ABSTRACT
Introduction:
Cancer stem cells (CSC) within the
tumors play a central
role in
tumorigenesis. It is, thus, of utmost importance to identify these
cells to develop effective
cancer therapy.
Triple-Negative Breast Cancer (TNBC) is an aggressive molecular subtype of
breast cancer associated with poor
patient outcomes. The
role of CD44
immunohistochemistry (IHC) as a putative CSC in
breast carcinomas, particularly of the TNBC-subtype is ambiguous, with equivocal results. Aims and
Objectives:
The present study aims to assess the
role of CSC in
breast carcinoma by immunohistochemical
analysis of CD44 expression in TNBC. The
association of TNBC expressing CSC with histological grade as well as with
angiogenesis (using CD34 IHC) has been studied. Materials and
Methods:
Biopsy samples from 58
patients with infiltrating
ductal carcinoma, NST were studied. The
histology of the
tumor was sub-classified into grades 1–3. Based on immunohistochemical
analysis (ER, PR, HER2/Neu), the cases were divided into TNBC and NTNBC groups. The
tissue sections were also subjected to
analysis for CD44 to identify the CSC-
phenotype and CD34 to evaluate
angiogenesis, to determine the
microvascular density (MVD).
Results:
Out of the 58 cases in the study, 28 were TNBC and 30 were NTNBC. CSC
phenotype (CD44 positive) was expressed significantly higher in the TNBC (78%) versus the NTNBC (53%) (p-value 0.043). The MVD estimated using CD34 IHC was lower in the TNBC group in our study, though the difference was not statistically significant. A larger proportion of cases in TNBC showed a higher histological grade (35%) in comparison to NTNBC (27%). However, statistically, it was not significant.
Conclusion:
Our study demonstrated that CD44 as a CSC marker is seen significantly more in the TNBC category of invasive
ductal carcinomas. Further large-scale studies, to confirm these findings,
will be of potential
therapeutic and prognostic value.