1. Combined CD133/CD44 Expression as a Prognostic Indicator of Disease-Free Survival in Patients With Colorectal Cancer
- Author
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Marica Gemei, Michele Orditura, Gennaro Galizia, Luigi Del Vecchio, Peppino Mirabelli, Ferdinando De Vita, Paolo Castellano, Francesco Salvatore, Carlo Pignatelli, Eva Lieto, Anna Zamboli, Rosa Di Noto, Margherita Pinto, Galizia, Gennaro, Gemei, M, Del Vecchio, L, Zamboli, A, Di Noto, R, Mirabelli, P, Salvatore, F, Castellano, P, Orditura, Michele, DE VITA, Ferdinando, Pinto, M, Pignatelli, C, Lieto, Eva, Gemei, M., DEL VECCHIO, Luigi, Zamboli, A., DI NOTO, Rosa, Mirabelli, P., Salvatore, Francesco, Castellano, P., Orditura, M., DE VITA, Felice, Pinto, M., and Pignatelli, C.
- Subjects
Male ,medicine.medical_specialty ,Pathology ,Colorectal cancer ,Pilot Projects ,medicine.disease_cause ,Disease-Free Survival ,Antigen ,Cancer stem cell ,Antigens, CD ,medicine ,Humans ,Neoplastic transformation ,AC133 Antigen ,neoplasms ,Aged ,Glycoproteins ,biology ,business.industry ,CD44 ,Middle Aged ,medicine.disease ,Prognosis ,Surgery ,Hyaluronan Receptors ,embryonic structures ,biology.protein ,Cancer research ,Biomarker (medicine) ,Female ,Stem cell ,Carcinogenesis ,business ,Colorectal Neoplasms ,Peptides - Abstract
Hypothesis Because of some inconsistencies in the traditional model of human colorectal carcinogenesis, the cancer stem cell (CSC) model was recently proposed, in which tumor results from neoplastic transformation of stem cells, which become CSCs. Identification of CSCs by expression of surface antigens remains a critical issue because no biomarker has been shown to be completely reliable. CD133 and CD44 are commonly used as CSC markers, and correlation of their expression with colorectal cancer (CRC) clinicopathological features and outcomes may be useful. Design Pilot study. Setting University hospital. Patients Thirty-six consecutive patients with CRC.CD133 and CD44 expression (alone or combined) was determined in nontumor cells and in tumor cells by flow cytometry, which identified viable cells only. Main Outcome Measures Correlation of CD133 and CD44 expression with each other, with other prognostic indicators, and with disease-free survival. Results CD133 and CD44 expression was significantly higher in tumor cells than in nontumor cells, and expression of one did not necessarily correlate with expression of the other. CD133 or CD44 expression alone was variable, while combined CD133/CD44 expression identified a small subset of cells positive for CRC. CD133 or CD44 overexpression was not associated with CRC recurrence; only high frequencies of CD133 + /CD44 + cells were a strong indicator of worse disease-free survival and an independent risk factor for CRC recurrence. Conclusion Evaluation of combined CD133/CD44 expression could be useful to identify putative colorectal CSCs and tumors with a poor prognosis.
- Published
- 2012