| 0bjective: To detect the expression of cancer stem cell markers CD24and Lgr5in colorectal polyps and colorectal cancer, analyze relevantinfluential factors and discuss their role in the colorectal polypscanceration.Methods: The patients receiving colonoscopy or treatment inGastroendoscope Room of Shanghai No.6People’s Hospital JinshanBranch from June to December2013were selected, including20casesfor inflammatory hyperplastic polyp, tubular adenomatous polyp, villousadenomatous polyp and adenocarcinoma respectively, according to thehyperplasia degree of colorectal polyps, respectively22case for atypicalhyperplasia,28cases for low-level intraepithelial neoplasia and10casesfor high-level intraepithelial neoplasia, in which there were27cases forpolyps with diameter below1.0cm,25cases with diameter between1.0cm and2.0cm and8cases with diameter more than2.0cm. Amongthe total80patients, there were53male, and27female, with ageranging from25to87, among whom21cases had an age younger than40and59cases40or older. To patients with multiple colorectal polyps,the largest polyp was counted as one case for statistic; those patients with both colorectal polyps and colorectal cancer were counted in cancergroup for statistic. The colonoscopy biopsys in the same period wereselected, and20cases of colorectal mucosa proved to be normal bypathological examination (10cases for colon and rectum respectively)were selected as the control group. The expressions of CD24and Lgr5were detected by immumohistochemical staining, all the pathologicalslides were analyzed after being examined independently by twopathological physicians.Results CD24was not expressed in normal intestinal mucosa andinflammatory hyperplastic polyp groups and had a high and strongexpression in adenomatous polyp and adenocarcinoma groups. CD24had a gradually high expression in non-adenoma, tubular adenoma,villous adenoma and adenocarcinoma, the two variable-related analysesshowed that CD24expression rate was linearly related with thepathological type of polyp (r=0.964, P>0.01); the expression of CD24increased gradually with the increasing of diameter of polyp (r=0.997,P<0.05); CD24expression rate gradually increased with atypicalhyperplasia, low-level intraepithelial neoplasia, high-level intraepithelialneoplasia and adenocarcinoma, the two variable-related analyses showedthat CD24expression rate was linearly related with the degree ofatypical hyperplasia; CD24expression rate was statistically significantbetween the patients younger than40and patients of40or older; CD24 and Lgr5expression rate was not statistically significant in male andfemale groups (P>0.05). Lgr5was not expressed or had a low expressionin normal intestinal mucosa and inflammatory hyperplastic polyp groups,and had a high and strong expression in adenomatous polyp andadenocarcinoma groups; Lgr5expression rate gradually increased withatypical hyperplasia, low-level intraepithelial neoplasia, high-levelintraepithelial neoplasia and adenocarcinoma, but the twovariable-related analyses showed that Lgr5expression was not linearlyrelated with the degree of atypical hyperplasia (r=0.897, P>0.05); it wasstatistically significant (P<0.005) in comparison with the polyp groupwith diameter less than1.0cm and that with diameter more than1.0cm;Lgr5expression rate increased with the atypical hyperplasia, low-levelintraepithelial neoplasia, high-level intraepithelial neoplasia andadenocarcinoma, but the two variable-related analyses showed that Lgr5expression was not linearly related with the degree of atypicalhyperplasia (r=0.833, P>0.05). But in the mutual comparison of atypicalhyperplasia group and low-level intraepithelial neoplasia, high-levelintraepithelial neoplasia and adenocarcinoma groups, Lgr5expressionrate was statistically significant (P<0.01); Lgr5expression rate was notstatistically significant between the patients younger than40and thoseof40or older (χ2=0.095, P>0.05). Conclusion1. In the sequences of non-adenoma, tubular adenoma,villous adenoma and adenocarcinoma, the expressions of both CD24andLgr5increased.2. With the increasing of size of colorectal polyps, the expressions ofCD24and Lgr5increased gradually.3. With the worsening of atypical hyperplasia of polyps, there was atrend that the expressions of CD24and Lgr5gradually increased.4. The expression of CD24is influenced by age, while there was nodifference for the expression of Lgr5, so compared with CD24, thedetection of Lgr5might be a better early indicator.5. The expressions of CD24and Lgr5were unrelated with gender.6. Both CD24and Lgr5were the important reference indicators for themalignant lesions of colorectal polyps, and their detection can providecertain help for the early diagnosis of colorectal cancer. |
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