Clinicopathological And Prognostic Significance Of CD44,CD133 And NLR In Patients With Colorectal Cancer

BackgroundColorectal cancer is one of the most commonly diagnosised cancers wordwide and its incidence in China is on the rise.Exploring the etiology and pathogenesis of colorectal cancer,looking for a new evaluation of prognosis indicators for colorectal patients,providing new ideas for the prevention and treatment of colorectal cancer has always been a research hotspot.With the development of medical molecular biology and research,The word scholars have suggested that chronic inflammation plays an important role in the occurrence and development of tumors,furthermore neutrophil/lymphocyte ratio(NLR)is an indicator of the body's inflammatory response and immune system status,and is associated with the clinicopathological features and prognosis of patients with colorectal cancer.At the same time,it was found that cancer stem cells(CSCs)are closely related to tumor recurrence and metastasis.The expression levels of tumor stem cell markers CD44 and CD133 are correlated with clinicopathological features and prognosis of colorectal cancer.However,there are few studies on the relationship between CD44 and CD133 and NLR and clinicopathological features and prognosis of colorectal cancer patients.More importantly,the study of CD44,CD133 combined with NLR in evaluating the prognosis of colorectal patients has not been reported in the literature.By studying the relationship between tumor stem cell CD44,CD133 combined with inflammatory index NLR and pathological features and prognosis of colorectal cancer,it provides a reference for clinicians to evaluate patient prognosis and clinical treatment.It is a tumor marker for colorectal cancer for the study of colorectal cancer.Treatment provides new ideas.Objective1.To explore the relationship between the expression of CD44 and CD133 in colorectal cancer and clinicopathological features and prognosis;2.To explore the relationship between neutrophil/lymphocyte ratio(NLR)and clinical pathological parameters of colorectal cancer and its significance in prognosis.3.To explore the relationship between tumor stem cell markers CD44,CD133 combined with inflammatory index NLR and colorectal cancer clinical pathological parameters in colorectal cancer and its significance in prognosis.MethodsClinicopathological data of 174 patients with colorectal cancer undergoing radical operation in the Department of Gastrointestinal Surgery of Luoyang Central Hospital April 2012 to December 2016 were analyzed retrospectively.The postoperative tumor specimens were collected and the expression of CD44 and CD133 in colorectal cancer was detected by immunohistochemical technique.The relationship between the expression level and the clinicopathological features and prognosis was analyzed.The blood routine was collected within 1 week before surgery.According to the results,the NLR value was calculated,and the relationship between the NLR value and the clinicopathological index and prognosis was analyzed.Kaplan-Meier method was used to analyze the overall survival time.Log-rank test was used to compare the survival of each group.Cox regression analysis was used to screen the independent prognostic factors of colorectal cancer.Results1.The expression of CD44 in colorectal tumors was significantly higher than that in adjacent tissues;84 cases of CD44 high expression and 90 cases of CD44 low expression.The expression of CD44 was correlated with the degree of tumor differentiation(?2=6.812 P=0.033)and TNM stage(?2=9.370 P=0.002).Univariate analysis showed that CD44 was a risk factor for prognosis(2=20.694 P=0.000)).2.The expression of CD133 in colorectal tumors was significantly higher than that in adjacent tissues;84 cases had high expression of CD133 and 90 cases had low expression of CD133.The expression of CD44 was correlated with the degree of tumor differentiation(?2=9.732 P=0.008)and TNM stage(?2=9.370 P=0.002).Univariate analysis showed that CD133 was a risk factor for prognosis(?2=20.186 P=0.000).3.There were 122 patients in the low NLR group and 52 patients in the high NLR group.NLR was associated with tumor differentiation,lymph node metastasis,tumor infiltration depth and TNM stage(P<0.05).Cox multivariate regression model was used for risk factor analysis.It is an independent risk factor for the prognosis of patients with colorectal cancer.4.CD44,CD133 combined with NLR group,89 cases without high expression group,33 cases with single high expression group,52 cases with high expression group,all high expression group and tumor differentiation degree,lymph node metastasis,depth of tumor invasion and TNM stage and prognosis Relevant(P<0.05)was an independent risk factor for the prognosis of patients with colorectal cancer.Conclusions1.The expression levels of CD44 and CD133 are related to the degree of tumor differentiation and TNM staging,and the increased expression is a risk factor for prognosis;2.NLR is associated with tumor differentiation,lymph node metastasis,depth of tumor invasion,and TNM stage,and is an independent prognostic factor for colorectal cancer.3.CD44,CD133 combined with NLR group were associated with tumor differentiation,lymph node metastasis,depth of tumor invasion and TNM stage.The simultaneous increase of the three indicators was worse than the single index,which was an independent prognostic factor for colorectal cancer.Combined detection can be a new test for predicting the prognosis of patients with colorectal cancer.