title: Immunological and Clinical Impact of Cancer Stem Cells in Vulvar Cancer: Role of CD133/CD24/ABCG2-Expressing Cells.
abstract: Cancer stem cells (CSCs) are tumour-initiating cells with self-renewal properties and chemo/radio-resistance. Regulatory T-cells (Tregs) influence CSCs through several mechanisms. In different solid tumours, the presence of both cell populations correlated with poor survival. In vulvar cancer, little is known regarding biological markers able to predict patient prognosis. We investigated the presence and clinical impact of CSCs and infiltrating Treg in primary vulvar cancer.
  
  
  
  Paraffin-embedded tissue specimens derived from 43 patients with vulvar cancer were analyzed by immunohistochemistry for the expression of prominin-1 (CD133), CD24, ATP-binding cassette sub-family G member 2 (ABCG2) (CSC markers) and forkhead box protein P3 (FOXP3) (Treg marker).
  
  
  
  CD133 expression correlated with younger age at diagnosis (p<0.01), lymph-node metastasis (p<0.05) and larger tumour diameter (p<0.05). CD133+tumours showed a high FOXP3+T-cell infiltration. Overall survival and progression-free survival were not influenced by the expression of the analyzed biomarkers.
  
  
  
  In vulvar cancer, CSCs were more frequently expressed in younger aged patients and those with aggressive disease. Their presence was also associated with high Treg infiltration, which contributes to the generation of an immunosuppressive milieu.
authors: Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
authors: Chiara
authors: C
authors: Napoletano
authors: Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy filippo.bellati@uniroma1.it.|Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.
authors: Filippo
authors: F
authors: Bellati
authors: Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.|Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome, Rome, Italy.
authors: Ilary
authors: I
authors: Ruscito
authors: Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome, Rome, Italy.
authors: Milena
authors: M
authors: Pernice
authors: Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
authors: Ilaria Grazia
authors: IG
authors: Zizzari
authors: Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
authors: Salvatore
authors: S
authors: Caponnetto
authors: Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome, Rome, Italy.
authors: Federica
authors: F
authors: Tomao
authors: Department of Gynaecology and Obstetrics, Papa Giovanni XXIII Hospital, Bergamo, Italy.
authors: Luigi
authors: L
authors: Frigerio
authors: Obstetrics and Gynaecology Unit, SS. Annunziata Hospital Chieti, G. d'Annunzio University Chieti-Pescara, Chieti, Italy.
authors: Marco
authors: M
authors: Liberati
authors: Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
authors: Aurelia
authors: A
authors: Rughetti
authors: Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.
authors: Donatella
authors: D
authors: Caserta
authors: Department of Gynecology, Obstetrics and Urology, Sapienza University of Rome, Rome, Italy.
authors: Pierluigi Benedetti
authors: PB
authors: Panici
authors: Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
authors: Marianna
authors: M
authors: Nuti
mesh_terms: D000071916:AC133 Antigen / Q000378:metabolism*; D000070997:ATP Binding Cassette Transporter, Subfamily G, Member 2 / Q000378:metabolism*; D000368:Aged; D000369:Aged, 80 and over; D051927:CD24 Antigen / Q000378:metabolism*; D005260:Female; D051858:Forkhead Transcription Factors / Q000378:metabolism*; D006801:Humans; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000378:metabolism*; D014411:Neoplastic Stem Cells / Q000378:metabolism*; D050378:T-Lymphocytes, Regulatory / Q000378:metabolism; D014846:Vulvar Neoplasms / Q000378:metabolism*
chemical_list: C116614:ABCG2 protein, human; D000071916:AC133 Antigen; D000070997:ATP Binding Cassette Transporter, Subfamily G, Member 2; D051927:CD24 Antigen; C497889:CD24 protein, human; C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors; D009363:Neoplasm Proteins; C000606023:PROM1 protein, human
keywords: ABCG2; CD133; CD24; Vulvar cancer; cancer stem cells