title: The clinicopathologic and prognostic significance of CD44+/CD24(-/low) and CD44-/CD24+ tumor cells in invasive breast carcinomas.
abstract: Cells with distinct phenotypes and stem cell-like properties have been reported to exist in breast cancer. The aim of the present study was to investigate the clinicopathologic and prognostic significance of the CD44(+)/CD24(-/low) and CD44(-)/CD24(+) tumor phenotypes' prevalence. Double immunohistochemistry was applied on a series of 155 paraffin-embedded breast tissue specimens to detect CD44 and CD24. Evaluation of the phenotypes was performed by image analysis. The prevalence of CD44(+)/CD24(-/low) and CD44(-)/CD24(+) tumor cells was 58.7% and 82.6%, respectively. The dominance of the CD44(+)/CD24(-/low) tumor cells was inversely associated with lymph node metastasis (P = .019) and tended to inversely associate with the stage of the disease (P = .068). Moreover, the prevalence of CD44(+)/CD24(-/low) was found to exert no significant impact on patients' prognosis although it displayed a tendency toward an increase in disease-free survival (P = .074). On the other hand, the prevalence of CD44(-)/CD24(+) tumor cells was found to have no clinicopathologic significance. However, it was found to exert an unfavorable impact on both relapse-free (P = .009) and overall survival (P = .046) of the patients with breast carcinomas of intermediate differentiation (grade 2). In breast tissue, CD44(+)/CD24(-/low) tumor cells seem to be associated with lack of lymph node metastasis and a tendency toward an increase of the relapse-free survival of the patients. On the contrary, tumor cells with the phenotype CD44(-)/CD24(+) seem to identify patients with worse disease-free and overall survival within the group of intermediate-grade differentiation patients whose prognosis is difficult to assess.
authors.affiliation: Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, GR-11527 Athens, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Mylona
authors.forename: Ioanna
authors.initials: I
authors.lastname: Giannopoulou
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Fasomytakis
authors.forename: Alexandros
authors.initials: A
authors.lastname: Nomikos
authors.forename: Christina
authors.initials: C
authors.lastname: Magkou
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Bakarakos
authors.forename: Lydia
authors.initials: L
authors.lastname: Nakopoulou
mesh_terms: D001943:Breast Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D051927:CD24 Antigen / Q000378:metabolism*; D018270:Carcinoma, Ductal, Breast / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D018275:Carcinoma, Lobular / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D018960:Hyaluronan Receptors / Q000378:metabolism*; D007091:Image Processing, Computer-Assisted; D007124:Immunoenzyme Techniques; D008198:Lymph Nodes; D008207:Lymphatic Metastasis; D008408:Mastectomy; D009361:Neoplasm Invasiveness; D015996:Survival Rate
chemical_list: D051927:CD24 Antigen; C497889:CD24 protein, human; C497483:CD44 protein, human; D018960:Hyaluronan Receptors