{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T13:52:24Z","timestamp":1769003544560,"version":"3.49.0"},"reference-count":39,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T00:00:00Z","timestamp":1628726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Malignant pleural effusion (MPE) can accompany advanced lung adenocarcinoma. Recent studies suggest that MPE could contain a heterogeneous subpopulation of cells with stem-like properties, such as tumorigenicity and self-renewal, indicating that they could be the source of metastasis. Although previous studies analyzed the correlation between cancer stem cell (CSC) marker expression and clinical outcomes using lung cancer tissues, investigations regarding the association of MPE with CSC marker expression are limited. We performed immunohistochemistry to examine the expression of aldehyde dehydrogenase 1 (ALDH1) and Sal-like 4 (SALL4) in 46 cell block samples of MPE from patients with lung adenocarcinoma. ALDH1-positive and SALL4-positive cancer cells in MPE were detected in 30 (65.2%) and 21 samples (45.7%), respectively. Cluster formation was detected in 26 samples (56.5%). The number of clusters was significantly higher in ALDH1-positive\/SALL4-negative samples. SALL4 expression was inversely correlated with the cluster ratio (r = \u22120.356) and positively associated with the Ki-67 index (r = 0.326), suggesting that MPE cells with high SALL4 expression comprised the proliferative subpopulation. In conclusion, we demonstrated that MPE contains an ALDH1-positive\/SALL4-negative subpopulation exhibiting cluster formation and a SALL4-positive proliferative subpopulation.<\/jats:p>","DOI":"10.3390\/diagnostics11081463","type":"journal-article","created":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T10:54:41Z","timestamp":1628765681000},"page":"1463","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["ALDH1 and SALL4 Expression in Cell Block Samples from Patients with Lung Adenocarcinoma and Malignant Pleural Effusion"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8845-6827","authenticated-orcid":false,"given":"Tomohiro","family":"Kanayama","sequence":"first","affiliation":[{"name":"Department of Tumor Pathology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan"},{"name":"Division of Pathology, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiaki","family":"Taniguchi","sequence":"additional","affiliation":[{"name":"Department of Tumor Pathology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3291-0274","authenticated-orcid":false,"given":"Hiroyuki","family":"Tomita","sequence":"additional","affiliation":[{"name":"Department of Tumor Pathology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayumi","family":"Niwa","sequence":"additional","affiliation":[{"name":"Department of Tumor Pathology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kei","family":"Noguchi","sequence":"additional","affiliation":[{"name":"Division of Pathology, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikiko","family":"Matsuo","sequence":"additional","affiliation":[{"name":"Department of Tumor Pathology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuko","family":"Imaizumi","sequence":"additional","affiliation":[{"name":"Department of Tumor Pathology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahiro","family":"Kuroda","sequence":"additional","affiliation":[{"name":"Department of Tumor Pathology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5121-6325","authenticated-orcid":false,"given":"Yuichiro","family":"Hatano","sequence":"additional","affiliation":[{"name":"Department of Tumor Pathology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isao","family":"Okazaki","sequence":"additional","affiliation":[{"name":"National Hospital Organization Nagara Medical Center, Department of Clinical Laboratory, Gifu 502-8558, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuo","family":"Kato","sequence":"additional","affiliation":[{"name":"National Hospital Organization Nagara Medical Center, Department of Respiratory Medicine, Gifu 502-8558, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5554-8060","authenticated-orcid":false,"given":"Akira","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Tumor Pathology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan"},{"name":"Division of Pathology, Gifu University Hospital, 1-1 Yanagido, Gifu 501-1194, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1111\/cyt.12627","article-title":"Cell blocks in cytopathology: An update","volume":"29","author":"Nambirajan","year":"2018","journal-title":"Cytopathology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1016\/S0140-6736(14)62038-9","article-title":"Global surveillance of cancer survival 1995\u20132009: Analysis of individual data for 25 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