Background: Astrocytic gliomas are the most common primary brain tumors that developed from glial origin.
The angiogenic cell population from brain tumor enhances the recruitment of circulating cancer stem cells
homing towards tumor site.
Objectives: This study aimed to investigate the tumor angiogenic cell population that stained with CD133+
and VEGFA+ markers and its association with circulating cancer stem cell (CD133+/VEGFR2-) population in the
peripheral blood mononuclear cells (PBMCs) of astrocytic glioma patients.
Methods: A total of 22 astrocytic glioma patients from Hospital Universiti Sains Malaysia who consented to
the study were included. Tumors (n=22) were sliced and stained with CD133+ and VEGFA+ angiogenic markers
and counter stained with DAPI. The circulating cancer stem cells (CD133+/VEGFR2-) in PBMCs (n=22) were
quantified using FACS based on the expression of CD133 and VEGFR2 markers. The paired t-test and Pearson
correlation were used for the data analysis.
Results: The percentage of angiogenic cell population was significantly higher in brain tumor compared to
adjacent normal brain tissue (1.25 ± 0.96% vs. 0.74 ± 0.68%; paired t-test=2.855; df=21, p = 0.009). Positive
correlation was found between the angiogenic cells of brain tumor tissue and adjacent normal brain tissue
(Pearson correlation, r = 0.53, p = 0.011). Significant positive correlation was found between angiogenic cells
in glioma tumor and cancer stem cells in peripheral circulating systems of astrocytic glioma patients (Pearson
correlation, r = 0.42, p = 0.049).
Conclusion: Angiogenic cells in the brain tumor resident promote the recruitment of circulating cancer stem cells
homing to the tumor site and induce the proliferation and growth of the tumor in astrocytic glioma patients.