title: Increased expression of CD133 and reduced dystroglycan expression are strong predictors of poor outcome in colon cancer patients.
abstract: BACKGROUND
  Expression levels of CD133, a cancer stem cell marker, and of the α-subunit of the dystroglycan (α-DG) complex, have been previously reported to be altered in colorectal cancers.
  
  
  METHODS
  Expression levels of CD133 and α-DG were assessed by immunohistochemistry in a series of colon cancers and their prognostic significance was evaluated.
  
  
  RESULTS
  Scattered cells positive for CD133 were rarely detected at the bases of the crypts in normal colonic mucosa while in cancer cells the median percentage of positive cells was 5% (range 0-80). A significant correlation was observed with pT parameter and tumor stage but not with tumor grade and N status. Recurrence and death from disease were significantly more frequent in CD133-high expressing tumors and Kaplan-Meier curves showed a significant separation between high vs low expressor groups for both disease-free (p = 0.002) and overall (p = 0.008) survival.Expression of α-DG was reduced in a significant fraction of tumors but low α-DG staining did not correlate with any of the classical clinical-pathological parameters. Recurrence and death from the disease were significantly more frequent in α-DG-low expressing tumors and Kaplan-Meier curves showed a significant separation between high vs low expressor tumors for both disease-free (p = 0.02) and overall (p = 0.02) survival. Increased expression of CD133, but not loss of α-DG, confirmed to be an independent prognostic parameters at a multivariate analysis associated with an increased risk of recurrence (RR = 2.4; p = 0.002) and death (RR = 2.3; p = 0.003).
  
  
  CONCLUSIONS
  Loss of α-DG and increased CD133 expression are frequent events in human colon cancer and evaluation of CD133 expression could help to identify high-risk colon cancer patients.
authors.affiliation: Dipartimento di Scienze Chirurgiche, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Coco
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Zannoni
authors.forename: Emanuele
authors.initials: E
authors.lastname: Caredda
authors.forename: Stefano
authors.initials: S
authors.lastname: Sioletic
authors.forename: Alma
authors.initials: A
authors.lastname: Boninsegna
authors.forename: Mario
authors.initials: M
authors.lastname: Migaldi
authors.forename: Gianluca
authors.initials: G
authors.lastname: Rizzo
authors.forename: Luca Reggiani
authors.initials: LR
authors.lastname: Bonetti
authors.forename: Giannicola
authors.initials: G
authors.lastname: Genovese
authors.forename: Egidio
authors.initials: E
authors.lastname: Stigliano
authors.forename: Achille
authors.initials: A
authors.lastname: Cittadini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sgambato
mesh_terms: D000071916:AC133 Antigen; D000368:Aged; D015703:Antigens, CD / Q000235:genetics / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism; D003110:Colonic Neoplasms / Q000235:genetics / Q000378:metabolism / Q000473:pathology / Q000628:therapy; D018572:Disease-Free Survival; D049030:Dystroglycans / Q000235:genetics / Q000378:metabolism; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006023:Glycoproteins / Q000235:genetics / Q000378:metabolism; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010455:Peptides / Q000235:genetics / Q000378:metabolism; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D000071916:AC133 Antigen; D015703:Antigens, CD; D014408:Biomarkers, Tumor; D006023:Glycoproteins; C000606023:PROM1 protein, human; D010455:Peptides; D049030:Dystroglycans