ALDH1+、CD44+/CD24-重叠与乳腺癌基因亚型和临床因素相关性研究

 目的比较ALDH1⁺和CD44⁺/CD24^-做为人乳腺癌干细胞标志物时在基因亚型中的分布和与临床相关因素方面的异同，并了解两种标志物互补后在基因亚型中的分布和临床因素的相关性。方法采用免疫组织化学单染、双染技术检测203例未接受放化疗乳腺癌患者肿瘤组织中重叠表达ALDH1⁺、CD44⁺/CD24^-表型的情况。结果所有乳腺癌组织中重叠表达ALDH1⁺/CD44⁺/CD24^-表型为5.4%，主要存在于HER-2（18.2%）型和Triple negativ型（45.5%），病理类型主要为浸润性导管癌，2年无病生存率低于其它表型（P <0.05）。结论只有很小一部分乳腺癌患者为ALDH1⁺/CD44⁺/CD24^-/low表型，主要存在于Triple negative型，病理类型主要为浸润性导管，2年无病生存率低。ALDH1⁺和CD44⁺/CD24^-可能标志不同层次的乳腺癌干细胞，未来采用免疫组织化学技术互补检测ALDH1⁺和CD44⁺/CD24^-可能预测患者预后。 结果显示，ALDH1⁺表达与乳腺癌患者的年龄、肿瘤大小、淋巴结状态、病理类型、ER，PR等临床相关变量分布差异无统计学意义（P >0.05），而与临床分期有关（P <0.05）；CD44⁺/CD24^-、ALDH1⁺/CD44⁺/CD24^-表型与乳腺癌患者的年龄、肿瘤大小、临床分期、淋巴结状态、ER，PR等临床相关因素分无明显相关性（P >0.05），而与病理类型有关（P <0.05），见表2。

Overlapped Expression of ALDH1~+,CD44~+/CD24~- in Breast Cancer and Its Correlation with Gene Subtypes and Clinical Factors

Objective To compare the differences and similarities of the breast cancer stem cell makers,ALDH1⁺ and CD44⁺/CD24^- ,in gene subtypes and clinical correlated factors,and to investigate the distribution in gene subtypes of the two complementary markers and the clinical correlation. Methods Double-staining immunohistochemistry (IHC) and single-staining IHC were applied to test the overlapped expression of ALDH1⁺ and CD44⁺/CD24^- phenotypes in cancer tissues of 203 breast cancer patients who had not received chemotherapy. Results 5.4% breast cancer patients showed overlapped expression of ALDH1⁺/CD44⁺/CD24^- phenotype which was mainly found in HER-2 type (18.2%) and Triple negative type (45.5%),with a main pathological type of invasive ductal carcinoma,and the 2-year disease-free survival rate was lower than other phenotypes (P<0.05). Conclusion Only a small part of the breast cancer patients were of ALDH1⁺/CD44⁺/CD24^-/low phenotype which mainly existed in Triple negative type,and the main pathological type was invasive ductal carcinoma,the 2-year disease-free survival rate was low. ALDH1⁺ and CD44⁺/CD24^- may mark different levels of breast cancer stem cells,therefore,ALDH1⁺ and CD44⁺/CD24^- detection by complementary immunohistochemical techniques may predict patient prognosis.