Expression Of CD133，Nestin，CD44and ALDH1A1in Endometrial Hyperplasia And Type I Endometrial Tumor

Study Backgroud Present study shows that cancer stem cells (CSCs)exist in all kinds of carcinomas. CSCs are a small proportion of thetoumor cells with the properties of self-renewal，multipotentdifferentiation and tumorigenic capacity in vivo，and closely related to thetumor occurrence，development，metastasis and recurrence. So are theendometrial cancer stem cells, which are, however, lack of the specificsurface markers. And it is little known about their biological function inthe development of endometrial cancer.Objective To investigate the expression of CSC markers CD133,Nestin, CD44and ALDH1A1in the development of endometrial cancer，and to approach the probable functions of the CSC markers above, westudied the expression of four CSC markers in endometrial hyperplasiaand type I endometrial cancer.Methods Eighty-six cases of paraffin tissue samples were studied frompatients who underwent hysterectomy or diagnostic dilatation&curettagein the Department of Obstetrics and Gynecology of Shanghai NinthPeople’s Hospital Affiliated to Shanghai Jiaotong University, School ofMedicine from May2003to December2010，including15cases of proliferative endometrium (group A),24cases of simple and complexendometrial hyperplasia (group B),23cases of atypical endometrialhyperplasia(group C) and24cases of type I endometrial carcinoma(group D). All subjects were pathologically diagnosed with completelyclinical data. Then the expression of CD133, Nestin, ALDH1A1andCD44were detected in the four groups by means of immunohistochem-istry tissue microarray，and to analyze their relationship with clinicalpathological parameters of endometrial cancer such as FIGO stage,histologic grade and depth of myometrial invasion.Results It was found that the positive rates of CD133, CD44andALDH1A1were gradually increased from groups A to D, but the positiveexpression of Nestin firstly increased from groups A to C, and thendecreased in group D. The positive expression of CD133in group C orgroup D was significantly higher than that in group A or group Brespectively(p＜0.05)，while between groups C and D, and betweengroups A and B，there is no statistically significant difference (P>0.05).The positive expression of CD44in group D was significantly higher thanthat in group A or group B (p<0.0.5)，and there was statisticallysignificant difference between group B, group C and group A (p<0.05).While between group C and D, and between group B and C，there is nostatistically significant difference (p>0.05). The positive expression ofNestin in group B or group C was significantly higher than that in group A or group D respectively (p<0.05). But there was no statisticallysignificant difference between group A and group D (p>0.05)，and it wasthe same between group B and group C(p>0.05). The positiveexpression of ALDH1A1in group D was significantly higher than that ingroup A(p<0.05), and there was no statistically significant differencebetween other groups(p>0.05).Conclusions1. Their high expression of CSC markers CD133, Nestin, CD44andALDH1A1in endometrial hyperplasia, atypical endometrial hyperplasiaand endometrial cancer suggested that they may play a certain role in theinitiation and development of endometrial cancer.2. The expression of CD133and ALDH1A1rather than CD44wascorrelated to the tumor prognosis in type I endometrial cancer. ThereforeCD133and ALDH1A1may be further studied as the prognosticindicators.3. The expression of Nestin in precancerous lesions such as simple,complex endometrial hyperplasia and atypical endometrial hyperplasiasuggests it may play a role in precancerous process. However its lowerexpression in endometrial cancer was unclear and need further studing.