Colorectal cancer (CRC) as a common malignancy in the digestive tract, its incidence and mortality increase significantly in China. Cancer stem cells (CSCs) are defined as a small fraction of tumor initiating cells that are endowed with both self-renewal and tumor growth potential. They may be responsible for tumor progression, metastasis, relapse and drug-resistance. Therefore, the isolation and characterization of tumorigenic CSCs in CRC may help to devise novel diagnostic and therapeutic procedures. This review briefly discusses the most recent advances in research on colorectal cancer stem cells including definition of the cancer stem cells, origin and specific markers of the colorectal CSCs. Transduction signal pathway involved in CSCs, potential therapeutic strategies targeting CSCs, and current issues in CSCs related research are also discussed.
Biomarkers, Tumor ; metabolism ; Colorectal Neoplasms ; metabolism ; pathology ; Humans ; Neoplastic Stem Cells ; metabolism ; pathology ; Signal Transduction

Objective: To investigate the expression of cortactin in colorectal cancer and its correlation with clinicopathological parameters and prognosis. Methods: The expressions of cortactin in normal colorectal mucosal tissue and colorectal cancer tissue in paraffin-embedded tissue microarray from 319 patients who were diagnosed as colorectal cancer and treated in Cancer Hospital of Chinese Academy of Medical Sciences from 2006 to 2009 was detected by immunohistochemistry. Kaplan-Meier method and Log rank test were used for survival analysis, and Cox proportional risk regression model was used for multivariate analysis. Results: The positive expression rates of cortactin in colorectal cancer tissue and normal colorectal mucosal tissue were 61.1% (195/319) and 5.6% (18/319, P<0.001), respectively. T-stage, N-stage, American Joint Committee on Cancer (AJCC) stage, degree of tumor differentiation, neural invasion and preoperative carcinoembryonic antigen (CEA) levels were associated with the expression of cortactin (P<0.05). The positive expression of cortactin was associated with poorer disease-free survival (P=0.036) and overall survival (P=0.043), and the effect was more significant in patients with stage Ⅱ to Ⅲ. For patients with stage Ⅱ-Ⅲ colorectal cancer, postoperative adjuvant therapy was associated with disease-free survival (P=0.007) and overall survival (P=0.015). The vascular tumor embolus, pathological type, preoperative CEA level and cortactin expression were independent influencing factors for disease-free survival (P<0.05). The age, AJCC stage, preoperative CEA level and cortactin expression were independent influencing factors for overall survival (P<0.05). Preoperative CEA level and cortactin expression were independent influencing factors for disease-free survival and overall survival (P<0.05). Conclusion: Cortactin is expressed in colorectal cancer and in stage Ⅱ-Ⅲ patients, it is a potential predictor of colorectal cancer prognosis.
Biomarkers, Tumor/metabolism* ; Carcinoembryonic Antigen/metabolism* ; Colorectal Neoplasms/pathology* ; Cortactin/metabolism* ; Humans ; Prognosis ; Retrospective Studies

OBJECTIVETo explore the expression of Survivin (SVV) protein in colorectal carcinogenesis and its clinical significance. METHODS Immunohistochemistry staining was performed by two-step EnVision technique for the paraffin sections, which included 90 adenomas, 25 ademomas with high-grade glandular intraepithelial neoplasia, and 108 colorectal adenocarcinomas.

RESULTSExpressions of SVV, P53, and Bcl-2 were observed in tumor cells of the sections. The positive rate of SVV in tubular adenomas, villous adenomas, and tubulovillous adenomas were 30% (12/40), 40.9% (9/22), and 35.8% (10/28), respectively. The positive rate of SVV in tubulovillous adenomas with high-grade glandular intraepithelial neoplasia were 68% (17/25). The positive rate of SVV in carcinomas of stage A, B, and C were 75% (27/36), 81.3% (26/ 32), and 95% (38/40), respectively. SVV expressions among the three types of adenomas without neoplasia were not significantly different (P > 0.05). SVV expression between each type of the above-mentioned ademoma and tubulovillous adenoma with high-grade glandular intraepithelial neoplasia or different Dukes stages of colorectal carcinoma was significantly different (P < 0.05). SVV expressions in adenocarcinomas and adenomas with high grade glandular intraepithelial neoplasia were significantly higher than those in adenomas (P < 0.01). The expressions of P53 and Bcl-2 had no significant difference among them. No association was noted between SVV expression and P53 or Bcl-2 expression (P = 0.487, P = 0. 437).

CONCLUSIONSSVV is abnormally expressed in the early stage of colorectal carcinogenesis, which may be correlated with the carcinogenesis of colorectal ademoma. SVV expression may be useful to distinguish adenocarcinoma from adenoma in colorectal carcinogenesis.

Adenocarcinoma ; metabolism ; pathology ; Adenoma ; metabolism ; pathology ; Colorectal Neoplasms ; metabolism ; pathology ; Humans ; Inhibitor of Apoptosis Proteins ; Microtubule-Associated Proteins ; biosynthesis

Animals ; Apoptosis ; Bone Neoplasms ; metabolism ; pathology ; Breast Neoplasms ; metabolism ; pathology ; Cell Proliferation ; Chondrosarcoma ; metabolism ; pathology ; Colorectal Neoplasms ; metabolism ; pathology ; Female ; Humans ; Male ; Ovarian Neoplasms ; metabolism ; pathology ; Prostatic Neoplasms ; metabolism ; pathology ; RNA, Messenger ; metabolism ; SOX9 Transcription Factor ; biosynthesis ; genetics ; physiology

Antigens, Neoplasm ; metabolism ; Antigens, Surface ; metabolism ; Colorectal Neoplasms ; immunology ; pathology ; Humans ; Prognosis ; Trophoblasts ; immunology

OBJECTIVETo investigate the role of the expression of growth hormone receptor (GHR) in the development and progression of human colorectal cancer (CRC).

METHODSThe expression levels of GHR and Ki-67 were detected by immunohistochemistry technique in CRC specimens and normal mucous tissue from 100 patients with CRC. The association between expression of GHR and clinicopathological factors was analyzed.

RESULTSThe expression of GHR was higher in the colorectal cancerous tissue compared to the normal mucous tissue (81% vs. 68%). The expression of GHR was significantly correlated with pathological staging (P=0.047), tumor differentiation (P=0.003) and tumor size (P=0.017). The expression of GHR was significantly associated with the expression of Ki-67 (P< 0.01) as well as tumor proliferation (P< 0.01).

CONCLUSIONThe over-expression of GHR is shown in human colorectal cancer and it also plays an important role in the development of human colorectal cancer. The use of rhGH in clinic should be cautious.

Colorectal Neoplasms ; metabolism ; pathology ; Female ; Gene Expression ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Receptors, Somatotropin ; metabolism

Objective: To investigate the clinicopathological features, immunophenotype, and genetic alterations of rectal adenocarcinoma with enteroblastic differentiation. Methods: Four cases of rectal adenocarcinoma with enteroblastic differentiation were collected at the Affiliated Hospital of Qingdao University, Qingdao, China (three cases) and Yantai Yeda Hospital of Shandong Province, China (one case) from January to December 2022. Their clinical features were summarized. Hematoxylin and eosin stain and immunohistochemical stain were performed, while next-generation sequencing was performed to reveal the genetic alterations of these cases. Results: All four patients were male with a median age of 65.5 years. The clinical manifestations were changes of stool characteristics, bloody stools and weight loss. All cases showed mixed morphology composed of conventional adenocarcinoma and adenocarcinoma with enteroblastic differentiation. Most of the tumors consisted of glands with tubular and cribriform features. In one case, almost all tumor cells were arranged in papillary structures. The tumor cells with enteroblastic differentiation were columnar, with relatively distinct cell boundaries and characteristic abundant clear cytoplasm, forming fetal gut-like glands. Immunohistochemically, the tumor cells were positive for SALL4 (4/4), Glypican-3 (3/4) and AFP (1/4, focally positive), while p53 stain showed mutated type in 2 cases. The next-generation sequencing revealed that 2 cases had TP53 gene mutation and 1 case had KRAS gene mutation. Conclusions: Rectal adenocarcinoma with enteroblastic differentiation is rare. It shows embryonal differentiation in morphology and immunohistochemistry, and should be distinguished from conventional colorectal adenocarcinoma.
Humans ; Male ; Aged ; Female ; Biomarkers, Tumor/metabolism* ; Adenocarcinoma/pathology* ; Colorectal Neoplasms ; Rectal Neoplasms/genetics* ; Cell Differentiation

OBJECTIVETo investigate and analyze the expression of fascin and CK14 in multiple histological types of cancer and to explore the potential value of the two proteins as markers in diagnosis and differential diagnosis of various cancer types.

METHODSTissue microarray containing esophageal squamous cell carcinoma (SCC), lung SCC, larynx SCC, uterine cervical SCC, SCC of external genital organs, lung adenocarcinoma, gastric adenocarcinoma, colorectal adenocarcinoma, heptocellular carcinoma, pancreatic ductal adenocarcinoma, breast infiltrating ductal carcinoma, thyroid papillary carcinoma, uterine endometrioid adenocarcinoma, ovarian serous adenocarcinoma and renal clear cell carcinoma, 30 cases each, as well as corresponding normal controls was constructed. The expression of fascin and CK14 among different types of carcinoma and corresponding normal controls was detected by immunohistochemistry.

RESULTSIn normal esophagus, bronchus, larynx, uterine cervix and skin, fascin was mainly expressed in the basal cells or reserve cells, but the expression was diffuse in esophageal SCC, lung SCC, larynx SCC, uterine cervical SCC and SCC of external genital organs, with a positive rate of 90.0%, 90.0%, 96.7%, 78.6% and 89.7%, respectively. In the normal tissue of other organs, except breast and uterine endometrium, fascin was negative. In lung adenocarcinoma, gastric adenocarcinoma, colorectal adenocarcinoma, hepatocellular carcinoma, pancreatic ductal adenocarcinoma, breast infiltrating dutal adenocarcinoma, thyroid papillary carcinoma, uterine endometrioid adenocarcinoma, ovarian serous adenocarcinoma and renal clear cell carcinoma, the positive rates were 38.0%, 23.3%, 14.3%, 10.3%, 73.3%, 13.3%, 6.7%, 60.0%, 66.7% and 10.0%, respectively. The difference between fascin expression in SCC and in other histological types was statistically significant (P < 0.001). CK14 was mainly expressed in the basal cells, reserve cells or myoepithelia of normal tissues. The positive rates of CK14 were 76.7%, 36.7%, 83.3%, 60.7% and 96.3% in esophageal SCC, lung SCC, larynx SCC, uterine cervical SCC and SCC of external genital organs, respectively. It was weak and focal in lung adenocarcinoma, gastric adenocarcinoma, colorectal adenocarcinoma, hepatocellular carcinoma, pancreatic ductal adenocarcinoma, breast infiltrating dutal adenocarcinoma, thyroid papillary carcinoma, uterine endometrioid adenocarcinoma, ovarian serous adenocarcinoma, and renal clear cell carcinoma, with a positive rate of 13.3%, 13.3%, 20.7%, 41.4%, 46.7%, 6.7%, 40.0%, 13.3%, 20.0% and 6.7%, respectively. The difference between CK14 expression in SCC and in other histological types was statistically significant (P < 0.001). The difference between co-expression of fascin/CK14 in SCC and in other histological types was also statistically significant (P < 0.001).

CONCLUSIONFascin and CK14 are highly expressed in SCC, compared with other histological types of carcinoma. Combination of fascin and CK14 should be a valuable marker in diagnosis and differential diagnosis of carcinoma.

Adenocarcinoma ; metabolism ; pathology ; Breast Neoplasms ; metabolism ; pathology ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Carrier Proteins ; metabolism ; Colorectal Neoplasms ; metabolism ; pathology ; Cystadenocarcinoma, Serous ; metabolism ; pathology ; Diagnosis, Differential ; Esophageal Neoplasms ; metabolism ; pathology ; Female ; Humans ; Keratin-14 ; metabolism ; Laryngeal Neoplasms ; metabolism ; pathology ; Liver Neoplasms ; metabolism ; pathology ; Lung Neoplasms ; metabolism ; pathology ; Male ; Microfilament Proteins ; metabolism ; Ovarian Neoplasms ; metabolism ; pathology ; Stomach Neoplasms ; metabolism ; pathology ; Uterine Cervical Neoplasms ; metabolism ; pathology

OBJECTIVETo investigate the expression differences of apoptosis-inducing factor (AIF) and caspase-3 among colorectal carcinoma, adenoma and normal mucosa, and to identify the relationship between AIF and caspase-3 expression in colorectal adenoma-carcinoma sequence.

METHODSFormalin-fixed paraffin embedded colorectal tissues from 174 cases, including 84 adenomas, 72 carcinomas, and 18 normal mucosa, were examined for expression of AIF and caspase-3 by streptavidin-peroxidase (SP) immunohistochemistry.

RESULTSThe positive rates of AIF and caspase-3 in colorectal adenoma were higher than those in normal mucosa (P <0.05). The positive rate of AIF in adenoma showed no significant difference compared to colorectal carcinoma (P >0.05). However, caspase-3 expression in adenomas was significantly higher than that in carcinoma (P <0.05). The positive rate of AIF in tubular adenoma was significantly higher than that in villous adenoma (P <0.05), while the positive expression rate of caspase-3 in the two types of adenoma showed no significant difference (P >0.05). AIF expression had no prominent correlation with the caspase-3 expression (P >0.05).

CONCLUSIONSThe dysregulation of caspase-independent pathway of apoptosis may be an early event in the development of colorectal carcinogenesis, while the dysregulation of the caspase-dependent pathway of apoptosis may be one of contributing factors of colorectal carcinogenesis. The caspase-independent pathway of apoptosis and the caspase-dependent pathway of apoptosis are two relatively independent pathways in colorectal carcinogenesis.

Adenoma ; metabolism ; pathology ; Adult ; Aged ; Apoptosis Inducing Factor ; metabolism ; Caspase 3 ; metabolism ; Colorectal Neoplasms ; metabolism ; pathology ; Female ; Humans ; Intestinal Mucosa ; metabolism ; pathology ; Middle Aged ; Young Adult

We analyzed the expression of p21, bcl2, and p53 in normal and different pathologic mucosa of the human colorectum using immunohistochemistry and cold polymerase chain reaction-single strand conformation polymorphism. The topography of normal mucosa showed; bcl2 and p53 expression restricted to basal epithelial cells and p21 expressed only in superficial epithelial cells. This topographic expression was altered in hyperplastic polyps and adenomas. Hyperplastic polyps revealed absence of or weak bcl2 expression and strong p21 expression without topography. In adenomas, whereas bcl2 expression increased and extended to parabasal and superficial dysplastic epithelium, the increase of p21 expression was limited to surface dysplastic epithelium. p53 was weakly expressed throughout the full thickness of dysplastic epithelium. Bcl2 expression in adenomas was stronger than in carcinomas; p53 expression was converse and p21 expression was variable. In carcinomas, this topographic expression was largely abrogated but p53 mutation (36%) was more frequent than in adenomas (2%). In carcinomas, p21 and p53 expression correlated inversely, but there was no relationship with bcl2. These results suggest that there is precisely ordered topographic pattern of p21, bcl2, and wild p53 expression in normal colorectal cells, but this becomes disordered during the early stage of colorectal carcinogenesis.
Colorectal Neoplasms/physiopathology ; Colorectal Neoplasms/pathology ; Colorectal Neoplasms/metabolism* ; Colorectal Neoplasms/genetics ; Cyclins/biosynthesis* ; Human ; Mutagenesis ; Protein p53/genetics ; Protein p53/biosynthesis* ; Proto-Oncogene Proteins c-bcl-2/biosynthesis* ; Time Factors