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已发表论文
早期非小细胞肺癌筛查及预后评估中肿瘤干细胞标志物 CD133 和 OCT4 的联合检测
Authors Guan S, Huangfu J, Zhu X, Ge Y, Ding Y , Chen T , Zhang Y, Yang T , Liu H, Zhang L, Chen X, Zhou J
Received 5 July 2025
Accepted for publication 8 September 2025
Published 19 September 2025 Volume 2025:17 Pages 2077—2087
DOI https://doi.org/10.2147/CMAR.S551828
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Antonella D'Anneo
Shuhong Guan,1,* Junkang Huangfu,2,* Xiaoqin Zhu,1 Yunqi Ge,1 Ying Ding,2 Tianyu Chen,1 Yilei Zhang,1 Tingting Yang,1 Huimin Liu,1 Long Zhang,2 Xiyao Chen,2 Jun Zhou1
1Department of Respiratory and Critical Care Medicine, Changzhou First People’s Hospital, Changzhou, Jiangsu, People’s Republic of China; 2Soochow University, Suzhou, Jiangsu, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jun Zhou, Department of Respiratory and Critical Care Medicine, Changzhou First People’s Hospital, Changzhou, Jiangsu, People’s Republic of China, Email ojv9qx@163.com
Objective: To investigate the expression of cancer stem cell (CSC) markers CD133 and OCT4 in early-stage non-small cell lung cancer (NSCLC), evaluate their diagnostic value in early screening, and analyze their prognostic significance.
Methods: A retrospective study was conducted on 80 patients with early-stage NSCLC (stages I–IIA) and 40 healthy controls from January 2021 to December 2023. Expression levels of CD133 and OCT4 were assessed by immunohistochemistry (IHC) and quantitative real-time PCR (qRT-PCR). Clinicopathological data were analyzed, and all patients were followed for 24 months to assess overall survival (OS). Diagnostic efficacy was evaluated by ROC analysis, and prognostic factors were identified by Cox regression.
Results: CD133 and OCT4 were significantly upregulated in NSCLC tissues compared with adjacent normal tissues and healthy controls (P< 0.001). High expression correlated with poor differentiation, larger tumor size (≥ 3 cm), lymph node metastasis, and stage IB–IIA (P< 0.05). ROC analysis showed AUCs of 0.809 for CD133, 0.796 for OCT4, and 0.893 for their combination, with combined sensitivity of 88.7% and specificity of 82.5%. Patients with high expression of both markers had markedly reduced 2-year OS compared with low-expression cases (P< 0.01). Multivariate Cox regression identified high CD133 expression (HR=2.45, 95% CI: 1.38– 4.36, P=0.003), high OCT4 expression (HR=2.17, 95% CI: 1.22– 3.86, P=0.007), poor differentiation (HR=1.91, P=0.021), tumor size ≥ 3 cm (HR=1.84, P=0.039), lymph node metastasis (HR=2.08, P=0.020), and stage IB–IIA (HR=2.22, P=0.016) as independent prognostic risk factors.
Conclusion: CD133 and OCT4 are overexpressed in early-stage NSCLC and are associated with aggressive disease and poor prognosis. Combined detection provides superior diagnostic accuracy (AUC=0.893) compared to single markers and may serve as a valuable biomarker panel for early screening and risk stratification. These markers also have potential utility in guiding individualized treatment strategies.
Keywords: NSCLC, CD133, OCT4, cancer stem cells, early screening, prognostic evaluation
1Department of Respiratory and Critical Care Medicine, Changzhou First People’s Hospital, Changzhou, Jiangsu, People’s Republic of China; 2Soochow University, Suzhou, Jiangsu, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jun Zhou, Department of Respiratory and Critical Care Medicine, Changzhou First People’s Hospital, Changzhou, Jiangsu, People’s Republic of China, Email ojv9qx@163.com
Objective: To investigate the expression of cancer stem cell (CSC) markers CD133 and OCT4 in early-stage non-small cell lung cancer (NSCLC), evaluate their diagnostic value in early screening, and analyze their prognostic significance.
Methods: A retrospective study was conducted on 80 patients with early-stage NSCLC (stages I–IIA) and 40 healthy controls from January 2021 to December 2023. Expression levels of CD133 and OCT4 were assessed by immunohistochemistry (IHC) and quantitative real-time PCR (qRT-PCR). Clinicopathological data were analyzed, and all patients were followed for 24 months to assess overall survival (OS). Diagnostic efficacy was evaluated by ROC analysis, and prognostic factors were identified by Cox regression.
Results: CD133 and OCT4 were significantly upregulated in NSCLC tissues compared with adjacent normal tissues and healthy controls (P< 0.001). High expression correlated with poor differentiation, larger tumor size (≥ 3 cm), lymph node metastasis, and stage IB–IIA (P< 0.05). ROC analysis showed AUCs of 0.809 for CD133, 0.796 for OCT4, and 0.893 for their combination, with combined sensitivity of 88.7% and specificity of 82.5%. Patients with high expression of both markers had markedly reduced 2-year OS compared with low-expression cases (P< 0.01). Multivariate Cox regression identified high CD133 expression (HR=2.45, 95% CI: 1.38– 4.36, P=0.003), high OCT4 expression (HR=2.17, 95% CI: 1.22– 3.86, P=0.007), poor differentiation (HR=1.91, P=0.021), tumor size ≥ 3 cm (HR=1.84, P=0.039), lymph node metastasis (HR=2.08, P=0.020), and stage IB–IIA (HR=2.22, P=0.016) as independent prognostic risk factors.
Conclusion: CD133 and OCT4 are overexpressed in early-stage NSCLC and are associated with aggressive disease and poor prognosis. Combined detection provides superior diagnostic accuracy (AUC=0.893) compared to single markers and may serve as a valuable biomarker panel for early screening and risk stratification. These markers also have potential utility in guiding individualized treatment strategies.
Keywords: NSCLC, CD133, OCT4, cancer stem cells, early screening, prognostic evaluation