Prognostic Value of Poorly Differentiated Clusters and expression of Cancer Stem Cell Marker in Non-Metastatic Colorectal Carcinoma

Abstract

Author(s): Heba A. Abdelbaky, Ahmed M. Fahmy, Mervat M.F. El-Deftar, Osman M. Mansour, Hoda Ismail

Background: Globally Colorectal Cancer (CRC) is considered as the third most common cancer after lung and breast cancers. It is more prevalent in developing countries. In Egypt, CRC is the seventh most prevalent cancer of total malignant tumors. In CRC, Poorly Differentiated Clusters (PDCs) are considered adverse prognosticators and seem to reflect Epithelial Mesenchymal Transition (EMT). CD44 and CD133 are Cancer Stem Cells (CSCs) that are considered as the most influential in colorectal cancer outcome. Our study aimed to evaluate the prognostic value of PDCs grades, CD44 and CD133 expression by real time PCR in non-metastatic CRC. Material and Methods: Consecutive 100 non-metastatic CRC patients were enrolled in this study. Following histopathological diagnosis, PDCs were counted on H&E slides. CD44 and CD133 CSC biomarker expression were assessed by real time PCR. Disease outcome was correlated with different molecular and pathological parameters. Results: PDCs were found to be significantly correlated with the positive lymph node status (P-value<0.001) and advanced tumor stage (P-value 0.003). CD44 was positive in (13%) of cases and CD133 was expressed in (51%) of cases. The independent factors that significantly affect Disease Free Survival (DFS) and Overall Survival (OS) were CD44 expression, presence of positive nodes and the tumor stage. Conclusions: This study confirms the prognostic value of PDC assessment in non-metastatic CRC cases. It is considered a more precise instrument for the prediction of lymph node metastases and advanced cancer stage. Expression of CD44 is associated with worse disease outcome as regard DFS and OS. CD133 was not associated with inferior overall survival.

Share this article