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1. Dis Esophagus. 2012 Jan 11. doi: 10.1111/j.1442-2050.2011.01298.x. [Epub ahead of

Prognostic value of the stem cell markers CD133 and ABCG2 expression in
esophageal squamous cell carcinoma.

Hang D, Dong HC, Ning T, Dong B, Hou DL, Xu WG.

Laboratory of Genetic Department of Pathology, Key Laboratory of Carcinogenesis
and Translational Research (Ministry of Education), Peking University School of
Oncology, Beijing Cancer Hospital and Institute, Beijing Department of Surgical
Oncology, The Affiliated Hospital of Hebei United University, Tangshan, China.

In the light of increasing evidence supporting cancer stem cells (CSCs) theory,
the expression of two stem cell markers, CD133 and adenosine triphosphate-binding
cassette superfamily G member 2 (ABCG2), in esophageal squamous cell carcinoma
(ESCC) was investigated, and their prognostic values were evaluated.
Paraffin-embedded tissue sections of 110 ESCC patients were investigated using
Immunohistochemistry. The association of CD133 and ABCG2 expression with
clinicopathologic characteristics was analyzed by χ(2) test. Survival analysis
was carried out using Kaplan-Meier method and Cox proportional hazards model.
CD133 and ABCG2 expression were detected in 27.3% and 15.5% of ESCC patients,
respectively. The presence of CD133-positive cancer cells was associated with
tumor cell differentiation (P= 0.008) but not significantly related to the
survival of ESCC patients (P= 0.085). ABCG2 expression was not associated with
clinicopathologic characteristics but was a significant prognostic factor for
adverse overall survival of ESCC patients (P= 0.005). The median overall survival
time for ESCC patients with and without ABCG2 expression were 21.8 and >49.3
months, respectively. A combined analysis of CD133 and ABCG2 expression did not
show that ESCC patients with coexpression of these two markers had a worse
prognosis than those with only ABCG2 expression (P= 0.934). Moreover, ABCG2
expression was revealed to be an independent prognostic factor along with tumor
node metastasis stage in multivariate analysis (hazard ratio of ABCG2, 3.38; 95%
confidence interval, 1.61∼7.09; P= 0.001). By survival analysis based on tumor
node metastasis stage of ESCC, the association between ABCG2 expression and the
patients' prognosis was found significant in the group of relatively early stage
(P= 0.005) and marginally significant in the group of relatively late stage (P=
0.058). This is the first time to report the presence of CD133-positive cancer
cells in ESCC but not supporting its prognostic value and validity as a CSC
marker for ESCC. ABCG2 expression was found to correlate with the survival of
ESCC patients, especially those at relatively early stage, suggesting that
ABCG2-positive cancer cells may represent a pool of CSCs in ESCC, and relatively
early-stage patients with ABCG2 expression may deserve more intensive or targeted

© 2012 Copyright the Authors. Journal compilation © 2012, Wiley Periodicals, Inc.
and the International Society for Diseases of the Esophagus.

PMID: 22236447 [PubMed - as supplied by publisher]