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AIM:To analyze the expression of 8 putative cancer stem cell(CSC) markers within colorectal cancer tumor buds and to determine their prognostic impact in patients with this disease. METHODS:Immunohistochemistry was performed on 101 colorectal cancer resections for CK22(to identify tumor buds) as well as CD133,CD166,CD24,CD44s,CD90,EpCAM,ALDH1,and ABCG5,and their expression within tumor buds was evaluated. RESULTS:CD90,CD44s,and CD133 expression in tumor buds was found in less than 5%of all cases. ALDH1,CD24,CD166 were expressed in 16.5%,16.2%,and 34%cases,respectively,while ABCG5 and EpCAM expression was more frequent and found in 35%and 69%of cases,respectively.Of the 8 markers studied,EpCAM and ABCG5 positivity in tumor buds were significantly associated with poor prognosis(P=0.023,P=0.038,respectively) in multivariable analysis with pT and pN classificationP=0.048;hazard ratio(HR) :2.64;95%CI:1.0-6.9,for EpCAM and P=0.029;HR:2.22;95%CI:1.0-4.5,for ABCG5.Poor survival time was particularly striking for lymph node-negative patients with ABCG5-positive buds(P<0.001) . CONCLUSION:Expression of putative stem cell markers EpCAM and ABCG5 within the tumor buds of colorectal cancer are frequently noted and are associated with poor prognosis.
METHODS: Immunohistochemistry was performed on 101 colorectal cancer resections for CK22 (to identify tumor buds ): as well as CD133, CD166, CD24, CD44s, CD90, EpCAM, ALDH1, and ABCG5, and their expression within tumor buds was evaluated. RESULTS: CD90, CD44s, and CD133 expression in tumor buds was found in less than 5% of all cases. ALDH1, CD24, CD166 were expressed in 16.5%, 16.2%, and 34% cases, respectively, while ABCG5 and EpCAM expression was more frequent and found in 35% and 69% of cases, respectively. Of the 8 markers studied , EpCAM and ABCG5 positivity in tumor buds were significantly associated with poor prognosis (P = 0.023, P = 0.038, respectively) in multivariable analysis with pT and pN classificationP = 0.048; hazard ratio (HR): 2.64; 95% CI: 6.9, for EpCAM and P = 0.029; HR: 2.22; 95% CI: 1.0-4.5 for ABCG5.Poor survival time was partic CONCLUSION: Expression of putative stem cell markers EpCAM and ABCG5 within the tumor buds of colorectal cancer are frequently noted and are associated with poor prognosis.