title: Relationship of CD44+CD24-/low breast cancer stem cells and axillary lymph node metastasis.
abstract: BACKGROUND
  Axillary node staging plays an important role in the prognostic evaluation and planning of adjuvant treatment. Breast cancer stem cells, identified on the basis of CD44+CD24-/low expression, are associated with metastases and drug resistance. It is therefore important to investigate the proportion of CD44+CD24-/low breast cancer stem cells for the diagnosis of metastases in axillary nodes.
  
  
  METHODS
  Thirty-two ipsilateral axillary lymph nodes were collected from patients diagnosed with invasive breast cancer. Each lymph node (LN) was divided into two equals - one was examined by H&E staining, while the other was made into a single cell suspension to study the content of CD44+CD24-/low cells by flow cytometry (FCM). The relationship was investigated between the content of CD44+CD24-/low cells and metastases in axillary nodes which were confirmed by histology. Associations were tested using the chi-square test (linear-by-linear association), and the significance level was set at a value of p < 0.05.
  
  
  RESULTS
  In the 32 axillary nodes, the level of CD44+CD24-/low cells was determined to be between 0 and 18.4%: there was no presence of CD44+CD24-/low cells in 9 LNs, of which 2 had confirmed metastasis; there were less than 10% CD44+CD24-/low cells in 12 LNs, of which 6 had confirmed metastasis; and there were more than 10% CD44+CD24-/low cells in 11 LNs, of which 9 had confirmed metastasis. A higher percentage of detected CD44+CD24-/low cells was significantly associated with more confirmed LN metastases (p = 0.009).
  
  
  CONCLUSIONS
  CD44+CD24-/low breast cancer stem cells might help clinicians to determine the presence of LN metastases. However, its prognostic value remains unclear, while histological diagnosis is still the gold standard.
authors.affiliation: Department of Breast Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China. rxwei1123@163.com
authors.forename: Wei
authors.initials: W
authors.lastname: Wei
authors.forename: Hui
authors.initials: H
authors.lastname: Hu
authors.forename: Haosheng
authors.initials: H
authors.lastname: Tan
authors.forename: Louis W C
authors.initials: LW
authors.lastname: Chow
authors.forename: Adrian Y S
authors.initials: AY
authors.lastname: Yip
authors.forename: Wings T Y
authors.initials: WT
authors.lastname: Loo
mesh_terms: D000328:Adult; D000368:Aged; D001365:Axilla / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology*; D051927:CD24 Antigen / Q000378:metabolism*; D005260:Female; D006801:Humans; D018960:Hyaluronan Receptors / Q000378:metabolism*; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology*; D008875:Middle Aged; D014411:Neoplastic Stem Cells / Q000473:pathology*; D013194:Staining and Labeling; D055815:Young Adult
chemical_list: D051927:CD24 Antigen; D018960:Hyaluronan Receptors