抄録
Background; The CD44 and CD133 expressions have been identified to be putative cancer stem cell (CSC) markers. Some
reports have revealed a correlation between these CSC markers and a poor prognosis in the clinical setting. However, clinical
impact of combined use of these markers has not been determinated in advanced gastric cancer.
Methods; Specimens were obtained from 73 patients with gastric cancer with invasion beyond the muscularis (T3/4a) who
underwent curative gastrectomy. Immunohistochemically, tumors with more than 5% CD44-positive cells or at least one CD133-
positive cancer cell were regard as being CSC marker-positive.
Results; Forty patients were CSC marker-positive. There were significant correlations between the CSC marker expression
and the extent of lymphatic (p=0.04) and vessel invasion (p < 0.001). The CSC marker-positive patients exhibited poor prognoses
in both the overall (p=0.006) and disease-free survival analyses (p=0.019). Based on the results of the univariate analysis, the
peritoneal CEA value, the extent of lymph node metastasis and CSC marker positivity were analyzed in the multivariate analysis.
The results revealed that the extent of lymph node metastasis (p < 0.001) and CSC marker positivity (p=0.04) were significant risk
factors.
Conclusion; CSC marker positivity is an independent prognostic factor in patients with T3/4a gastric cancer.
