Evaluation and Clinicopathological Correlation of CD44 in Colorectal Adenoma with Low/High-Grade Dysplasia and Carcinoma

Colorectal carcinoma (CRC) is one of the most common malignant neoplasms with significant morbidity and mortality worldwide. Cancer stem cell hypotheses have gathered significant attention to their molecular progression. CD44, a stem cell marker, is reported to be more concentrated in the malignant and premalignant cells. We aimed to study the prognostic and therapeutic utility of CD 44 in colorectal adenoma with low/high-grade dysplasia and carcinoma and its correlation with clinicopathological parameters. Histological examination was performed according to the criteria outlined in the World Health Organization Classification of tumors 2019 and AJCC 8^th edition. RAmbispective analysis of colorectal neoplasms yielded 50 cases, of which 30 were malignant. Positive staining and high expression of CD44 were more frequent in carcinoma than in adenoma. Further staining and expression were higher in adenoma with high-grade dysplasia than in adenoma with low-grade dysplasia (p value=0.021). A significant statistical correlation was noted in CRC cases with younger age (0.0006), increased mitosis (0.038), and higher AJCC stage (0.014). Our study suggests that CD 44 expression perhaps is higher in adenomas with high-grade dysplasia and CRC with higher pathological stage, and thus could predict a worse prognosis. Larger multi-institutional studies might help study its role as a prognostic and therapeutic stem cell marker.