Spatial distribution of cancer stem cells in head and neck squamous cell carcinomas

• Published in: Journal of oral pathology & medicine Vol. 43; no. 7; pp. 499 - 506
• Main Authors: Hildebrand, Laura C., Carvalho, Ana L., Lauxen, Isabel S., Nör, Jacques E., Cerski, Carlos T. S., Sant'Ana Filho, Manoel
• Format: Journal Article
• Language: English
• Published: Frederiksberg Blackwell Publishing Ltd 01.08.2014; Wiley
• Subjects: Adult; Aged; aldehyde dehydrogenase; Biological and medical sciences; Biomarkers, Tumor - analysis; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - secondary; CD44; Dentistry; Disease Progression; Disease-Free Survival; Epithelium - pathology; Female; Follow-Up Studies; Head and Neck Neoplasms - pathology; head and neck squamous cell carcinomas; Humans; Hyaluronan Receptors - analysis; Hyperplasia; Isoenzymes - analysis; Male; Medical sciences; Middle Aged; Mouth Neoplasms - pathology; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Neoplasm Grading; Neoplasm Invasiveness; Neoplasm Staging; Neoplastic Stem Cells - pathology; Otorhinolaryngology (head neck, general aspects and miscellaneous); Otorhinolaryngology. Stomatology; Precancerous Conditions - pathology; Retinal Dehydrogenase - analysis; Survival Rate; Treatment Outcome; tumor-initiating cells; tumorigenesis; Tumors; head and neck squamous cell carcinomas; aldehyde dehydrogenase; Enzyme; Stomatology; Stem cell; tumor-initiating cells; ENT; Malignant tumor; Dehydrogenase; Spatial distribution; ENT disease; Head and neck cancer; Head and neck squamous cell carcinoma; Oxidoreductases; tumorigenesis; Tumor cell; CD44; Cancer
• ISSN: 0904-2512; 1600-0714
• DOI: 10.1111/jop.12169

Background CD44 and aldehyde dehydrogenase 1 (ALDH1) are considered putative markers of highly tumorigenic cells (i.e., cancer stem‐like cells) in head and neck squamous cell carcinomas. This small subset of cells is believed to be the primary responsible for tumor initiation and progression. The objectives of this study were (i) to evaluate the patterns of CD44 and ALDH1 expression in the tumor center and in the invasive front, as well as in adjacent non‐tumor epithelium, and (ii) to correlate these findings with clinical parameters. Materials and methods The sample comprised 44 patients with primary head and neck squamous cell carcinomas. Hematoxylin and eosin (HE) staining was used for histopathological tumor grading and for morphological analysis of adjacent non‐tumor epithelium. Semiquantitative analysis was performed in histological sections immunostained for CD44 and ALDH1. Results ALDH1 immunostaining in the invasive front showed positive association with tumor size, regional metastasis, tumor histopathological grading, and disease progression. Moreover, expression of this marker in both tumor invasive front and adjacent non‐tumor epithelium was related with more aggressive tumors. CD44 immunostaining was heterogeneous in all areas evaluated and did not show association with clinical data. Conclusion Collectively, these data suggest that ALDH1 immunostaining in the invasive front and in adjacent non‐tumor epithelium may help identify tumors with a more aggressive behavior, potentially contributing to improving treatment customization and the monitoring of patients with head and neck cancer.