Prognostic Value of Stem Cell Quantification in Stage II Colon Cancer

Abstract

BackgroundCancer stem cells (CSCs) are a subset of tumor cells with capacity to self-renew and generate the diverse cells that make up the tumor. The aim of this study is to evaluate the prognostic value of CSCs in a highly homogeneous population of stage II colon cancer.MethodsOne hundred stage II colon cancer patients treated by the same surgical team between 1977 and 2005 were retrospectively analyzed. None of the patients received adjuvant chemotherapy. Inmunohistochemistry expression of CD133, NANOG and CK20 was scored, using four levels: <10%, 11–25%, 26–50% and >50% positivity. Kaplan-Meier analysis and log rank test were used to compare survival.ResultsThe average patient age was 68 years (patients were between 45–92 years of age) and median follow up was 5.8 years. There was recurrent disease in 17 (17%); CD133 expression (defined by >10% positivity) was shown in 60% of the tumors, in 95% for NANOG and 78% for CK20. No correlation was found among expression levels of CD133, NANOG or CK20 and relapse-free survival (RFS) or overall survival (OS). However, a statistical significant correlation was found between established pathological prognostic factors and RFS and OS.ConclusionsStem Cell quantification defined by CD133 and NANOG expression has no correlation with RFS or OS in this cohort of Stage II colon cancer.

Prognostic significance of NANOG expression in solid tumors: a meta-analysis

“…The study selection process is described in Figure 1 . A total of 33 studies 5 – 16 , 19 – 39 published from 2008–2018 and including 35 data sets with 3,959 patients were selected to evaluate the relationship of NANOG expression and tumor prognosis. The average study population size was 113, ranging from 42 to 312 patients.…”

“…Four studies evaluated non-small cell lung cancer (NSCLC), 5 , 32 – 34 four evaluated gastric cancer (GC), 9 , 26 , 27 , 38 and five evaluated OSCC; 8 , 15 , 28 , 29 , 36 breast cancer, 6 , 30 , 31 hepatocellular carcinoma (HCC), 7 , 25 , 39 and ovarian cancer (OC) 13 , 21 , 22 were each evaluated in three studies. Esophageal squamous cell carcinoma (ESCC), 10 , 23 colorectal cancer (CRC), 11 , 16 and pancreatic cancer (PC) 12 , 24 were each evaluated in two studies. Nasopharyngeal carcinoma (NPC), 14 astrocytoma, 20 cervical cancer (CC), 37 tongue squamous cell carcinoma (TSCC), 35 and mucoepidermoid carcinoma (MEC) 19 were each evaluated in one study.…”

“…Nasopharyngeal carcinoma (NPC), 14 astrocytoma, 20 cervical cancer (CC), 37 tongue squamous cell carcinoma (TSCC), 35 and mucoepidermoid carcinoma (MEC) 19 were each evaluated in one study. Thirty-three studies 5 – 16 , 19 – 39 reported OS and nine studies 6 , 9 , 13 , 15 , 21 , 22 , 31 , 32 , 38 reported DFS. NANOG expression was assayed in all tumor tissues by IHC and stratified by high and low expression.…”

“… 10 Vaz et al found that NANOG expression was not related to prognosis in rectal cancer. 16 Therefore, the prognostic value of NANOG expression in solid tumors is controversial. This meta-analysis was conducted to overcome design limitations and sample size limitations of previous studies to further evaluate the potential prognostic and clinical values of NANOG in patients with malignant cancers.…”

CD133 expression may be useful as a prognostic indicator in colorectal cancer, a tool for optimizing therapy and supportive evidence for the cancer stem cell hypothesis: a meta-analysis

“…Based on a systematic review of previous work, we found that CD133 expression was highly correlated with poor OS and DFS, indicating that CD133 + CSCs likely have a close relationship with patient survival and tumor relapse. Among the included studies, six selected patients who received curative surgery rather than postoperative therapy (non-AT subgroup) [ 53 , 55 , 58 , 63 , 72 , 73 ]. Eleven evaluated cancer survival and recurrence among patients, all or most of whom underwent both surgical and adjuvant therapy (AT subgroup) [ 50 , 51 , 55 , 58 , 59 , 67 – 72 ].…”