Clinical significance of CD44 and EPCR mRNA expression in breast cancer

doi:10.3877/cma.j.issn.1674-0785.2018.09.003

Abstract

Abstract:

Objective

To detect the expression of the stem cell markers CD44 and EPCR in breast cancer and analyze their correlation with clinicopathological parameters.

Methods

Quantitative real-time PCR (qRT-PCR) was performed to measure the expression of CD44 and EPCR mRNAs in invasive breast carcinoma of no special type (IBC-NST) tissues and matched normal breast tissues from 46 women.

Results

The expression level of CD44 mRNA was significantly higher in IBC-NST than in adjacent normal tissues (t=2.486, P=0.017), in ER- IBC-NST than in ER+ IBC-NST tissues (t=-2.332, P=0.024), and in normal breast-like triple negative IBC-NST than in non-normal breast-like triple negative IBC-NST tissues(t=-4.209, P<0.01). However, there was no significant correlation between CD44 expression and patient age, tumor size, histological grade, clinical stage, or lymph node metastasis (P>0.05). The expression level of EPCR mRNA in IBC-NST tissues was significantly higher than that in adjacent normal tissues (t=4.028, P<0.01). The expression of EPCR mRNA was significantly related to tumor size (t=2.998, P<0.01), histological grade (t=4.082, P<0.01), lymph node metastasis (t=2.152, P=0.037), clinical stage (t=-2.378, P=0.022), ER status (t=-5.585, P<0.01), PR status (t=-3.896, P<0.01), and Ki-67 index (t=2.197, P=0.033), but not to patient age and HER-2 status (P>0.05). In addition, the expression level of EPCR mRNA was significantly higher in triple negative (especially basal-like subtype) than in non-triple negative tissues (t=9.163, P<0.01), and in luminal B IBC-NST than in non-luminal B IBC-NST tissues (t=9.163, P<0.01; t=3.653, P=0.003). There was a positive correlation between CD44 and EPCR mRNA expression (r_s=0.540, P<0.01).

Conclusion

The expression of the stem cell markers CD44 and EPCR in breast cancer is significantly higher and positively correlated in IBC-NST, but the expression of EPCR is associated with more clinicopathological features, suggesting that EPCR can better predict lymph node metastasis and a poor prognosis in breast cancer. It is speculated that CD44 and EPCR may represent respective markers of two different types of breast cancer stem cells.

Key words: Cancer stem cell, Breast neoplasm, CD44, EPCR, Real-time fluorescence quantitative PCR

Minghua Luo, Jing Ye, Zeng Zhang, Xianglan Jin, Weihua Yin. Clinical significance of CD44 and EPCR mRNA expression in breast cancer[J]. Chinese Journal of Clinicians(Electronic Edition), 2018, 12(09): 492-499.

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Figures/Tables 6

References 24

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临床病理参数		例数	CD44mRNA相对表达量	t值	P值
年龄（岁）		?	?	-0.451	0.654
?	≤50	23	7.49±2.84	?	?
?	>50	23	6.03±1.56	?	?
肿瘤大小（cm）		?	?	1.447	0.155
?	≤2	20	4.14±1.35	?	?
?	>2	26	8.78±2.60	?	?
淋巴结转移		?	?	1.266	0.212
?	无	19	4.35±1.64	?	?
?	有	27	8.46±2.46	?	?
pN		?	?	-0.39	0.698
?	0/1	35	7.12±2.07	?	?
?	2/3	11	5.63±1.38	?	?
临床分期		?	?	-0.665	0.509
?	Ⅰ期	11	4.842±2.431	?	?
?	Ⅱ/Ⅲ期	35	7.365±1.975	?	?
组织学分级		?	?	1.063	0.294
?	Ⅰ/Ⅱ级	26	5.27±2.18	?	?
?	Ⅲ级	20	8.71±2.36	?	?
?	ER	?	?	-2.332	0.024
?	阴性	11	13.14±3.76	?	?
?	阳性	35	4.76±1.64	?	?
PR		?	?	-1.405	0.167
?	阴性	17	9.68±2.72	?	?
?	阳性	29	5.05±1.95	?	?
HER2		?	?	-1.71	0.098
?	阴性	25	9.06±2.80	?	?
?	阳性	21	4.02±0.93	?	?
Ki-67		?	?	0.854	0.398
?	<30%	10	4.15±2.40	?	?
?	≥30%	36	7.49±1.94	?	?

临床病理参数		例数	CD44mRNA相对表达量	t值	P值
年龄（岁）		?	?	-0.451	0.654
?	≤50	23	7.49±2.84	?	?
?	>50	23	6.03±1.56	?	?
肿瘤大小（cm）		?	?	1.447	0.155
?	≤2	20	4.14±1.35	?	?
?	>2	26	8.78±2.60	?	?
淋巴结转移		?	?	1.266	0.212
?	无	19	4.35±1.64	?	?
?	有	27	8.46±2.46	?	?
pN		?	?	-0.39	0.698
?	0/1	35	7.12±2.07	?	?
?	2/3	11	5.63±1.38	?	?
临床分期		?	?	-0.665	0.509
?	Ⅰ期	11	4.842±2.431	?	?
?	Ⅱ/Ⅲ期	35	7.365±1.975	?	?
组织学分级		?	?	1.063	0.294
?	Ⅰ/Ⅱ级	26	5.27±2.18	?	?
?	Ⅲ级	20	8.71±2.36	?	?
?	ER	?	?	-2.332	0.024
?	阴性	11	13.14±3.76	?	?
?	阳性	35	4.76±1.64	?	?
PR		?	?	-1.405	0.167
?	阴性	17	9.68±2.72	?	?
?	阳性	29	5.05±1.95	?	?
HER2		?	?	-1.71	0.098
?	阴性	25	9.06±2.80	?	?
?	阳性	21	4.02±0.93	?	?
Ki-67		?	?	0.854	0.398
?	<30%	10	4.15±2.40	?	?
?	≥30%	36	7.49±1.94	?	?

分子亚型		CD44mRNA相对表达量		t值	P值
分子亚型		例数	±s	t值	P值
Luminal A型	-	43	7.04±1.71	0.641	0.525
Luminal A型	＋	3	2.84±2.03	?	?
Luminal B型	-	14	10.93±3.17	1.755	0.086
Luminal B型	＋	32	4.94±1.79	?	?
HER2过表达型	-	41	6.62±1.78	-0.244	0.809
HER2过表达型	＋	5	7.89±2.74	?	?
三阴型	-	40	5.15±1.48	2.776	0.008
三阴型	＋	6	17.51±6.19	?	?
基底样型	-	44	6.99±1.67	0.684	0.497
基底样型	＋	2	1.57±0.92	?	?
正常乳腺样型	-	42	4.98±1.41	-4.209	0.001
正常乳腺样型	＋	4	25.47±5.67	?	?

分子亚型		CD44mRNA相对表达量		t值	P值
分子亚型		例数	±s	t值	P值
Luminal A型	-	43	7.04±1.71	0.641	0.525
Luminal A型	＋	3	2.84±2.03	?	?
Luminal B型	-	14	10.93±3.17	1.755	0.086
Luminal B型	＋	32	4.94±1.79	?	?
HER2过表达型	-	41	6.62±1.78	-0.244	0.809
HER2过表达型	＋	5	7.89±2.74	?	?
三阴型	-	40	5.15±1.48	2.776	0.008
三阴型	＋	6	17.51±6.19	?	?
基底样型	-	44	6.99±1.67	0.684	0.497
基底样型	＋	2	1.57±0.92	?	?
正常乳腺样型	-	42	4.98±1.41	-4.209	0.001
正常乳腺样型	＋	4	25.47±5.67	?	?

临床病例参数		例数	EPCRmRNA相对表达量	t值	P值
年龄（岁）		?	?	0.172	0.864
?	≤50	23	3.97±0.95	?	?
?	>50	23	4.17±0.62	?	?
肿瘤大小（cm）		?	?	2.998	0.005
?	≤2	20	2.44±0.45	?	?
?	>2	26	5.33±0.85	?	?
淋巴结转移		?	?	2.152	0.037
?	无	19	2.69±0.72	?	?
?	有	27	5.04±0.76	?	?
临床分期		?	?	-2.378	0.022
?	Ⅰ期	11	1.817±0.703	?	?
?	Ⅱ/Ⅲ期	35	4.780±0.660	?	?
组织学分级		?	?	4.082	<0.01
?	Ⅰ/Ⅱ级	26	2.21±0.29	?	?
?	Ⅲ级	20	6.49±1.01	?	?
ER		?	?	-5.585	<0.01
?	阴性	11	9.37±1.22	?	?
?	阳性	35	2.41±0.25	?	?
PR		?	?	-3.896	0.001
?	阴性	17	6.98±1.16	?	?
?	阳性	29	2.37±0.26	?	?
HER2		?	?	-1.034	0.308
?	阴性	25	4.57±0.94	?	?
?	阳性	21	3.48±0.49	?	?
Ki-67		?	?	2.197	0.033
?	<30%	10	1.84±0.58	?	?
?	≥30%	36	4.69±0.66	?	?

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