Combined Detection of Tumor Stem Cell Markers CD133 and OCT4 in Early Non-Small Cell Lung Cancer Screening and Prognostic Evaluation.

OBJECTIVE: To investigate the expression of cancer stem cell (CSC) markers CD133 and OCT4 in early-stage non-small cell lung cancer (NSCLC), evaluate their diagnostic value in early screening, and analyze their prognostic significance. METHODS: A retrospective study was conducted on 80 patients with early-stage NSCLC (stages I-IIA) and 40 healthy controls from January 2021 to December 2023. Expression levels of CD133 and OCT4 were assessed by immunohistochemistry (IHC) and quantitative real-time PCR (qRT-PCR). Clinicopathological data were analyzed, and all patients were followed for 24 months to assess overall survival (OS). Diagnostic efficacy was evaluated by ROC analysis, and prognostic factors were identified by Cox regression. RESULTS: CD133 and OCT4 were significantly upregulated in NSCLC tissues compared with adjacent normal tissues and healthy controls (P<0.001). High expression correlated with poor differentiation, larger tumor size (≥3 cm), lymph node metastasis, and stage IB-IIA (P<0.05). ROC analysis showed AUCs of 0.809 for CD133, 0.796 for OCT4, and 0.893 for their combination, with combined sensitivity of 88.7% and specificity of 82.5%. Patients with high expression of both markers had markedly reduced 2-year OS compared with low-expression cases (P<0.01). Multivariate Cox regression identified high CD133 expression (HR=2.45, 95% CI: 1.38-4.36, P=0.003), high OCT4 expression (HR=2.17, 95% CI: 1.22-3.86, P=0.007), poor differentiation (HR=1.91, P=0.021), tumor size ≥3 cm (HR=1.84, P=0.039), lymph node metastasis (HR=2.08, P=0.020), and stage IB-IIA (HR=2.22, P=0.016) as independent prognostic risk factors. CONCLUSION: CD133 and OCT4 are overexpressed in early-stage NSCLC and are associated with aggressive disease and poor prognosis. Combined detection provides superior diagnostic accuracy (AUC=0.893) compared to single markers and may serve as a valuable biomarker panel for early screening and risk stratification. These markers also have potential utility in guiding individualized treatment strategies.