Immunohistochemical analysis of cancer stem cell markers in invasive breast carcinoma and associated ductal carcinoma in situ: Relationships with markers of tumor hypoxia and microvascularity

Abstract

We performed immunohistochemical analysis of 3 cancer stem cell-related markers (CD44+/CD24-/low, aldehyde dehydrogenase [ALDH]-1, CD133) in 94 invasive ductal carcinomas and assessed relationships with markers of hypoxia (carbonic anhydrase IX [CAIX]), tumor microvessel density (CD31), and clinicopathologic variables. Overall, 10% of tumors were CD44 +/CD24-/low, 13% were ALDH-1+, 25% were CD133+, 35% were immunonegative, and 1 tumor was immunopositive for all 3 markers. Associated ductal carcinoma in situ (DCIS) was present in 48% of tumors. Marker immunopositivity was detected in DCIS in 13% (CD44 +/CD24-/low), 7% (ALDH-1+), and 32% (CD133 +) of these tumors and was more likely present in DCIS when also detected in the invasive compartment (P =.03, P =.001, and P =.009, respectively). CD44+/CD24-/low cells were more common in progesterone receptor-negative tumors (P