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Prognostic and Predictive Significance of Cancer Stem Cell Markers (ZIP-4 and ALDH1A1) in Ovarian Serous Carcinoma Patients: An Immunohistochemical Study

Article scientifique 2026 Anglais

Résumé

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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Attia, A., AbdAlsalam, M., Iraki, A., Hussein, S., Waley, A., Khalil, A., Aboafya, Z., Sameh, R. (2026). Prognostic and Predictive Significance of Cancer Stem Cell Markers (ZIP-4 and ALDH1A1) in Ovarian Serous Carcinoma Patients: An Immunohistochemical Study. https://doi.org/10.31557/apjcp.2026.27.1.255

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Amany Selim Attia Mohamed AbdAlsalam Ahmed Iraki Samia Hussein Ahmad Barakat Waley Amr Khalil Zahraa I. Aboafya Reham Sameh

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