Progenitor stem cell marker expression by pulmonary carcinomas

Carcinomas may arise as a disorder of regeneration, so that a malignant cell may represent a failure to fully attain the characteristics of differentiated tissue. We hypothesized that there is a differential distribution of progenitor cell markers among different histological types of lung cancers, with poorly differentiated tumors being more likely to express progenitor stem cell markers. The study was limited to paraffin-embedded archival material of resected untreated pulmonary carcinomas, including adenocarcinoma, squamous cell carcinoma, large cell carcinoma, and small cell carcinoma. The sections were stained for putative stem cells markers (Musashi-1, Musashi-2, CD34, CD21, KIT, CD133, p63, and OCT-4). Positivity was read as isolated, focal, or diffuse staining. Stem cell markers were detected in all histological types of pulmonary carcinomas. There was a difference in the expression of markers among the histological types. Small cell carcinoma showed diffuse positivity for most of the markers; in contrast to focal or negative staining in other histological groups. An inverse relationship between CD21 and Musashi-1 was observed. No staining for OCT-4 and CD34 was seen in any of the tumor types. Hierarchical clustering based on marker expression separated tumors into two groups, with one group marked by high expression of Musashi-1 and KIT, contained most of the poorly differentiated adenocarcinomas and small cell carcinomas. Therefore, stem cell markers are expressed in lung cancers with different patterns seen for different histological types and degrees of differentiation. Modern Pathology (2010) 23, 889-895; doi:10.1038/modpathol.2010.68; published online 19 March 2010