[No authors listed]
The present study aimed to explore the relationship between the efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFRâTKIs) and the expression of the cancer stem cell (CSC)ârelated markers. Specimens of 72 cases of lung adenocarcinoma with significantly different therapeutic effects of the firstâgeneration EGFRâTKI treatment were collected. The patients were divided into a sensitive group [progressionâfree survival (PFS) longer than 26 months] and a resistant group (PFS less than 5 months) according to the efficacy of firstâline EGFRâTKI treatment. The expression of CSCârelated markers (OCT4, SOX2, NANOG) in tumor tissues of the two groups was detected by immunohistochemical (IHC) staining, immunofluorescence and reverse transcriptaseâquantitative polymerase chain reaction (RTâqPCR). IHC staining was quantified using Hâscores. The unpaired nonparametric tâtest was used to detect the differences in the results of IHC and RTâqPCR analyses between the groups. The Chiâsquare test was used to detect the differences in the clinical characteristics between the two groups. The tâtest revealed that the IHC Hâscores of SOX2 (P=0.003), OCT4 (P=0.036) and NANOG (P=0.032) were significantly higher in the resistant group than in the sensitive group. The results of RTâqPCR revealed that the relative levels of SOX2 (P=0.018), OCT4 (P=0.035) and NANOG (P=0.044) were significantly higher in the resistant group than in the sensitive group. The number of male patients, patients who smoked, patients with stage IV lung adenocarcinoma disease, and patients with poor differentiation was higher in the resistant group than in the sensitive group, with statistically significant differences. The poor efficacy of firstâgeneration EGFRâTKIs for lung adenocarcinoma appears to be related to the increased expression of CSC markers.
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