Expression of the stem cell markers CD133 and nestin in pancreatic ductal adenocarcinoma and clinical relevance

Background: To evaluate the prognostic implication of cancer stem cell markers in pancreac ductal adenocarcinoma (PDAC), the expression of CD133 and nestin were investigated in a series of PDAC patients in relation to the survival rate. Methods: This series included 42 cases of PDAC patients and evaluated the stem cell markers CD133 and nestin expression detected by immunohistochemistry. The presence of immunopositive tumor cells considering intensity and area was evaluated and interpreted in comparison to the patients’ clinicopathological and survival data. Results: Twenty eight cases (66.7%) showed high CD133 expression. The CD133 expression was mainly identified in the apical border of the tumor cell, but aberrant expression in the cytoplasmic or perinuclear location was also noted. High nestin expression in tumor cells were found in only 2 cases, but high nestin expression along perinuerial or stromal region was found in 15 cases (35.7%). There was no correlation between CD133, nestin expression and gemcitabine resistance. Statistically significant difference was found in patient survival in N stage (p=0.007), and CD133 expression (p= 0.014) in univariate analysis. Nestin expression wan not statistically significant, but it was helpful to identify the perineurial invasion. In Cox-regression hazard model stratified by age and sex for multivariable analysis, AJCC stage and CD133 were independent prognostic factors for overall survival. Conclusions: CD133 expression is upregulated in PDAC that is related to poor prognosis, and treatment targeted the CD133 positive cancer/cancer stem cells might be a promising therapeutic strategy for this patients.     

CD133: molecule of the moment

CD133 (prominin-1) was the first in a class of novel pentaspan membrane proteins to be identified in both humans and mice, and was originally classified as a marker of primitive haematopoietic and neural stem cells. Due to the highly restricted expression of CD133 family molecules on plasma membrane protrusions of epithelial and other cell types, in association with membrane cholesterol, a role in the organization of plasma membrane topology has also recently been assigned to this family. Studies have now confirmed the utility of CD133 as a marker of haematopoietic stem cells for human allogeneic transplantation. In addition, CD133 represents a marker of tumour-initiating cells in a number of human cancers, and therefore it may be possible to develop future therapies towards targeting cancer stem cells via this marker. The development of such therapies will be aided by a clearer understanding of the molecular mechanisms and signalling pathways that regulate the behaviour of CD133-expressing cells, and new data outlining the role of Wnt, Notch, and bone morphogenetic protein (BMP) signalling in CD133(+) cancer stem cell regulation are discussed within.     

Prognostic value of cancer stem cell marker CD133 expression in non-small cell lung cancer: a systematic review

Objective: To investigate the correlation between CD133-positive non-small cell lung cancer (NSCLC) and clinicopathological features and its impact on survival. Methods: A search in the Pubmed, Embase and Wanfang databases (up to July 15, 2013) was performed. Only articles in which CD133 antigen was detected in situ localization by immunohistochemical staining were included. This meta-analysis was done using RevMan 5.2 software. Outcomes included overall survival and various clinicopathological features. Results: A total of 1004 NSCLC patients from 11 studies were included. Meta-analysis showed that CD133 expression patients had a significant worse 5-year overall survival compared to the low expression ones (RR = 3.19, 95% CI: 2.05-4.98, P<0.0001 fixed random). With respect to clinicopathological features, CD133 expression by IHC method was closely correlated with tumor T stage (OR = 0.91, 95% CI: 0.59-1.39, P = 0.67 fixed-effect) and tumor grade (OR = 1.20, 95% CI: 0.80-1.79, P = 0.37 fixed-effect). Conclusion: CD133-positive NSCLC patients had worse prognosis, and was associated with common clinicopathological poor prognostic factors.     

Prognostic value of CD133 expression in stage I lung adenocarcinomas

CD133 is one of the most representative cancer stem cell markers. This study evaluated the potential prognostic value of CD133 expression in stage I lung adenocarcinomas (ADC). Tumors from 177 patients were immunohistochemically examined for CD133 expression, and their associations with disease recurrence were analyzed. Also, the potential prognostic value of combining CD133 expression with proliferating activity measured by immunohistochemical expression of Ki-67 and vessel involvement was evaluated. CD133 high expressers showed a significantly higher risk of recurrence than CD133 low expressers: 5-year disease-free survival (DFS) rate 77.2% vs. 95.1% (p=0.004), adjusted Hazard ratio (HR) 4.37, 95% Confidence Interval (CI) 1.30-14.71 (p=0.017). CD133 high expressers having strong proliferating activity and/or with vessel invasion showed a higher risk of recurrence: 5-year DFS rate 66.5% in CD133 high/Ki-67 high expressers vs. 93.2% in the other types (p<0.001), adjusted HR 8.39, 95% CI 2.65-26.54 (p<0.001): 5-year DFS rate 51.0% in CD133 high expressers with vessel invasion vs. 92.9% in the other types (p<0.001), adjusted HR 4.50, 95% CI 1.51-13.34 (p=0.007): 5-year DFS rate 53.9% in CD133 high/Ki-67 high expressers with vessel invasion vs. 91.2% in the other types (p<0.001), adjusted HR 9.32, 95% CI 3.42-25.39 (p<0.001). In conclusion, the level of CD133 expression is an independent prognostic marker and its combination with proliferating activity and/or vessel invasion could have excellent prognostic value to predict postoperative recurrence in patients with stage I lung ADC.     

人CD133基因转染细胞株的建立及其生物学功能的初步研究

目的:构建人干细胞标记分子CD133-2转基因细胞并探讨CD133-2分子的生物学功能。方法:利用分段克隆和重叠PCR方法从人胎肝cDNA文库中克隆出人CD133-2全长基因,经双酶切后装入真核表达载体p IRES2-EGFP中,用脂质体法转染L929细胞,加入G418选择性培养基进行筛选。经RT-PCR、Western blot、流式细胞术(FCM)等方法鉴定转基因细胞;MTT法分析转基因细胞对T细胞的体外增殖作用;流式细胞仪分析T细胞表面活化分子标记CD4CD25、CD8CD25的表达。结果:成功克隆和构建了能稳定表达人CD133-2分子的转基因细胞CD133-2/L929,该转基因细胞与T细胞共培养可抑制其体外增殖,下调T细胞表面分子CD4CD25和CD8CD25的表达。结论:稳定表达CD133-2蛋白的转基因细胞株的建立为该基因功能的后续研究奠定了物质基础。     

肿瘤干细胞标志物ALDH1及CDl33在鼻咽癌中的表达及其临床意义

目的：研究乙醛脱氢酶1（aldehyde dehydrogenase 1,ALDHl）、CDl33在鼻咽癌组织中的表达情况,探讨其作为鼻咽癌干细胞标志物的临床病理意义。方法：应用免疫组织化学法检测112例鼻咽癌及20例正常组织中ALDHl和CDl33的表达情况。结果：鼻咽癌组织中ALDHl和CDl33表达高于正常组织（P〈0．05）。ALDHl表达在患者年龄、性别、病理分型、原发癌和转移癌、是否伴有颈部淋巴结转移等各组间差异均无统计学意义（均P〉0．05）。CDl33表达在鼻咽部原发癌与淋巴结转移癌之间差异有统计学意义（P〈0．01）,在患者年龄、性别、病理分型以及是否伴有颈部淋巴结转移等各组间差异均无统计学意义（均P〉0．05）。结论：ALDHl作为鼻咽癌肿瘤干细胞标志物有待进一步研究。CDl33可作为鼻咽癌干细胞较特异的表面标志物,在鼻咽癌转移方面可能起重要作用。     

CD133 expression is associated with poor outcome in neuroblastoma via chemoresistance mediated by the AKT pathway

Sartelet H, Imbriglio T, Nyalendo C, Haddad E, Annabi B, Duval M, Fetni R, Victor K, Alexendrov L, Sinnett D, Fabre M & Vassal G
(2012) Histopathology  60, 1144–1155 CD133 expression is associated with poor outcome in neuroblastoma via chemoresistance mediated by the AKT pathway Aims: Neuroblastoma is a frequent childhood cancer with a heterogeneous prognosis. CD133 expression is an independent prognostic marker for a low survival rate in several cancers. The aim of this study was to determine the prognostic value of CD133 expression in a large cohort of neuroblastoma cases, to define the chemoresistance of neuroblastoma cells expressing CD133, and to determine whether this chemoresistance is regulated by activation of the AKT pathway. Methods and results: Two hundred and eighty samples of neuroblastoma were screened for CD133 expression. The sensitivity of purified CD133+ neuroblastoma cells isolated from two human cell lines to doxorubicin, vincristine and cisplatin, as single agents or in combination with LY294002, an AKT inhibitor, was evaluated in vitro. CD133 expression was found in 100 of 280 tumours. There was a significant association between CD133 expression and the following poor prognosis covariates: age, International Neuroblastoma Staging System stage, MYCN amplification, and phospho‐AKT (pAKT) expression. Patients with CD133? tumours had significantly better 3‐year event‐free and overall survival than patients with CD133+ tumours. In a multivariate model, CD133 expression was independently associated with decreased overall survival. CD133^high neuroblastoma cells were significantly resistant to chemotherapy as compared with CD133^low cells. Treatment of unsorted neuroblastoma cells with the three anticancer drugs significantly enriched the CD133+ subpopulation. CD133^high cells expressed significantly higher levels of pAKT than CD133^low cells. LY294002 treatment abolished the preferential survival of CD133^high cells. Conclusions: CD133 is associated with in‐vitro resistance to chemotherapy involving activation of the AKT pathway.     

CD133 expression and cancer stem cells predict prognosis in high-grade oligodendroglial tumors

High-grade oligodendroglial tumors, that is, anaplastic oligodendroglial tumors and glioblastomas with oligodendroglial component, differ significantly in terms of prognosis and response to chemotherapy. Differentiation might be difficult because the histological differences are vague and reliable markers are not established. We correlated the presence of putative cancer stem cells (CSC) in high-grade oligodendroglial tumors (WHO grades III and IV) with clinical outcome. Tumors with favorable prognosis neither contained CSC nor did they show CD133 expression. Tumor cells resembled lineage-restricted progenitor cells with limited proliferative capacity and differentiation profile. In contrast, CD133 expression and stem cell-like tumor cells characterized tumors with poor prognosis. They showed neurosphere-like growth, differentiated into cells of all neural lineages, and were tumorigenic in nude mice. In our series, CSC and expression of CD133 predicted the clinical course of disease better than the histological grading. To confirm these results, we retrospectively analyzed 36 high-grade oligodendroglial tumors. Again, CD133 expression indicated shorter survival and predicted clinical outcome more reliable than the histological assessment. Our data show that detection of CSC and expression of CD133 is predictive of prognosis in high-grade oligodendroglial tumors. The presence or absence of CD133(+) CSC might explain the crucial biological difference between WHO grade III and IV oligodendroglial tumors.     

A possible interplay between HR-HPV and stemness in tumor development: an in vivo investigation of CD133 as a putative marker of cancer stem cell in HPV18-infected KB cell line

High-risk HPVs (HR-HPVs) are DNA viruses considered as primary etiologic factors in malignancies of the low female genital tract. Their presence has also been documented in oropharyngeal and laryngeal cancers. However, HPV infection is considered a necessary but not sufficient cause of tumoral development; meantime, increasing evidences on the tumorigenic role of cancer stem cells (CSCs) have been documented in the literature. CSCs represent a small subpopulation of neoplastic cells with self-renewal potential, capable of maintaining tumor growth and cell differentiation, also involved in metastatic process, recurrence, and resistance to chemotherapeutic agents. In the present study, performed on KB cell lines, we evaluated the tumor forming potential of CSCs, and their relationship with the HPV infection status. We started our study by identifying the most aggressive cell line on the minimal number of cells being able of growth in vivo in a model of athymic nude mice (BALB/c nu/nu). We used an oral-derived KB cell line separated in the KB-CD133+ and KB-CD133- populations, by using immunomagnetic beads and fluorescence-activated cell sorting (FACS). The separated populations were injected in athymic nude mice (BALB/c nu/nu). Xenograft tumors have been analyzed for tumor size, CD133 expression by immunohistochemistry (IHC) and for DNA HR-HPV integration by in situ hybridization (ISH), comparing CD133-enriched xenograft tumors versus the CD133 non-enriched ones. On standard conditions, the KB cell line has a poor population of glycosylated CD133 marker (<5.0%) when investigated with antibodies versus CD133, and more specifically its glycosylated epitope (AC133). Enriched CD133 KB cells possess a higher capacity of tumor growth in xenograft models of nude mice when compared to KB CD133-negative cells. We observed that the AC133 epitope, extensively used to purifying hematopoietic stem cells, is able to select an epithelial subpopulation of cancer stem cells with aggressive behavior. We retain that CD133 may be a useful target in anticancer strategies including pharmacological and immunological therapies.     

Invasion and EMT-associated genes are up-regulated in B viral hepatocellular carcinoma with high expression of CD133-human and cell culture study

Hepatocellular carcinomas (HCCs) with expression of stem/progenitor cell markers including CD133 have been reported to have more aggressive biological behavior, and epithelial–mesenchymal transition (EMT), closely related invasion, has been suggested to generate cancer stem cells. To elucidate biological characteristics of HCCs expressing CD133, we evaluated migration assay and the mRNA expression levels of CD133, invasion-associated genes [urokinase plasminogen activator receptor (uPAR), villin 2 (VIL2), and MMP1 and MMP2], and EMT regulators (Snail, Slug, Twist, E-cadherin, and N-cadherin) by real-time PCR in HCC cell lines including HepG2, Hep3B, Huh7, PLC/RFP/6, SNU423, SNU449, and SNU475. Same genes and pathological features were also investigated in 49 samples of hepatitis B virus-related human HCCs. In all HCC cell lines studied, CD133-positive cells showed higher cell migration activity and up-regulated invasion- and EMT-associated genes with increased N-cadherin and decreased E-cadherin expressions compared to CD133-negative cells. The human HCCs were divided into the CD133-high group (top 40%) and the CD133-low group (bottom 40%) according to the level of CD133 mRNA. The CD133-high group showed relatively frequent vascular invasion and significantly higher expression of invasion-associated genes [uPAR (p = 0.002), MMP1 (p = 0.01), and MMP2 (p = 0.003)] and EMT regulators [Snail (p = 0.002) and Twist (p = 0.0003)] compared to the CD133-low group. In conclusion, our results suggest that there is a subtype of HCC with high expression of CD133, which might have more invasive characteristics by up-regulation of invasion-associated genes and EMT-associated genes.     

Nomenclature of prominin-1 (CD133) splice variants - an update

Prominin-1 (CD133), a pentaspan membrane glycoprotein that constitutes an important cell surface marker of various, either normal or cancerous, stem cell populations is widely used to isolate or characterize such cells in different systems. Occurring throughout the metazoan evolution with a remarkably conserved genomic organization, it may be expressed as different splice variants with distinctive characteristics. A rational nomenclature has been proposed earlier for their consistent designation across species. Although generally accepted, it seems to be misunderstood in view of the recent report of novel prominin-1 complementary DNAs in rhesus monkey and humans with improper naming. As this may lead to confusion, we have reexamined the genomic organization of prominin-1 in various primates to provide an update that should further clarify the rationale of the nomenclature for prominin-1 gene products. This report comprises (i) the determination of the genomic organization of prominin-1 gene in two non-human primates, i.e. Macaca mulatta and Pan troglodytes, commonly used in research, (ii) the mapping of a new exon that creates an alternative cytoplasmic C-terminal end of prominin-1, (iii) the identification of various potential PDZ-binding domains generated by alternative cytoplasmic C-terminal tails, suggesting that different prominin-1 splice variants might interact with distinct protein partners, and (iv) a summing up of the different prominin-1 splice variants.     

CD133 as a biomarker for putative cancer stem cells in solid tumours: limitations,problems and challenges

The cancer stem cell (CSC) hypothesis, despite the limitations of the currently available models and assays, has ushered in a new era of excitement in cancer research. The development of novel strategies for anti‐tumour therapy relies on the use of biomarkers to identify, enrich, and/or isolate the cell population(s) of interest. In this context, various cell characteristics and antigen expression profiles are discussed as surrogate markers. The cell surface expression of the human prominin‐1 (CD133) antigen, in particular of the AC133 epitope, is among those that have been most frequently studied in solid cancers, although no mechanism has yet been proposed to link CD133 expression with the CSC phenotype. Some inconsistencies between published data can be ascribed to different analytical tools as well as methodological limitations and pitfalls, highlighted in the present review. Therefore, a comprehensive overview on the current state of knowledge in this growing and exciting field with an emphasis on the most recent studies is presented. We highlight the link between the tumour microenvironment, tumour cell plasticity, and CD133 expression, and evaluate the utility of CD133 expression as a prognostic marker. Copyright © 2012 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.     

CD133和CD44在结直肠癌细胞中的表达及其与患者5年生存率的相关性分析

目的: 探讨不同CD133/CD44细胞亚群的成瘤能力及CD133、CD44的表达水平对根治性结直肠癌患者术后生存率的影响,明确CD133和CD44作为结直肠癌肿瘤干细胞表面标志物的意义。方法: 利用流式细胞术分选出SW480细胞系中CD133和CD44标记的不同细胞亚群,比较其在裸鼠皮下成瘤情况;并利用免疫组化的方法观察CD133和CD44在90例结直肠癌患者石蜡切片标本的表达情况,对CD133、CD44与患者临床病理资料及生存率进行分析。结果: CD133⁺CD44⁺细胞群成瘤能力明显优于其它各组。CD133和CD44均在细胞膜上表达,两者均与患者性别、年龄 、肿瘤位置、肿瘤大小、浸润深度、淋巴结转移、肝转移、肿瘤分化程度及UICC分期无关(P＞0.05)。Kaplan-Meier生存分析法显示,CD133高表达组5年生存率为45.2%,CD133低表达组5年生存率为83.8%,两者有明显差异(P＜0.01);而CD44高表达组5年生存率(75.6%)与低表达组(70.1%)无明显差异(P＞0.05);其中CD133/CD44同时高表达者5年生存率明显较差(P＜0.01)。Cox风险回归模型分析结果表明,CD133、肝转移、分化程度及淋巴结转移是影响结直肠癌患者预后的几个独立危险因素(P＜0.05)。结论: CD133可作为结直肠癌肿瘤干细胞的良好标志物。CD133是影响结直肠癌患者预后的独立危险因素,其表达水平越高,预后越差;尽管CD44与结直肠癌患者预后无明显相关性,但联合检测CD133/CD44却能更好地判断患者的预后情况。     

人鼻咽癌细胞株分选CD133~+细胞实验研究

目的观察CD133在人鼻咽癌细胞株中的表达,探讨CD133+肿瘤细胞的体外增殖及分化能力从而确定鼻咽癌肿瘤干细胞的标志。方法使用免疫细胞化学及流式细胞技术检测鼻咽癌CNE2Z细胞株中的表达,免疫磁珠分选技术纯化肿瘤细胞,体外培养,观察其增殖及分化能力。结果鼻咽癌CNE2Z细胞株中有0.168%呈微量阳性表达,利用免疫磁珠分选技术纯化细胞的百分比为87.2%,免疫磁珠富集的CD133+肿瘤细胞在无血清培养基中1、3、5、7天的吸光度均高于相同条件下未分选细胞和CD133-细胞;CD133+在培养体系中的比例逐日下降,至培养的第12天,由第1天的87.2%下降至0.1%。结论鼻咽癌CNE2Z细胞株中,CD133+癌细胞有比其他细胞亚群强的体外分化和增殖能力,具有自我更新、生成其他表型肿瘤细胞等干细胞样特性,CD133可能是肿瘤起始细胞的标志之一。     

The Utility and Limitations of Neurosphere Assay,CD133 Immunophenotyping and Side Population Assay in Glioma Stem Cell Research

The newly proposed glioma stem cell (GSC) hypothesis may re‐model the way we diagnose and treat the tumor, which highlights the need for a complete knowledge on the genetic and epigenetic “blueprints” of GSCs. To identify the true “stemness” signatures, pure GSC populations are primarily needed. Reliable in vitro methods enriching for GSCs and thereby identifying the key stem‐like characteristics constitute the preliminary step forward. We discuss in this review the current widely used methods for enriching and isolating GSCs, namely neurosphere assay, CD133 Immunophenotyping and side population assay, and detail their limitations and potential pitfalls that could complicate interpretation of corresponding results.     

5氟尿嘧啶上调干细胞标记物CD133在结肠癌细胞中的表达

目的: 研究通过5氟尿嘧啶(5-FU)对结肠癌干细胞标记物CD133表达的影响,探讨5-FU对结肠癌干细胞的影响。方法: 用流式细胞仪检测CD133在结肠癌细胞株表面的表达, 磁珠细胞分离的方法分离结肠癌细胞株DLD1中CD133阳性和阴性的细胞群,细胞克隆形成实验检测2群细胞的自我更新能力,新型四唑氮盐方法(MTS)检测2群细胞对5-FU敏感性的差异,qPCR方法检测5-FU处理结肠癌细胞后CD133mRNA水平的变化。结果: 结肠癌细胞株DLD1、HT29、SW480、HCT116、Lovo、RKO细胞表面CD133的表达率分别为30.20%、82.00%、0.34%、91.80%、85.30%、0.28%。DLD1细胞中以CD133为标记有2群明显的细胞,MACS方法分离后阳性细胞群中CD133为87.21%±5.33%, 而阴性细胞群中阴性细胞的比例为84.30%±4.65%;CD133阳性的细胞与未分离及CD133阴性细胞相比,克隆形成能力强(46.33%±4.44% vs 31.00%±2.00%,P<0.05),对5-FU的敏感性下降20%,P<0.01。在DLD1和HT29细胞中,5-FU 1 mg/L上调CD133mRNA水平的表达,从1升为1.684±0.012(P<0.01)、HT29细胞从30.702±0.284升为49.379±0.460(P<0.01)。结论: 与CD133阴性细胞相比CD133阳性细胞克隆形成能力强,对5-FU的敏感性下降;5-FU上调干细胞标记物CD133mRNA水平的表达,CD133阳性的结肠癌干细胞在5-FU的治疗过程中被富集。     

CD133与SLC7A11在NSCLC中的表达及其与病理特征的关系

目的 探讨CD133及SLC7A11在非小细胞肺癌（NSCLC）组织及邻近正常肺组织中的表达及临床意义。方法 选取2015年1月~2019年7月我院经病理科确诊的NSCLC组织标本42例,并选取病理证实无癌细胞浸润的邻近正常肺组织标本（距癌组织＞5 cm）30例,比较NSCLC组织和邻近正常肺组织中CD133和SLC7A11阳性率表达、CD133及SLC7A11阳性表达与临床病理的关系及其在NSCLC组织中共表达关系。结果 NSCLC组织中CD133、SLC7A11阳性率为57.14%、64.29%,高于邻近正常肺组织的10.00%、6.67%,差异有统计学意义（P＜0.05）。不同分化程度、淋巴结转移、TNM分期癌组织中CD133、SLC7A11阳性表达比较,差异有统计学意义（P＜0.05）;不同性别、年龄、组织学类型癌组织中的CD133、SLC7A11阳性表达比较,差异无统计学意义（P＞0.05）。24例CD133阳性表达中,有21例SLC7A11阳性表达;18例CD133阴性表达中,有12例SLC7A11阴性表达,CD133、SLC7A11在NSCLC中的表达呈正相关（r=0.532,P＜0.05）。结论 CD133、SLC7A11在NSCLC中的高表达与癌组织的恶性行为及患者较差预后密切相关,对NSCLC早期诊断和靶向治疗具有重要意义。