The Significance Of Clinical Pathology Of CD44~+/ALDH1~+Cancer Stem Cells In Colorectal Carcinomas

ObjectiveTo investigate the expression, relationship and its clinicopathologic significance of the cancer stem cells(CSCs) makers CD44and ALDH1in colorectal carcinomas. Further to compare the quantity, location, and morphological characteistics of colorectal cacer stem cells CD44+/ALDH1+in tubular adenoma, colorectal carcinomas and normal intestinal mucosa. To observe the morphological characteristics, quantity of CD44+/ALDH1+cells in human colon cancer cell lines(SW480). Further more to demonstrate the value of CD44+/ALDH1+as a marker of colorectal cancer stem cells(Co-CSCs).Methods68cases colorectal cancer,20cases tubular adenoma and12cases normal intestinal mucosa were collected and made into three tissue microarray(6×7) by microarray instrument. The expression of CD44and ALDH1were detected by HE staining, immunohistochemical staining and double immunohistochemical staining technology. The location, morphological characteristics, quantity of CD44+/ALDH1+cells in human colon cancer cell lines(SW480) were detected by HE staining, immunohistochemical staining and double immunohistochemical staining technology.ResultsCD44and ALDH I were negatively expressed in normal intestinal mucosa, were focal positively expressed in tubular adenoma, and were strongly positively expressed in colorectal carcinomas. The expressione rates of CD44and ALDH1were obviously higher in colorectal carcinomas than in normal intestinal mucosa, and tubular adenoma (P<0.05). The expression rates of CD44and ALDH1were correlated to the pathological grade, invasion and lymph node metastasis (P<0.05). There were no double positive cells of CD44and ALDH1in normal intestine mucosa, and a very small amount of CD44and ALDH I double positive cells in adenoma, but there were more double positive cellsof CD44and ALDH1in colorectal carcinomas. The expression rate of CD44+/ALDH1+cells was obviously higher in colorectal carcinomas than in normal mucosa and tubular adenoma (P<0.05), the expression rate of CD44+/ALDH1+cells was correlated withpathological grade, depth of invasion and lymph node metastasis (P<0.05). The CD44+/ALDH1+cells were scattered or distributed focally along the side of the gland basement wall or the side of co-wall in colorectal carcinomas. Meanwhile with scarcely cytoplasm of the CD44+/ALDH1+cells were spindle, and its nucleus was oval, deep stained and homogeneous.3. In human colon cancer cell lines(SW480), the positive rate of CD44and ALDH1accounted for12.34%,10.86%respectively, and the rate of CD44+/ALDH1+accounted for7.68%was similar to solid tumor. The double positive cells were mainly small round or spindle cells, and its nucleus was deep stained and homogeneous, and its cytoplasm was scarce or empty bubble. Conclusions1. The expression rates of CD44and ALDH1are related to the differentiated degree, the depth of invasion and lymph node metastasis in colorectal carcinomas. And CD44and ALDH1may be the avlueable cancer stem cells markers of colorectal cancer.2. The results of the relationship between the CD44+/ALDH1+cells and the pathological grade, depth of invasion, lymph node metastasis of colorectal carcinomas provide the evidence for the colorectal cancer pathological grade and clinical treatment.The CD44+/ALDH1+cells may be the avlueable markers of colorectal cancer stem cells.The morphological characteristics, quantity of CD44+/ALDH1+cells in human colon cancer cell lines(SW480) is similar to solid tumor, and further demostrate the CD44+/ALDH1+cells may be the markers of colorectal cancer stem cells.