The role of ALDH1 and CD133 expression as stem cell tumor marker in early-stage NSCLC.

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e13508 Background: A 70% of patients with non-small cell lung cancer (NSCLC) stage I die of their disease within five years of diagnosis. Cancer stem cells (CSC) have been described as poor prognostic factors. This is a group of tumorigenic cells with capacity for self-renewal and differentiation, and also for migration and recurrence. Two of the markers used to identify these CSC are Aldehyde dehydrogenase 1 (ALDH1) and CD133. Methods: We conducted a retrospective study of 78 patients diagnosed with stage I NSCLC in the Hospital Universitario Puerta de Hierro between 2004 and 2009 who had not received adjuvant chemotherapy, and with a minimum follow-up time of 24 months. The expression of CD133 and ALDH1 was determined by immunohistochemistry and also EGFR mutations in adenocarcinomas. We analyzed the relationship between ALDH1 and CD133 with various clinicopathological variables, as well as the survival of these patients. Results: We found differences between the two markers with different histological subtypes. ALDH1 expression was most frequent in squamous cell carcinomas and CD133 expression was exclusive between adenocarcinomas. We found no co-expression of the two markers of CSC in any of the cases reviewed. We also found no association between ALDH1 and CD133 expression and other poor prognostic factors (high degree of differentiation, tumor size or invasion of visceral pleura). Furthermore, there were no differences in survival based on the expression of ALDH1 and CD133. We describe for the first time the nuclear expression of ALDH1, probably related to a better prognosis in these patients. No relation was found between EGFR mutations and ALDH1 and CD133 expression. Conclusions: We found no co-expression of ALDH1 and CD133 in any of our patients. Therefore, we have not managed to identify CSC in stage I NSCLC using as markers ALDH1 and CD133. ALDH1 is expressed in both the nucleus and cytoplasm. ALDH1 cytoplasmic expression has no influence on the survival of patients. The nuclear expression of ALDH1 can be associated with a better prognosis. The expression of CD133 is associated with a lower relapse rate. CD133 and ALDH1 are not associated with the presence of EGFR mutations in adenocarcinomas.

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