Abstract
Objective: Integrin alpha 7 (ITGA7), a potential glioma stem cell marker, regulates several other stem cell markers including CD133 and Nestin in several cancers, meanwhile its high expression is related to poor prognosis in multiple solid tumor patients. However, few studies report correlation of ITGA7 with prognosis in astrocytoma patients. Hence, this study aimed to determine the astrocytoma-tissue ITGA7, CD133 and Nestin expressions to explore their relationship and clinical value for astrocytoma management. Methods: Totally, 124 patients with primary astrocytoma were included. Their tumor tissue ITGA7, CD133 and Nestin expressions were determined by immunohistochemical (IHC) assay and scored by intensity and density ranging from 0-12 points. Besides, their clinical features (such as world health organization (WHO) grade, isocitrate dehydrogenase (IDH) mutation, and adjuvant therapy etc.) were collected, also their overall survival (OS) were analyzed by follow-up data. Results: The mean IHC scores for ITGA7, CD133 and Nestin were 4.9±2.5, 2.1±2.6 and 5.8±2.6, respectively. Moreover, ITGA7 high expression correlated with absence of IDH mutation (P=0.004), advanced WHO grade (P=0.001) and shorter OS (P=0.005). Besides, ITGA7 positively correlated with CD133 (P=0.001) and Nestin (P=0.001) expressions. Regarding CD133 and Nestin, their high expression also correlated with increased WHO grade and shorter OS. Furthermore, multivariant Cox’s regression analysis displayed that only CD133 high expression (P=0.021) could independently predict reduced OS, while ITGA7 or Nestin high expression could not. Conclusion: ITGA7, CD133 and Nestin are intercorrelated, also their high expressions associate with deteriorating disease conditions and poor prognosis in astrocytoma patients.
High expression of the stem cell marker nestin is an adverse prognostic factor in WHO grade II–III astrocytomas and oligoastrocytomas
