title: Clinicopathological significance of CD133 and CD44 expression in infiltrating ductal carcinoma and their relationship to angiogenesis.
abstract: BACKGROUND
  Breast cancer is the leading cause of cancer death in females worldwide, and the majority type is infiltrating ductal carcinoma (IDC). Most of IDC patients died of metastasis and recurrence. Cancer stem cells (CSCs) are defined with the ability to be self-renewal and potentially promote proliferation and formation of tumors. CSCs are related to angiogenesis and are important targets in new cancer treatment strategies. In this study, we purposed to investigate on expression and clinical significances of CSCs marked by CD133 and CD44 in IDC and their relationship to angiogenesis.
  
  
  METHODS
  The specimens of IDC from 325 Chinese patients with follow-up were analyzed for CD133, CD44, CD82, and CD34 protein expression by immunohistochemical staining. The Pearson chi-square test and t test were used to assess the associations among the positive staining of these markers and clinicopathological characteristics. Postoperative overall survival time in these patients with IDC was analyzed by univariate and multivariate analyses.
  
  
  RESULTS
  In IDC tissues, positive rates of 48.6%, 53.8%, and 42.2% were obtained for CD133, CD44, and CD82 protein, respectively; the mean score of microvessel density (MVD) was 20.5 ± 7.0 in IDC group. And there was a significant difference between the two groups. There was a positive relationship between the expression of CD133, CD44, and the score of MVD and the grades of tumor, lymph node metastasis, tumor-node-metastasis (TNM) stages (all P < 0.05); and the expression of CD82 was negatively related to grades of tumor, lymph node metastasis, and TNM stages (all P < 0.05). The overall mean survival time of the patients with CD133, CD44, and the score of MVD (≥21) positive expression was lower than that of patients with negative expression. The overall mean survival time of patients of CD82-positive expression was longer than that of patients of the negative expression group. The positive expression of CD133 and CD82, and TNM stages were independent prognostic factors of IDC (P < 0.05).
  
  
  CONCLUSIONS
  CSCs, angiogenesis, and aberrant expression of CD82 may be involved in the initiation, development, metastasis, and recurrence. It is suggested that CSCs, angiogenesis, and CD82 be possible as a therapeutic marker for anti-tumor therapy.
authors.affiliation: Department of Medical Oncology, The Second Affiliated Hospital of Anhui Medical University, No. 687, Furong Road, Hefei, 230000, Anhui Province, China. 1607080464@qq.com.|Department of Medical Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, 233000, Anhui Province, China. 1607080464@qq.com.
authors.forename: Zhengquan
authors.initials: Z
authors.lastname: Han
authors.affiliation: Department of Medical Oncology, The Second Affiliated Hospital of Anhui Medical University, No. 687, Furong Road, Hefei, 230000, Anhui Province, China. chenzhendong@csco.org.cn.
authors.forename: Zhendong
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Medical Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, 233000, Anhui Province, China. zhengrongsheng2011@163.com.
authors.forename: Rongsheng
authors.initials: R
authors.lastname: Zheng
authors.affiliation: Department of Pathology, The First Affiliated Hospital of Bengbu Medical College of Bengbu Medical College, No. 287 Changhuai Road, Bengbu, 233000, Anhui Province, China. cheng_li958@sohu.com.
authors.forename: Zenong
authors.initials: Z
authors.lastname: Cheng
authors.affiliation: Department of Pathology, The First Affiliated Hospital of Bengbu Medical College of Bengbu Medical College, No. 287 Changhuai Road, Bengbu, 233000, Anhui Province, China. 1051807365@qq.com.
authors.forename: Xiaomeng
authors.initials: X
authors.lastname: Gong
authors.affiliation: Department of Pathology, The First Affiliated Hospital of Bengbu Medical College of Bengbu Medical College, No. 287 Changhuai Road, Bengbu, 233000, Anhui Province, China. 582812127@qq.com.
authors.forename: Danna
authors.initials: D
authors.lastname: Wang
mesh_terms: D000071916:AC133 Antigen; D000328:Adult; D000368:Aged; D015703:Antigens, CD; D001943:Breast Neoplasms / Q000098:blood supply / Q000378:metabolism / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000098:blood supply / Q000378:metabolism / Q000556:secondary*; D005260:Female; D005500:Follow-Up Studies; D006023:Glycoproteins; D006801:Humans; D018960:Hyaluronan Receptors; D008207:Lymphatic Metastasis; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D014411:Neoplastic Stem Cells / Q000378:metabolism / Q000473:pathology*; D009389:Neovascularization, Pathologic / Q000378:metabolism / Q000473:pathology*; D010455:Peptides; D011379:Prognosis; D055815:Young Adult
chemical_list: D000071916:AC133 Antigen; D015703:Antigens, CD; C497483:CD44 protein, human; D006023:Glycoproteins; D018960:Hyaluronan Receptors; C000606023:PROM1 protein, human; D010455:Peptides