Cancer stem-like cells (CSCs)/
cancer-initiaiting cells (CICs) are defined as a small population of
cancer cells that have self-renewal capacity, differentiation potential and high
tumor-initiating ability. CSCs/CICs of
ovarian cancer have been isolated by side population (SP) analysis, ALDEFLUOR assay and using cell surface markers. However, these approaches are not definitive markers for CSCs/CICs, and it is necessary to refine recent methods for identifying more highly purified CSCs/CICs. In this study, we analyzed SP cells and
aldehyde dehydrogenese bright (ALDH(Br)) cells from
ovarian cancer cells. Both SP cells and ALDH(Br) cells exhibited higher
tumor-initiating ability and higher expression level of a stem cell marker, sex determining region Y-box 2 (SOX2), than those of main population (MP) cells and ALDH(Low) cells, respectively. We analyzed an SP and ALDH(Br) overlapping population (SP/ALDH(Br)), and the SP/ALDH(Br) population exhibited higher
tumor-initiating ability than that of SP cells or ALDH(Br) cells, enabling initiation of
tumor with as few as 10(2) cells. Furthermore, SP/ADLH(Br) population showed higher sphere-forming ability,
cisplatin resistance, adipocyte differentiation ability and expression of SOX2 than those of SP/ALDH(Low), MP/ALDH(Br) and MP/ALDH(Low) cells. Gene knockdown of SOX2 suppressed the
tumor-initiation of
ovarian cancer cells. An SP/ALDH(Br) population was detected in several gynecological
cancer cells with ratios of 0.1% for HEC-1
endometrioid adenocarcinoma cells to 1% for MCAS ovary
mucinous adenocarcinoma cells. Taken together, use of the SP and ALDH(Br) overlapping population is a promising approach to isolate highly purified CSCs/CICs and SOX2 might be a novel functional marker for ovarian CSCs/CICs.