Molecular Surgical Pathology

**6**

*Basic Principles and Practice in Surgery*

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**9**

**Chapter 2**

**Abstract**

**1. Introduction**

*Miana Gabriela Pop*

Stem Cell Markers in Colon Cancer

Colon cancer incidence is increasing in young people. Even if, so far, colon cancer had a maximum incidence in the sixth and seventh decades of life, lately its incidence in people age 50 and younger is increasing. Thus, colon cancer still represents a major health problem despite constant research made in the field. Early detection of colon cancer is mandatory for an appropriate treatment of the disease and to attain increased overall survival. Even if various stem cell markers have been studied in order to evaluate their prognostic value in colon cancer cases, results in literature are heterogeneous, and no clear consensus has been drafted so far. This paper aims to review the most important stem cell markers identified in colon cancer and to establish their role in both cancer diagnosis and progression.

**Keywords:** colon, cancer, stem cell markers, CD133, CD44, CD166, EpCAM

patients present with late stage, often inoperable tumors.

Colon cancer is a frequent neoplastic disease which is ranked second in female after breast cancer and third in men after prostate and lung and cancer [1]. Despite constant research in the field of colon cancer, its incidence continues to be high worldwide. Moreover, the number of people age 50 or younger diagnosed with colon cancer is dramatically increasing in last years. This finding upholds the idea that colon cancer is not a disease considered to be under control at this time, and efforts should be made in order to better understand its pathogenic mechanism. Five-year overall survival in colon cancer ranges from 90% in early stages to less than 10% in advanced, metastatic cases [2]. It is thus important to try to diagnose the disease in early stage, so an appropriate treatment can be applied. Achieving this condition can be difficult, considering the fact that a large number of colon cancer

Even if important progress has been made in terms of imaging diagnosis of colon cancer, early detection is still difficult to achieve. An important role in detecting early colon cancer cases is assigned to screening programs that have to be applied nationally, and population should be well informed of their importance. More than detecting incipient cases, early detection of advanced cases is also of crucial importance, and efforts should continue in this direction by further research groups. Colon cancer stem cells (CCSCs) are multipotent neoplastic cells that have the ability to differentiate and initiate the carcinogenesis process [3]. Due to their increased viability, CCSCs are responsible for both tumor growth and tumor recurrence [4, 5]. According to a recent study, the presence of CCSCs is also responsible for resistance to chemotherapeutic treatments, which is observed in some cases [5]. A new treatment concept linked to CCSCs is based on their early detection, before the onset of the tumor, which would allow them to target with apoptotic substances.
