Clinicopathological evaluation of cancer-associated fibroblast markers in colorectal cancer (histopathological and immunohistochemical study)

Abstract

Background and objectives Worldwide, colorectal cancer is considered one of the most common cancer mortality causes. Recent studies have documented that cancer-associated fibroblasts (CAFs) evoke neoangiogenesis and tumor growth for different tumors. Our study analyzed CAF markers, including α-smooth muscle actin (α-SMA), D2-40 (antibody recognizing podoplanin), and vessel markers, including CD31, for 44 colorectal cancer cases. The association between CAF markers and vessel markers with clinicopathological factors was investigated. Furthermore, the association between CAF markers with each other and their association with vessel markers was analyzed and correlated with different clinical parameters like tumor size, grade, and staging. Materials and methods Forty-four paraffin-embedded colectomy specimens were evaluated pathologically for α-SMA, D2-40 (antibody recognizing podoplanin), and CD31 (histopathological and immunohistochemical study). Results Out of forty-four cases studied, 21 (47.7%) males and 23 (52.3%) females with a mean age of 46.20 (SD ±10.619) years old. D2-40 positivity was localized to the peritumoral area, while α-SMA was detected in both intratumoral and peritumoral areas. α-SMA ahd low expression (scores 0 and 1) in three (6.8%) cases and high expression (scores 2 and 3) in 41 (93.2%) cases. Neoangiogenesis and microvessel density were estimated and calculated in intratumoral and peritumoral areas by CD31 expression. The mean±SD of CD31 was 38.34 ± 14.12. Lymphatic vessel density was also estimated and calculated by the D2-40 expression, and the mean±SD of D2-40 was 48.52 ± 13.72. Significant relationships were found between α-SMA expression, D2-40 expression, CD31 expression, and stromal fibroblast proliferation with each other and with tumor size, tumor stage, tumor grade, lymph node metastasis, and deposits. Conclusions Our study results indicated that individual CAFs might have different expression patterns and strength effects for tumor invasion and vascular invasion in colorectal cancer stroma. These findings may evoke novel therapeutic strategies for colorectal cancer treatment and prognosis.