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Cancer stem cell markers are associated with adverse biomarker profiles and molecular subtypes of breast cancer

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Abstract

Cumulative evidence has demonstrated the presence of cancer stem cells (CSC) in breast cancer and its putative role in cancer progression. Nonetheless, the clinical significance of CSC in breast cancer remains elusive. The underlying reasons could be due to the heterogeneity of breast cancer subtypes as well as different markers used to define breast CSC. In this study, three widely used markers (aldehyde dehydrogenase (ALDH)1+ and CD24−CD44+) were used to define two populations of CSC in a large cohort of breast cancers. The expressions of these markers were correlated with different clinicopathological features and the molecular subtypes. ALDH1+ breast cancers were associated with basal-like and HER2-overexpressing subtypes and the characteristics histologic features were related to these two subtypes. On the other hand, CD24−CD44+ breast cancers were associated positively with the presence of extensive in situ component, the absence of lymph node involvement, and basal markers, but negatively with HER2. CD24−CD44+ breast cancers were also positively associated with luminal B cancers. As the expression of CSC markers varied among different molecular subtypes and different clinicopathological features, it appeared that each CSC population could have distinct clinical values in different subgroups of breast cancers. For improved prognostication with CSC, combining the analysis of CSC markers would be required. Within the luminal cancers, CSC appeared to identify cancers with poor outcome. The presence of CSC populations was associated with ER−PR+ cancers and tumors expressing basal markers. Basal marker expression can complement with CSC for improved indicator for poor prognosis in luminal breast cancers. For the first time, the possible contribution of CSC to these aggressive luminal cancers was demonstrated. The association of basal features and CSC in luminal cancers also raised the possibility that luminal cancer cells may acquire basal phenotype and CSC properties together during their progression.

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Authors and Affiliations

  1. Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Ngan Shing Street, Shatin, NT, Hong Kong

    Julia Y. S. Tsang, Yun-Bi Ni & Gary M. Tse

  2. Department of Pathology, Shenzhen Second People Hospital, Shenzhen, China

    Yu-Hua Huang

  3. Department of Pathology, Peking University Shenzhen Hospital, Shenzhen, China

    Ming-Hua Luo

  4. Department of Pathology, Kwong Wah Hospital, Kowloon, Hong Kong

    Siu-Ki Chan

  5. Department of Pathology, Union Hospital, Hong Kong, Hong Kong

    Philip C. W. Lui & Alex M. C. Yu

  6. Department of Pathology, Singapore General Hospital, Singapore, Singapore

    Puay Hoon Tan

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  1. Julia Y. S. Tsang
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Correspondence to Gary M. Tse.

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Tsang, J.Y.S., Huang, YH., Luo, MH. et al. Cancer stem cell markers are associated with adverse biomarker profiles and molecular subtypes of breast cancer. Breast Cancer Res Treat 136, 407–417 (2012). https://doi.org/10.1007/s10549-012-2271-6

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  • DOI: https://doi.org/10.1007/s10549-012-2271-6

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