = 0.002, respectively), and Sox2 (P = 0.005 and P = 0.003, respectively), and low expression of CD49f (P = 0.027 and P = 0.025, respectively) were correlated with poor OS and PFS in CSCC patients. Interestingly, tumors with Msi1high/CD49flow expression had the poorest prognosis according to Msi1/CD49f stratification. In multivariate Cox regression analysis, Sox2 expression (P = 0.047 and P = 0.018, respectively), ALDH1 expression (P = 0.013 and P = 0.003, respectively), and CD49f expression (P = 0.008 and P = 0.003, respectively) were independent prognostic markers for both OS and RFS.ConclusionsOur results suggest that cancer stem cell markers are linked with poor prognosis of CSCC patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-015-1826-4) contains supplementary material, which is available to authorized users.
Highlights
The aim of this study was to elucidate the value of putative cancer stem cell markers Musashi-1, ALDH1, Sox2, and CD49f in predicting the prognosis in cervical squamous cell carcinoma (CSCC)
Patterns of expression To investigate the potential roles of Cancer stem cells (CSCs) markers in the development of cervical cancer, we determined the expression of Msi1, ALDH1, Sox2 and CD49f in 179 paraffin-embedded cervical carcinoma samples by immunohistochemistry
Associations between Msi1, ALDH1, Sox2 and CD49f expression and clinical prognosis To examine the prognostic value of CSCs markers in cervical cancer, we evaluated the correlation between Msi1, ALDH1, Sox2 and CD49f expression and prognosis in CSCC patients
Summary
The aim of this study was to elucidate the value of putative cancer stem cell markers Musashi-1, ALDH1, Sox, and CD49f in predicting the prognosis in cervical squamous cell carcinoma (CSCC). Cervical cancer is the second most common gynecologic cancer in developing countries, with over 500,000 new cases and 274,000 deaths annually [1]. Despite advances in surgical capabilities and chemotherapy strategies, a substantial proportion of patients still die from recurrent or chemoresistant disease. 30–50 % of advanced-stage patients will develop recurrent disease [2]. Even in patients with early-stage disease, 10–20 % will. There is a lack of biomarkers for predicting the response to chemotherapy in cervical cancer patients. Cancer stem cells (CSCs) are defined as a small population of cells within a tumor that can self-renew and drive tumorigenesis. Increasing evidence has suggested that CSCs are naturally resistant to chemotherapeutic
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