The cancer stem cell concept in progression of head and neck cancer

Abstract

Human head and neck cancer (HNC) is a highly heterogeneous disease. Understanding the biology of HNC progression is necessary for the development of novel approaches to its prevention, early detection, and treatment. A current evolutional progression model has limitations in explaining the heterogeneity observed in a single tumor nest. Accumulating evidence supports the existence of cancer stem cells (CSCs) as small subpopulations in solid tumors, including HNC. These CSCs can be selected by appropriate cell surface markers, which are cancer type specific and have been confirmed by unique in vitro and in vivo assays. Selected CSC populations maintain a self-renewal capability and show aggressive behaviors, such as chemoresistance and metastasis. In addition to introducing the CSC concept in solid tumors, this short review summarizes current publications in HNC CSC and the prospective development and application of the CSC concept to HNC in the clinic.

Figure 1

Hierarchical and stochastic models of CSC in progression of solid tumors.

Figure 2

ALDH1 expression in HNSCC tissues: (a) nonmetastatic primary tumor with negative ALDH1 expression, (b) metastatic primary tumor with positive ALDH1 expression, and (c) corresponding lymph node metastases. (Magnification: 400x).