P-202 - Molecular confocal laser endomicroscopy (CLE) for the assessment of prognosis in colorectal carcinoma, based on evaluation of putative cancer stem c...

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Colon and Rectal Cancer
Staging procedures (clinical staging)
Translational Research
Basic Principles in the Management and Treatment (of cancer)
Presenter I. Cherciu
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors I. Cherciu1, T. Cartana1, L. Brink2, M. Malmstrom2, T. Stigaard2, P. Klausen2, J. Karstensen2, H. Hassan2, A. Saftoiu1, P. Vilmann2
  • 1University of Medicine and Pharmacy Craiova, Craiova/RO
  • 2Copenhagen University Hospital Herlev, Copenhagen/DK



Colorectal cancer is one of the most common diagnosed malignancies in the world. Successful treatment is related not only to the elimination of the main tumor mass but also to the destruction of colorectal cancer cells which are highly resistant to chemotherapeutics and radiation, with unlimited self-renewal and tumor-initiating capacities. CD44 is an important adhesion molecule and one of the proposed stem cell markers in colorectal cancer known to be involved in cell growth, differentiation and survival. The aim of our study was to evaluate the distribution patterns of CD44 between patients and tumor stage, due to the role that it might play in improving cancer detection, individualized cancer therapy and better tumor control.


Fresh biopsies from tumor and normal tissue were collected from 8 patients with different stages colorectal carcinoma and were marked with fluorescently labeled anti-CD44 antibodies. A series of optical slices spanning 250 mm inside the tissue were immediately collected for each sample using a dedicated confocal laser endomicroscopy system (Pentax EC-3870 CIFK, Tokyo, Japan) and analyzed using Image J. The images with the strongest fluorescent signal and a good display of the tissue and stem cells were selected. The staging was assessed based on radial EUS evaluation. The patients were previously diagnosed with primary colorectal adenocarcinoma during routine colonoscopy procedures, with pathology confirmation


Our study included 8 patients (3 women and 5 men), with an average age of 59,62 ± 18,5. A number of 537 slides were analyzed, stacked and the most 32 relevant were selected for cell counting using Image J. Standard biopsy sections from normal mucosa showed a well defined layout of the mucosal structures while this characteristic was lost among the tumor samples. CLE evaluation of the selected images revealed 44,25 ± 11,96 cells/slide for the tumor tissue and 28,25 ± 11,24 cells/slide for the normal tissue (p = 0,0154). CD44 expression was associated with some clinicopathological factors such as T category (r= -0,746) but not with N category (r= 0,092). A correlation was also evident among the CD44 expression in tumor tissue and adenocarcinoma grading.


Our study results suggest that CD44 is an efficient detection and prognostic factor in CRC. The association of imunoCLE and EUS is feasible for real-time diagnosis and tumor evaluation in CRC patients, although imunohistological validation and further extended studies are required.

This paper was published under the frame of European Social Found, Human Resources Development Operational Programme 2007-2013, project no. POSDRU/159/1.5/S/133377.