title: CD44+/CD24- cells and lymph node metastasis in stage I and II invasive ductal carcinoma of the breast.
abstract: The presence of tumor-initiating cells (CD44(+)/CD24(-)) in solid tumors has been reported as a possible cause of cancer metastasis and treatment failure. Nevertheless, little is know about the presence of CD44(+)/CD24(-) cells within the primary tumor and metastasis. The proportion of CD44(+)/CD24(-) cells was analyzed in 40 samples and in 10 lymph node metastases using flow cytometry phenotyping. Anti-human CD326 (EpCam; FITC), anti-human CD227 (MUC-1; FITC), anti-human CD44 (APC), and anti-human CD24 (PE), anti-ABCG2 (PE), and anti-CXCR4 (PeCy7) were used for phenotype analysis. The mean patient age was 60.5 years (range, 33-87 years); mean primary tumor size (pT) was 1.8 cm (0.5-3.5 cm). The Wilcoxon or Kruskal-Wallis test was used for univariate analyses. Logistic regression was used for multivariate analysis. The median percentage of CD44(+)/CD24(-) cells within primary invasive ductal carcinomas (IDC) was 2.7% (range, 0.2-71.2). In lymph node metastases, we observed a mean of 6.1% (range, 0.07-53.7). The percentage of CD44(+)/CD24(-) cells in IDCs was not associated with age, pT, tumor grade and HER2. We observed a significantly enrichment of CD44(+)/CD24(-) and ABCG2(+) cells in ESA(+) cell population in patients with positive lymph nodes (P = 0.02 and P = 0.04, respectively). Our data suggest that metastatic dissemination is associated with an increase in tumor-initiating cells in stage I and II breast cancer.
authors.affiliation: Department of Gynecology and Obstetrics, Breast Disease Division, Ribeirão Preto School of Medicine, University of São Paulo, 3900 Bandeirantes Ave, Ribeirão Preto, São Paulo 14048-900, Brazil. dtiezzi@usp.br
authors.forename: Daniel Guimarães
authors.initials: DG
authors.lastname: Tiezzi
authors.forename: Fernando Antonio Mourão
authors.initials: FA
authors.lastname: Valejo
authors.forename: Heitor Ricardo Cosinski
authors.initials: HR
authors.lastname: Marana
authors.forename: Hélio Humberto Angotti
authors.initials: HH
authors.lastname: Carrara
authors.forename: Luciana
authors.initials: L
authors.lastname: Benevides
authors.forename: Heriton Marcelo Ribeiro
authors.initials: HM
authors.lastname: Antonio
authors.forename: Renata Danielle
authors.initials: RD
authors.lastname: Sicchieri
authors.forename: Cristiane Maria
authors.initials: CM
authors.lastname: Milanezi
authors.forename: João Santana da
authors.initials: JS
authors.lastname: Silva
authors.forename: Jurandyr Moreira
authors.initials: JM
authors.lastname: de Andrade
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology*; D051927:CD24 Antigen / Q000032:analysis; D018270:Carcinoma, Ductal, Breast / Q000473:pathology*; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D018960:Hyaluronan Receptors / Q000032:analysis; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis / Q000473:pathology*; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D014411:Neoplastic Stem Cells / Q000473:pathology*
chemical_list: D051927:CD24 Antigen; D018960:Hyaluronan Receptors