Abstract
ObjectiveIntegrin alpha 7 (ITGA7), a potential glioma stem cell marker, regulates several other stem cell markers including CD133 and Nestin in several cancers, meanwhile its high expression is related to poor prognosis in multiple solid tumor patients. However, few studies report correlation of ITGA7 with prognosis in astrocytoma patients. Hence, this study aimed to determine the astrocytoma-tissue ITGA7, CD133 and Nestin expressions to explore their relationship and clinical value for astrocytoma management. MethodsTotally, 124 patients with primary astrocytoma were included. Their tumor tissue ITGA7, CD133 and Nestin expressions were determined by immunohistochemical (IHC) assay and scored by intensity and density ranging from 0 to 12 points. Besides, their clinical features (such as world health organization (WHO) grade, isocitrate dehydrogenase (IDH) mutation, and adjuvant therapy etc.) were collected, also their overall survival (OS) were analyzed by follow-up data. ResultsThe mean IHC scores for ITGA7, CD133 and Nestin were 4.9 ± 2.5, 2.1 ± 2.6 and 5.8 ± 2.6, respectively. Moreover, ITGA7 high expression correlated with absence of IDH mutation (P = 0.004), advanced WHO grade (P = 0.001) and shorter OS (P = 0.005). Besides, ITGA7 positively correlated with CD133 (P = 0.001) and Nestin (P = 0.001) expressions. Regarding CD133 and Nestin, their high expression also correlated with increased WHO grade and shorter OS. Furthermore, multivariant Cox’s regression analysis displayed that only CD133 high expression (P = 0.021) could independently predict reduced OS, while ITGA7 or Nestin high expression could not independently predict that. ConclusionITGA7, CD133, and Nestin are intercorrelated, also their high expressions associate with deteriorating disease conditions and poor prognosis in astrocytoma patients.
Highlights
Astrocytoma, as the most frequent central nervous system (CNS) tumor, has a high incidence in males compared to females with a ratio of 1.4:1 [1–3]
integrin alpha-7 (ITGA7) high expression correlated with absence of isocitrate dehydrogenase (IDH) mutation (P=0.004), advanced world health organization (WHO) grade (P=0.001) and shorter overall survival (OS) (P=0.005)
ITGA7, CD133 and Nestin are intercorrelated, their high expressions associate with deteriorating disease conditions and poor prognosis in astrocytoma patients
Summary
Astrocytoma, as the most frequent central nervous system (CNS) tumor, has a high incidence in males compared to females with a ratio of 1.4:1 [1–3]. Integrin alpha-7 (ITGA7) is a key mediator in rectal cancer, breast cancer and astrocytoma pathogenesis [9–12]. In the clinical field, ITGA7 high expression correlates with poor prognosis in clear renal cell carcinoma patients, rectal cancer patients and breast cancer patients [10,13,14]. ITGA7 acts as a potential cancer stem cell (CSC) marker, and regulates multiple other CSC marker expressions (including CD44, CD90, CD133, SOX2, OCT3/4 and NANOG), these CSC markers (such as CD133 and Nestin) correlate with shorter overall survival (OS) in astrocytoma patients [9,11,15–17]. Given the fact that ITGA7 regulates CSC marker expressions in several cancers, besides CD133 and Nestin are well-characterised CSC markers in astrocytoma, we hypothesized that ITGA7 assessment might have a potentially clinical value in astrocytoma patients [18–21]. We performed this study and aimed to explore the relationship among ITGA7, CD133 and Nestin, as well as to explore their correlation with clinicopathological features and prognosis in astrocytoma patients
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