Ricerca di cellule staminali tumorali nel carcinoma colorettale

Colorectal cancer is the most frequent cancer of the digestive system; it is the second cause of death after that one for lung tumor in man, and for breast tumor in women. The highest incidence is between 60 and 70 years (higher in the USA and in Eastern Europe). The disease affects men and women with equal frequency, although rectal tumors show a higher prevalence in men. In the European Community population over the age of 65 the estimated incidence for rectal cancer is 95 new cases / year per 100.000 men and 53 new cases / year per 100.000 women. Every year in our country about 27.000 people get cancer of the colon-rectum and, of these, just over half die from the disease. Five-year survival exceeds 50%. Therapy is based on surgery and chemotherapy. The prospects for research on the role of cancer stem cells (CSC) in cancer are extensive. In many cancer histotypes, in fact, CSC seem to determine the aggressiveness of neoplastic disease; CSC’s research in colorectal carcinoma (CRC) is important for prognostic and therapeutic objectives. In fact, metastases are the main cause of death linked to cancer and determine the transition from localized neoplastic disease to systemic neoplastic disease. The discovery of CSC represents a strategy for the control and prevention of overt metastatic disease. The molecular characterization of CSC may allow to identify drug targets and personalized antimetastatic therapies. While in breast, lung and prostate cancer CSC have been extensively characterized, these molecular features are still to be discovered in colorectal cancer. Therefore, the development of in vitro and in vivo models for the expansion and analysis of colorectal CSC is of primary importance for identifying novel prognostic and therapeutic approaches. In this experimental study, we searched for CSC in 22 colorectal cancers surgically excised. In the materials and methods, the technologies used for the research of CSC are widely described. CSC were isolated and characterized in 5 patients, as shown in the results table : 1 cancer of the cecum, 1 cancer of the ascending colon, 2 cancers of the transverse colon, 1 cancer of the rectum. The cell lines that have developed from the CSC discovered in the 5 patients are found in the CSC Bank of the Istituto Superiore di Sanità and are used for numerous experiments. In these patients there was a worse prognosis than in others confirming the negative prognostic role of the CSCs. The research therefore aims to identify these patients early in order to be able to submit them to a closer follow-up and to realize targeted therapies that have specific targets for CSCs, considered responsible for the aggressiveness and the possible recurrence of the disease.