Stem Cell Markers Epithelial Cell Adhesion Molecule (EpCAM) & Cluster of Differentiation (CD44) Expression in Colon Cancer Patients in Relation to Prognosis and Survival

Background: Worldwide, Colon cancer is the third& the second most common cancer in males& female respectively. Its recurrence, therapy resistance and metastasis remain causes of poor prognosis. The relationship between cancer stem cell (CSC) behavior and chemo-resistance to chemotherapy in patients with colon cancer is a recent point of researches that has taken attention. Identification of CSCs needed specific cell surface markers. CD44 had been the most frequently researched marker for colon CSCs. EpCAM is a cell surface molecule involved in cell to cell adhesion that is expressed in many epithelial carcinomas.Aim of the work: was to evaluate CSC markers EPCAM & CD44 expressions in colon carcinoma correlating their expressions with clinicopathological parameters and patients outcome. Patients and Methods: The clinic-pathological correlations between CD44&EpCAM expressions were assessed in specimens of colon carcinoma embedded in paraffin blocks and were taken from 50 patients, which we followed up for survival and prognosis. Results: CD 44&EpCam positive expression was significantly correlated with the grade, stage, presence of lymph node, lymphovascular invasion (p<0.001 for all), distant metastases (p<0.001& = 0.016 respectively), T stage (p= 0.027& 0.003) respectively. Mean PFS was 27.4±1.5 , median PFS was not reached.3-y PFS was 56% which was significant with each one of CD44&EpCam (P<0.001 for both). While, Mean OS was 30.5±1.2, median OS was not reached, 3-yOS was 64% with significant association with each one of the markers (P=0.002 for both). Conclusion: We concluded that bothCD44&EpCam positive expressions would be useful poor prognostic markers for colon carcinoma patients.