Abstract
Introduction: Cancer stem-cell (CSC) theory of tumorigenesis has been established during the last decade. There are phenotypically different subpopulations of cells in found in HNSCC tissue including diverse cancer cells, stromal cells and infiltrating inflammatory cells. According to a CSC theory only a small subpopulation of tumor cells can reproduce themselves and sustain the tumor growth. CSC subpopulation can retain some of the markers (surface epitopes) typical for normal stem cells, the most often mentioned being CD44+, CD29+, CD24+ and CD133+ markers. Isolated CSCs can be transplanted to the immunodeficient animal host and drive a tumor growth.
Material and Methods: Peripheral blood samples together with primary tumor, metastatic and non-metastatic lymph node tissue samples were collected from 178 patients with primary HNSCC. We examined peripheral blood from all patients with the focus on lymphocyte subpopulation (CD3+, CD4+CD25+, CD4+/CD8+, CD19+, CD4+CD45RA+, CD8+CD28-, CD3-CD16+CD56+, CD4+CD25+Foxp3+, CD4+161+, CD8+161+) before the commencement of anti-tumor therapy. The level of the markers of cancer stem cells (CD44+, CD133+, CD29+) on the surface of the cancer cells, the infiltration of immunocompetent cells in the tumor microenvironment of specimens from primary tumors, from metastases to the neck lymph nodes and in control lymph nodes was measured, where samples were taken during the surgery. The correlation of cancer stem cells (CD44+, CD133+, CD29+) with the prognosis of the patient was analyzed with a special interest. Mean follow-up was 40 months.
Results: A significant representation of cells expressing characteristics of CSCs has been identified in the tumor microenvironment of HNSCC. Subpopulation of CD44 + keratinocytes directly correlated with the presence of negative histological features (angioinvasion, lymphangioinvasion, perineural spread) (p = 0.007), i.e. factors significantly influencing the patient´s prognosis (p = 0.03). Conversely, CD133 + cells in the primary tumor negatively correlated with N stage (p = 0.04), thus suggesting that a higher proportion of CD133 + keratinocytes in the primary tumor yields lower metastatic potential. Presence of CD44 + and CD29 + keratinocytes does not correlate with N stage (p = 0.8 respectively. P = 0.4).
Conclusion: Cells with CSCs characteristics can be shown in the HNSCC tumor tissue. Presence of certain subpopulations of keratinocytes (CD44+, CD133+) expressing the cell surface markers of CSCs can elucidate the patient´s prognosis. The therapy targeted to the cancer stem cells, in combination with immunotherapy, could increase the survival of the patients with HNSCC. Acknowledgements: The research was supported by AZV MZ CR (grant No. NV16-28594A and NV16-28600A)
Note: This abstract was not presented at the conference.
Citation Format: Michal Zabrodsky, Jan Bouček. Prognostic value of cancer stem cells (CSC) in head and neck squamous carcinoma (HNSCC) [abstract]. In: Proceedings of the Second CRI-CIMT-EATI-AACR International Cancer Immunotherapy Conference: Translating Science into Survival; 2016 Sept 25-28; New York, NY. Philadelphia (PA): AACR; Cancer Immunol Res 2016;4(11 Suppl):Abstract nr A141.