Document Type : Research Articles
Authors
1
Department of Pathology, Faculty of Medicine, Zagazig University, Sharkia, Egypt.
2
Department of Obstetrics& Gynaecology, Al-Ahrar Teaching Hospital, Sharkia, Egypt.
3
Department of Obstetrics& Gynaecology, Faculty of Medicine, Zagazig University, Sharkia, Egypt.
4
Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Zagazig University, Sharkia, Egypt.
5
Department of Medical Oncology, Faculty of Medicine, Zagazig University, Sharkia, Egypt.
6
Department of Surgical Oncology, Al-Ahrar Teaching Hospital, General Organization for Teaching Hospitals and Institutes (GOTHI), Egypt.
7
Department of Clinical and Chemical Pathology, Institute of Medical Research and Clinical Studies, National Research Centre, Cairo, Egypt.
Abstract
Background: Worldwide, ovarian cancer is the eighth most common cancer among females and the fifth leading cause of cancer-related deaths in women. In Egypt, it accounts for 4.5% of all cancer cases and ranks the fourth most common cancer among women. Cancer stem cells (CSCs) play a crucial role in tumor growth and chemoresistance. Our study examined the expression of cancer stem cell markers (ZIP-4 and aldehyde dehydrogenase-1 member A1 (ALDH1A1)) in ovarian serous carcinoma tissues using immunohistochemistry. We also analyzed the relationship between their expression levels and clinicopathological features, patient survival, and response to platinum-based chemotherapy. Subjects & Method: This study included 55 patients with ovarian serous carcinoma. Immunohistochemical staining for ZIP-4 and ALDH1A1 was performed. Results: Statistically significant relationships were detected between high ZIP-4 and ALDH1A1 expressions and patient age, tumor size, presence of malignant ascites, lymphovascular invasion, elevated cancer antigen-125 (CA-125) levels, disease stage, and lymph node involvement (P < 0.001 for each). Additionally, the log-rank test showed that high ZIP-4 and ALDH1A1 expressions were associated with shorter disease-free survival (DFS) (P = 0.002 and <0.001, respectively) and overall survival (OS) (P < 0.001 for each). Conclusion: Ovarian cancer stem cell markers (ZIP-4 and ALDH1A1) can be considered potential prognostic markers in ovarian cancer patients. Moreover, ZIP-4 and ALDH1A1 expressions are related to resistance to platinum-based chemotherapy, which leads to ovarian serous carcinoma progression. Clinical implications suggest that future therapeutic regimens targeting ZIP-4 and ALDH1A1 may help overcome platinum-based chemotherapy resistance and improve patients outcomes.
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