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Appl Immunohistochem Mol Morphol
Appl Immunohistochem Mol Morphol
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Abstract: The potentiation and activation of Wnt signaling pathways are now assumed to mediate the self-renewal and proliferation of colon cancer stem cells that are responsible for
therapeutic resistance, tumor relapse, and metastasis. We aimed to
evaluate LGR5, Prox1, and Notch1 immunohistochemical expression in stage II to III colon cancer. Their predictive role of
tumor relapse, overall survival, and disease-free survival was statistically analyzed. Our results revealed that high LGR5 expression was identified in 56.7% of the patients, LGR5 expression
was significantly associated with left-sided tumors (P < 0.001).
Moreover, its expression was significantly associated with the
unfavorable tumor characteristics including high grade, deep invasion (pT), lymph node metastasis, and advanced tumor stage
(P < 0.001 for each). High Prox1 expression was observed in 65%
of the cases, and its expression was significantly associated with
tumor grade, lymph node metastasis, and the advanced tumor
stage (P = 0.004, 0.009, 0.016, respectively). Positive Notch1 expression was identified in 35% of patients, and it was inversely
associated with high grade lymph node metastasis, deep invasion
(pT), and advanced tumor stage (P < 0.001 for each). During the
follow-up period, the tumor relapse was significantly associated
with high LGR5, high Prox1, and negative Notch1 expression.
Shorter overall survival and disease-free survival were significantly
associated with high LGR5, high Prox1, and negative Notch1
expression. High LGR5, high Prox1, and negative Notch1 expression are unfavorable prognostic factors in colon cancer. Prox1
is a crucial regulator of Notch-independent LGR5+ stem cells that
is mostly responsible for relapse and therapeutic resistance in stage
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