title: CD44+ cancer cells express higher levels of the anti-apoptotic protein Bcl-2 in breast tumours.
abstract: Breast tumours consist of phenotypically diverse populations of breast cancer cells of which only a minority has the ability to form new tumours. The capacity for breast tumour development has been shown to be restricted to breast cancer stem cells with the CD44+/CD24(-/low) phenotype. These cells can resist apoptosis through mechanisms such as the regulation of Bcl-2. Identification of this population of cells is important because of its implication in the development of new therapeutic strategies. One hundred and forty-six primary operable breast cancer patients were investigated in order to identify the population of CD44+ and Bcl-2+ cells in paraffin-embedded tissues by immunohistochemistry. The prevalence of these phenotypes was then correlated with clinicopathological features. CD44 and Bcl-2 expression was detected in 86% and 82% of breast tumours, respectively. There was no significant correlation between CD44+ tumour cell prevalence and tumour characteristics, whereas the prevalence of CD44+ cells was associated with higher levels of Bcl-2 expression (P = 0.004). In univariate analysis, Bcl-2 expression was correlated with breast tumours of lower grade (P < 0.001) and fewer lymphatic metastases (P < 0.05). Our findings suggest that the prevalence of CD44+ tumour cells as a subpopulation of breast cancer stem cells was of no clinicopathological significance, but was correlated with higher Bcl-2 expression. This population of tumour cells may thus be more resistant to apoptosis. Targeting these cells in combination with current treatments may be more effective in treating breast cancer patients.
authors.affiliation: Department of Pathology, Iran University of Medical Sciences, Tehran, Iran. zahra.madjd@yahoo.com
authors.forename: Zahra
authors.initials: Z
authors.lastname: Madjd
authors.forename: Ali Zare
authors.initials: AZ
authors.lastname: Mehrjerdi
authors.forename: Ali Mohammad
authors.initials: AM
authors.lastname: Sharifi
authors.forename: Saadat
authors.initials: S
authors.lastname: Molanaei
authors.forename: Shahriar Zohourian
authors.initials: SZ
authors.lastname: Shahzadi
authors.forename: Mohsen
authors.initials: M
authors.lastname: Asadi-Lari
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis / Q000276:immunology; D051017:Apoptosis Regulatory Proteins / Q000276:immunology* / Q000378:metabolism; D001943:Breast Neoplasms / Q000276:immunology* / Q000378:metabolism; D005260:Female; D006801:Humans; D018960:Hyaluronan Receptors / Q000276:immunology / Q000378:metabolism*; D008875:Middle Aged; D011379:Prognosis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000276:immunology / Q000378:metabolism*
chemical_list: D051017:Apoptosis Regulatory Proteins; D018960:Hyaluronan Receptors; D019253:Proto-Oncogene Proteins c-bcl-2