title: Increased expression of CD133 is a strong predictor of poor outcome in stage I colorectal cancer patients.
abstract: OBJECTIVE
  Stage I colorectal carcinomas display a highly variable behavior which is not accurately predicted by the available prognostic markers. CD133 is considered a useful marker to identify the so-called cancer stem cells in colorectal cancers (CRCs) and its expression has been shown to have prognostic significance in CRC patients. This study aimed to verify whether immunohistochemical evaluation of CD133 might correlate with the progression risk of stage I CRC patients.
  
  
  METHODS
  Expression levels of the CD133 molecule were analyzed and compared in two series of stage I surgically resected CRC patients showing disease progression and death for the disease and patients with no evidence of disease progression after at least 6 years after surgery.
  
  
  RESULTS
  A positive staining for CD133 was detected in 52% of the cases with poor prognosis and only in 9% of the group with good prognosis, and this difference was highly significant (p < 0.001). A significant correlation was detected between CD133 expression and histological parameters, such as tumor budding, vascular invasion, and presence of lymph node micrometastases but not tumor grading, gender, and age. Disease-free survival and cancer-specific survival of CD133 negative tumors were significantly longer compared to positive cases. In multivariate analyses, CD133 staining confirmed to be a predictor of shorter survival independent from vascular invasion but not from lymph nodes micrometastases.
  
  
  CONCLUSIONS
  These findings demonstrate that CD133 immunostaining is a useful predictor of high risk progression in stage I CRC patients and might help to identify patients eligible for adjuvant chemotherapy.
authors.affiliation: Dipartimento Misto di Anatomia Patologica e di Medicina Legale, Sezione di Anatomia Patologica, Università di Modena e Reggio Emilia, Modena, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Reggiani Bonetti
authors.forename: Mario
authors.initials: M
authors.lastname: Migaldi
authors.forename: Emanuele
authors.initials: E
authors.lastname: Caredda
authors.forename: Alma
authors.initials: A
authors.lastname: Boninsegna
authors.forename: Maurizio
authors.initials: M
authors.lastname: Ponz De Leon
authors.forename: Carmela
authors.initials: C
authors.lastname: Di Gregorio
authors.forename: Valeria
authors.initials: V
authors.lastname: Barresi
authors.forename: Domenico
authors.initials: D
authors.lastname: Scannone
authors.forename: Silvio
authors.initials: S
authors.lastname: Danese
authors.forename: Achille
authors.initials: A
authors.lastname: Cittadini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sgambato
mesh_terms: D000071916:AC133 Antigen; D000230:Adenocarcinoma / Q000556:secondary*; D000368:Aged; D015703:Antigens, CD / Q000032:analysis / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000032:analysis / Q000378:metabolism; D017024:Chemotherapy, Adjuvant / Q000379:methods; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology / Q000628:therapy; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006023:Glycoproteins / Q000032:analysis / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D014411:Neoplastic Stem Cells / Q000378:metabolism*; D018579:Patient Selection; D010455:Peptides / Q000032:analysis / Q000378:metabolism; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods
chemical_list: D000071916:AC133 Antigen; D015703:Antigens, CD; D014408:Biomarkers, Tumor; D006023:Glycoproteins; C000606023:PROM1 protein, human; D010455:Peptides