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Comparative evaluation of cancer stem cell markers in normal pancreas and pancreatic ductal adenocarcinoma.

Chemoresistance and self-renewal of cancer stem cells (CSC), found in many             tumors including pancreatic ductal adenocarcinoma (PDAC), are believed to underlie             tumor mass regrowth. The distribution of cells carrying the putative stem-cell             markers CD133, Nestin, Notch1-4, Jagged1 and 2, ABCG2 and aldehyde dehydrogenase             (ALDH1) was assessed immunohistochemically using PDAC and normal pancreas tissue             microarrays. The immunoreactivity was semi-quantitatively graded against the normal             pancreas and was correlated with the differentiation grade and disease stage.             No statistical significant differences were found between normal pancreas and             PDAC in the expression of Nestin, Notch1, 3 and 4, ABCG2 or ALDH1. Notch2 and             Jagged1 and 2 expression were increased in PDAC. CD133-positive cells were above-normal             in PDAC, but the difference was not statistically significant. Nestin, Notch1-4,             Jagged1, ABCG2 and ALDH1 immunostaining scores were not correlated with tumor             grade or disease stage. CD133 and Notch2 expression was significantly inversely             correlated with tumor grade, but not disease stage. Notch3 immunostaining positively             correlated with tumor stage, but not with differentiation grade. Jagged2 protein             expression correlated inversely with disease stage, but not with tumor grade.             From the clinical standpoint, improved delineation of the tumor CSC signature,             putatively responsible for tumor initiation and recurrence after initial response             to chemotherapy, may offer novel therapeutic targets for this highly lethal cancer.