Nestin and CD133: valuable stem cell-specific markers for determining clinical outcome of glioma patients

AIM Gliomas represent the most frequent neoplasm of the central nervous system. Unfortunately, surgical cure of it is practically impossible and their clinical course is primarily determined by the biological behaviors of the tumor cells. The aim of this study was to investigate the correlation of the stem cell markers Nestin and CD133 expression with the grading of gliomas, and to evaluate their prognostic value. METHODS The tissue samples consisted of 56 low- (WHO grade II), 69 high- (WHO grade III, IV) grade gliomas, and 10 normal brain tissues. The expression levels of Nestin and CD133 proteins were detected using SABC immunohistochemical analysis. Then, the correlation of the two markers' expression with gliomas' grading of patients and their prognostic value were determined. RESULTS Immunohistochemical analysis with anti-Nestin and anti-CD133 antibodies revealed dense and spotty staining in the tumor cells and their expression levels became significantly higher as the glioma grade advanced (p < 0.05). There was a positive correlation between the two markers' expression in different gliomas tissues (rs = 0.89). The low expression of the two markers significantly correlated with long survival of the glioma patients (p < 0.05). The survival rate of the patients with Nestin+/CD133+ expression was the lowest (p < 0.01), and the multivariate analysis confirmed that conjoined expression of Nestin+/CD133+ and Nestin-/CD133- were independent prognostic indicators of gliomas (both p < 0.01, Cox proportional hazard regression model). CONCLUSION These results collectively suggest that Nestin and CD133 expression may be an important feature of human gliomas. A combined detection of Nestin/CD133 co-expression may benefit us in the prediction of aggressive nature of this tumor.