CD44/CD24 and aldehyde dehydrogenase 1 in estrogen receptor-positive early breast cancer treated with tamoxifen: CD24 positivity is a poor prognosticator

Yong Wha Moon, Hee Jung An, Ja Seung Koo, Gun Min Kim, Hyunju Han, Seho Park, Seung Il Kim, Hyung Seok Park, Sewha Kim, Seung Ki Kim, Seung Ah Lee, Sohyun Hwang, Gun Woo Son, Joohyuk Sohn

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Abstract

CD44+/CD24- or aldehyde dehydrogenase 1 (ALDH1) has been suggested as a potential marker for breast cancer stem cells. In the cohort of 819 patients with resected ER-positive breast cancer, the '5-year relapse group' within 5 years postsurgery during adjuvant tamoxifen treatment and the 'non-relapse group' longer than 9 years postsurgery were defined. Paraffin-embedded tumor tissues were available in 31 patients from 5-year relapse group and 68 from the non-relapse group. CD44/ CD24 and ALDH1 expression was evaluated by immunohistochemical staining. Phenotypes of CD44/CD24 were CD44+/CD24- in one patient (1%), CD44+/ CD24+in one patient (1%), CD44-/CD24+ in 12 patients (12%), and CD44-/CD24- in 67 patients (68%). Four patients (4%) showed ALDH1-positivity. Due to the rarity of CD44-positivity or ALDH1-positivity, we dichotomized the patients into CD24-positive status (13%, 13/99 patients) and CD24-negative status (87%, 86/99 patients) only based on CD24 status, and only the status of CD24 was further analyzed. CD24- positivity was higher in the 5-year relapse group (32%) than in the non-relapse group (4%). CD24-positivity was associated with negative PR (P=0.026), higher N stage (P=0.029), and higher histologic grade (P=0.034). However, in the multivariate logistic regression adjusted for the known prognostic factors, CD24-positivity was still a significant predictive factor for 5-year relapse (hazard ratio=8.5; P=0.006). Our results indicated that the expression of CD24 was a significant poor prognostic factor in ER-positive early breast cancer treated with adjuvant tamoxifen. CD24 is worth further investigation as a novel biomarker for tamoxifen resistance beyond general aggressiveness of cancer cells.

Original languageEnglish
Pages (from-to)2622-2630
Number of pages9
JournalOncotarget
Volume9
Issue number2
DOIs
Publication statusPublished - 2018

All Science Journal Classification (ASJC) codes

  • Oncology

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    Moon, Y. W., An, H. J., Koo, J. S., Kim, G. M., Han, H., Park, S., Kim, S. I., Park, H. S., Kim, S., Kim, S. K., Lee, S. A., Hwang, S., Son, G. W., & Sohn, J. (2018). CD44/CD24 and aldehyde dehydrogenase 1 in estrogen receptor-positive early breast cancer treated with tamoxifen: CD24 positivity is a poor prognosticator. Oncotarget, 9(2), 2622-2630. https://doi.org/10.18632/oncotarget.23519