PURPOSE: To investigate the association of cancer stem-cell markers [octamer-binding transcription factor 4 (OCT4), sex determining region Y-box 2 (SOX2), and Nanog homebox (NANOG)] expression with clinicopathological properties and overall survival (OS) in operative rectal cancer (RC) patients receiving adjuvant therapy. MATERIALS AND METHODS: 153 patients with primary RC receiving surgery were enrolled. Tumor tissue and paired adjacent normal tissue sample were collected, and OCT4, SOX2, and NANOG expressions were assessed by immunofluorescent staining. The median follow-up duration was 5.2 years, and the last follow-up date was August 2016. RESULTS: Tumor tissue OCT4 (p < 0.001), SOX2 (p=0.003), and NANOG (p < 0.001) expressions were higher than those in adjacent tissue. OCT4 expression was positively correlated with pathological grade (R=0.185, p=0.022), tumor size (R=0.224, p=0.005), and N stage (R=0.170, p=0.036). NANOG expression was positively associated with tumor size (R=0.169, p=0.036). Kaplan-Meier suggested that OCT4+ was associated with worse OS compared with OCT4− (p < 0.001), while no association of SOX2 (p=0.121) and NANOG expressions (p=0.195) with OS was uncovered. Compared with one or no positive marker, at least two positive markers were associated with shorter OS (p < 0.001), while all three positive markers were correlated with worse OS compared with two or less positive markers (p < 0.001). Multivariate Cox's analysis revealed that OCT4+ (p < 0.001) and N stage (p=0.046) were independent factors for shorter OS. CONCLUSION: Tumor tissue OCT4 expression was correlated with poor differentiation, tumor size, and N stage, and it can serve as an independent prognostic biomarker in operative patients with RC receiving adjuvant therapy.
Aged ; Biomarkers, Tumor/metabolism ; Female ; Humans ; Male ; Multivariate Analysis ; Nanog Homeobox Protein/metabolism ; Neoplastic Stem Cells/metabolism ; Octamer Transcription Factor-3/metabolism ; Prognosis ; Rectal Neoplasms/metabolism ; Rectal Neoplasms/pathology ; Rectal Neoplasms/surgery ; SOXB1 Transcription Factors/metabolism ; Survival Analysis

In recent years, conventional targeting of chemotherapeutic drugs on colorectal tumor tissue is poor in the clinical application. Due to the multidrug resistance of colorectal tumors, penetration and cytotoxicity of conventional drugs greatly reduced on tumor tissue. With the advent of tumor-penetrating peptides, a new and highly effective antitumor drug delivery system has become a research topic of international scholars. This article will briefly describe the research progress of iRGD peptides with the modified nanomicelles drug delivery system on targeted drug delivery and resistance to drug-resistant colorectal tumors in recent years. These studies show that iRGD peptide-modified nanomicelles will be a highly potential anti-drug delivery system.