Objective: To evaluate role of stem cell markers Aldh1a1, Cd133 and Oct 4 and its association with Epithelial Mesenchymal Transition (EMT) markers in breast cancer patients.
Materials and method: Total of 100 breast cancer patients were enrolled. These markers were studied by immunohistochemistry method and correlated with clinicopathological parameters, ER, PR, HER2 and disease status.
Results: Aldh1a1 expression was noted in 43% patients with breast cancer and higher incidence was found in patients with age >45 years (p=0.02), postmenopausal status, IDC+ mucinous carcinoma and papillary carcinoma histological type and ER positivity. Cd133 expression was noted in 87% patients with breast cancer and showed significant positive correlation with Oct 4 expression (p=0.002) and vimentin (p=0.003). Univariate survival analysis showed an association of Cd133 negative expression with reduced DFS and OS. Oct 4 expression was noted in 84% patients with breast cancer and associated with poor OS. In multivariate survival analysis, for DFS lymph node entered at step 1 and Cd133 negative expression entered at step 2. For OS, lymph node entered at step 1, Cd133 negative expression entered at step 2 and Oct 4 positive expression entered at step 3.
Conclusion: Cd133 and Oct 4 emerged as independent biomarkers to predict worse prognosis in breast cancer patients. Cd133 may have a role in EMT and could be used as a drug target.
