Immunoexpression of stem cell markers CD44, CD133, ALDH1-2, and LGR5 in colorectal carcinoma and their association with clinicopathological tumor characteristics.

Abstract

Objective: To investigate the association of CD44, CD133, ALDH1-2, and LGR5 expression with clinicopathological tumor variables.

Methods: Twenty-eight adult patients with colorectal carcinoma who underwent curative surgery were included in the study. Paraffin-embedded samples were subjected to immunohistochemical staining with anti-CD44, anti-CD133, anti-ADLH1-2, and anti-LGR5 antibodies, and the results were compared with the patients' clinicopathological variables. P-values <0.05 were considered significant.

Results: Fifteen patients (53.6%) were male. The mean age was 66.8±13.01 (range: 38 to 88) years. The neoplasm was located in the rectum in 17 (60.7%) patients and colon in 11 (39.3%) patients. The mean tumor size was 4.3 (1.0-10.0) cm. The degree of cellular differentiation was moderate in 27 (94.4%) patients. The tumors presented with parietal invasion at the T1 level in two (7.1%) patients, T2 in seven (25%), and T3 in 19 (67.8%). Vascular invasion was present in nine (32.1%) patients and perineural invasion in five (17.8%). Lymph node involvement was observed in 11 patients (39.3%). ALDH1-5 and LGR5 proteins were significantly increased in patients >60 years of age, in the rectum and right colon, and in the presence of lymph node involvement. CD44 protein expression was increased in tumors of the left colon.

Conclusion: Increased tissue levels of ALDH1-2 and LGR5 were related to increased aggressiveness of colorectal carcinoma.