Colorectal cancer (CRC) is one of the most common solid tumors worldwide. Recent evidence suggests that a population of cancer cells, called cancer stem cells (CSCs), is responsible for tumor heterogeneity, invasion, metastasis, therapeutic resistance, and recurrence of CRC. The isolation and characterization of CSCs using cell surface markers have been reported previously with varying results. In this study, we investigated a panel of four putative CSC markers, CD44, CD24, CD166, and EpCAM, to define CRC-CSC. Paraffin embedded tissue samples from different grades of primary, untreated CRC were analyzed for the expression of four CSC markers CD44, CD326, CD24, and CD166, using immunohistochemistry. Flow cytometric analysis of CRC-CSC from HT29 (low grade) and HCT116 (high grade) human colorectal cancer cell lines was done. Marker-based isolation of CSC and non-CSC-bulk-tumor cells from HT29 was done using FACS, and tumor sphere assay was performed. There was a statistically significant difference (p < 0.05) in the expression of CD44, CD326, and CD166 between cases and controls. A novel cutoff distribution of CD44 and CD166 was suggested to help for better immunohistochemical analysis of CRC. Higher prevalence of CSC was seen in high-grade CRC as compared to low-grade CRC. Sorted and cultured CD44 + CD166+ cells formed tumor spheres, suggesting that these cells, having properties of self renewal and anchorage independent proliferation, were in fact CSC. Hence, CD44 and CD166 may serve as good CRC-CSC markers when used together with novel cutoff immunohistochemistry (IHC) expression levels.
Peripheral primitive neuroectodermal tumor is a rare group of tumors belonging to the Ewing's family of tumors. The female genital tract is a rare site of origin and to date there are 14 reported cases in the literature. We hereby report the 15(th) case of uterine primitive neuroectodermal tumor in a 24-year-old multipara in the reproductive age group. A 24-year-old multipara presented with pain and mass abdomen. Physical examination revealed a pelvic mass enlarged to 20 weeks size gravid uterus, fixed, tender and hard, occupying the whole pelvis. Magnetic resonance imaging showed a large mass posterior to the uterus. She underwent panhysterectomy and debulking of the tumor. Histopathology confirmed the diagnosis. She developed recurrence of the tumor within a month and is now on chemotherapy.
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