A Preliminary Study Of EpCAM^high/CD44⁺ Cancer Stem Cells Of Morphology, Quantity And Distribution In Colorectal Carcinoma

PurposeTo investigate the relationship between the expressions of ESA and CD44 and their clinicopathologic significance in primary colorectal carcinoma,furtherly to examine the distribution,quantity and morphological characteristics of the EpCAM^high/CD44⁺ colorectal cancer stem cells(Co-CSCs)in situ tissue,and explore the relationship between cancer stem cells(CSCs) and tumorigenesis mechanism and prognosis.The value of CD133 and CD44 as cancer stem cells markers were comparised.MethodsThe expressions of CD44,ESA and CD 133 protein in 10 cases of normal mucosa,13 cases of adenoma with atypical hyperplasia and 67 cases of colorectal carcinoma were detected by SP immunohistochemical method,and the relationship between CD44 and ESA with different pathological parameters were studied.The locations of duble-ESA and CD44 positive cells were detected by HE staining,SP immunohistochemical method and double immunohistochemical staining on continous slide.Results1.The expressions of CD44 and ESA in colorectal carcinoma(100%,53.7%) were significantly higher than in normal mucosa(00.0%,00.0%) and adenoma with atypical hyperplasia(7.1%,00.0%).Significant relationship was found among the expression of CD44 and lymphatica metastasis(x²=8.375 P=0.015),pathological grade(x²=14.284 P=0.006), and Dukes stage(x²=7.948 P=0.019).The expression of ESA was correlated with age (x²=16.918 P=0.000),depth of infiltration(x²=15.195 P=0.001),pathological grade (x²=10.395 P=0.034) and Dukes stage(x²=7.681 P=0.021).2.The expressions of ESA and CD44 were positive correlation(r_s=0.614 P=0.000)3.The number of double-positive ESA and CD44 cells accounted for 0.1%to 30%in all tumor cells;they was scattered or focal distribution along the basement of glandular-like structure;The cells were cube or oval,the cytoplasm was scarce,and the nucleus were oval or cylindrical high,relatively rules,deep stained and homogeneous;The number of double-positive cells and colorectal cancer was negatively correlated with the degree of differentiation.Conclusion1.The expressions ESA and CD44 are highly related to occurrence,development,infiltration and metastasis of colorectal carcinoma,they may form a complexes co-expressing on colorectal cancer stem cells.ESA and CD44 are very applicable the surface markers of colorectal cancer stem cells for the diagnosis of carcinoma metastasis and evaluating the prognosis of the patients.2.The distribution of Co-CSCs is help for the invasion and metastasis of carcinoma,the evaluation of the number,location,distribution and morphology of Co-CSCs and the relationship with pathological parameters will be applicable guidance for the diagnosis, staging,treatment and clinical prognosis.3.Both CD44 and CD133 are reported as putative markers for isolating colorectal CSC.The results indicate that CD44 is a more functional important marker for colorectal CSC in cancer initiation.