The immunohistochemical expression of cancer stem cell (CD44) in colorectal carcinoma and its association with different prognostic parameters in a sample of Iraqi patients
Abstract
Background: Colorectal carcinoma (CRC) is one of major causes of cancer- related
morbidity and mortality. It is the third most common cancer world-wide. Cancer stem cells
(CSCs) play an important role in the initiation and maintenance of the tumor, as well as
invasion, metastasis and therapeutic resistance. Among CSCs markers,CD44 is the most
investigated colorectal CSC marker which is implicated in cell growth ,differentiation,
survival as well as the metastatic behavior of cancer cells.
Objective: To evaluate the expression of CD44 immunohistochemical marker in colorectal
carcinoma and its association with clinicopathological parameters.
Materials and Methods: Retrospective cross-sectional study included sixty cases of
colorectal carcinoma at Babylon Training Center for Histopathology during the period from
November 2024 to September 2025.Two sections from each paraffin embedded tissue block
were taken, one for hematoxylin and eosin staining for histopathology revision and other for
immunohistochemistry staining of CD44
Results: A total of 60 cases were analysed. High expression of CD44 was observed in 65%
of cases,while low expression was detected in 35% of cases there was a significant
association between CD44 high expression and tumor size (p<0.001) ,tumor stage (p<0.001),
lymphovascular invasion(p<0.001)and perineural invasion(p=0.024).
Conclusion: CD44 play an important a role in CRC . There is a significant association
between high expression of CD44 and poor prognostic factors which are indicators of
aggressive tumor behavior.
Keywords: Colorectal carcinoma,CD44, Immunohistochemistry, Cancer stem cell
