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Int J Clin Exp Pathol 2011;4(1):32-42

Original Article
Prognostic value of CD133 expression in stage I lung adenocarcinomas

Tetsukan Woo, Koji Okudela, Hideaki Mitsui, Takuya Yazawa, Nobuo ogawa, Michihiko Tajiri, Taketsugu Yamamoto, Yasushi Rino, Hitoshi
Kitamura, Munetaka Masuda

Department of Surgery and Pathology, Yokohama City University Graduate school of Medicine, 3-9, Fukuura, Kanazawa-ku, 236-0004,
Yokohama, Japan; Division of Thoracic Surgery, Kanagawa Cardiovascular and Respiratory Center, 6-16-1, Tomioka-higashi, Kanazawa-ku,
230-0051, Yokohama, Japan.

Received November 26, 2010; accepted November, 2010; Epub November, 2010; published January 1, 2011

Abstract: CD133 is one of the most representative cancer stem cell markers. This study evaluated the potential prognostic value of CD133
expression in stage I lung adenocarcinomas (ADC). Tumors from 177 patients were immunohistochemically examined for CD133 expression,
and their associations with disease recurrence were analyzed. Also, the potential prognostic value of combining CD133 expression with
proliferating activity measured by immunohistochemical expression of Ki-67 and vessel involvement was evaluated. CD133 high expressers
showed a significantly higher risk of recurrence than CD133 low expressers (5-year disease-free survival (DFS) rate 77.2% vs. 95.1% (p=0.
004), adjusted Hazard ratio (HR) 4.37 (95% Confidence Interval (CI) 1.30–14.71, p=0.017)). CD133 high expressers having strong proliferating
activity and/or with vessel invasion showed a higher risk of recurrence (5-year DFS rate 66.5% in CD133 high/Ki-67 high expressers versus
93.2% in the other types (p<0.001), adjusted HR 8.39 (95% CI 2.65–26.54, p<0.001): 5-year DFS rate 51.0% in CD133 high expressers with
vessel invasion versus 92.9% in the other types (p<0.001), adjusted HR 4.50 (95% CI 1.51-13.34, p=0.007): 5-year DFS rate 53.9% in CD133
high/Ki-67 high expressers with vessel invasion versus 91.2% in the other types (p<0.001), adjusted HR 9.32 (95% CI 3.42–25.39, p<0.001)).
In conclusion, the level of CD133 expression is an independent prognostic marker and its combination with proliferating activity and/or vessel
invasion could have excellent prognostic value to predict postoperative recurrence in patients with stage I lung ADC. (IJCEP1011005).

Keywords: Lung adenocarcinoma, cancer stem cell, CD133, stage I, prognosis

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Address all correspondence to:
Tetsukan WOO, MD, PhD
Department of Surgery
Yokohama City University Graduate School of Medicine
3-9, Fukuura, Kanazawa-ku, 236-0004
Yokohama, Japan.
Tel: +81-45-787-2645, Fax: +81-45- 786-0226
E-mail:
tetsu.n.u@cotton.ocn.ne.jp