Is There Any Difference in Stem Cell Population between Type I and Type II Endometrial Cancer? A Pilot Study.

Background: The incidence of endometrial cancer is increasing globally. Cancer stem cells are now considered the driving force for tumour recurrence and metastasis. We studied whether the proportion of cancer stem cell population and stemness gene expression differ in type I and type II endometrial cancer.

Materials and methods: Type I and type II endometrial tumour tissues were obtained from patients who underwent hysterectomy. The tumour tissue was digested using collagenase, and we established a primary culture. In the primary cultures established from these two types of cancer, we used flow cytometry to measure the proportion of the cancer stem cell population expressing CD 133 and CXCR4 on its surface. We also looked for the expression of genes related to stemness, regulators of stemness, and markers of metastasis in both these cancer types.

Results: We found that the proportion of cancer stem cell population that expresses CD133 and CXCR4 was higher in type II endometrial cancer than in type I endometrial cancer. Also, genes (Nanog, ALDH, EZH2) related to stemness and aberrant transcriptome were found to be upregulated in type II endometrial cancer.

Conclusion: Our study demonstrates that the proportion of stem cells in type 2 endometrial cancer is higher than in type I endometrial cancer. The findings of this study should lead us to investigate with a larger sample size and see if the increase in the stem cell population in type II endometrial cancer may be the reason for its poor prognosis.