Cancer stem cells in colorectal cancer

Background. Cancer stem cells (CSCs) are considered to be responsible for progression and recurrence of colorectal cancer (CRC). A detailed study of the phenotype of these cells and their immunobiological properties is necessary for developing CRC treatments. The aim of the study was to assess the percentage of EpCAM^high/CD44⁺ cancer stem cells in colorectal cancer and to detect the expression of CD133, CD166, CD24 and CD184 on their surface.
Material and Methods. A one-stage cross-sectional study of the cellular composition of tumor tissue was performed in 123 patients with stage III colon adenocarcinoma. The control group consisted of 87 patients who underwent surgery for non-neoplastic diseases of the colon. An enzymatic method was used to obtain a suspension of tumor tissue cells. Gating of non-lymphoid cells (CD45-) was performed depending on the expression of the epithelial cell adhesion molecule EpCAM and the differentiation antigen CD44 on their surface. Expression of EpCAM, CD44, CD133, CD166, CD184 and CD24 on CSCs was studied by fow cytometry.
Results. The CD45-EpCAM^highCD44+ colorectal cancer stem cells (CSCs) accounted for 17.15 % [11.76; 26.44] of the non-lymphoid cell population. Within this CSC population, 42.83 % [37.07; 51.77] simultaneously expressed CD133 and CD166, while 57.17 % [48.23; 62.93] expressed the CD133 antigen alone. All CSCs in the primary tumor expressed CD184, and 95.18 % [88.48; 97.98] of them simultaneously expressed CD24. The percentage of EpCAM^highCD44⁺ cells in well-differentiated tumors was 1.5 times lower than that in moderately-differentiated tumors (U=326.5, p=0.002) and 2.1 times lower than in poorly-differentiated tumors (U=21.0, p<0.001). In addition, the percentage of EpCAM^highCD44⁺CD133⁺CD166⁺ cells in stage IIIC CRC was 13 % higher than that in stage IIIB CRC (U=1116.0, p=0.007).
Conclusion. In primary colorectal cancer tumors, cancer stem cells expressing high levels of EpCAM and CD44 accounted for 17.2 % of the non-lymphoid cell pool. The percentage of EpCAM^high/CD44⁺ cells in poorly differentiated tumors was higher than that in well-or moderately-differentiated tumors.

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