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Cancer stem cells (CSCs) are proposed to be involved in colorectal cancer (CRC) initiation, growth, and metastasis. The aim of our pilot study was to assess possible correlations between the clinicopathological characteristics of CRC patients and CSCs gene expression patterns, in order to provide insight into new methods for patient stratification and targeted therapeutic strategies. Our study involved 60 CRC patients, and the following three specific CSC genes were targeted: PROM1/CD133, ALCAM/CD166 and HCAM /CD44. Data are presented as relative mRNA expression of target genes to GAPDH. The expression of total CD133 and CD166 was assessed in paired samples of CRC tumors and adjacent tissue, while CD44 was assessed in similar samples. The qRT-PCR analysis detected all three targeted genes to different extents, in both normal and tumor tissue. In nine cases (15.69%), total CD133 had a higher expression in tumor tissue, whilst in 28 cases (47.06%) the expression was higher in non-malignant peritumor tissue. The total CD166 expression was increased in tumor tissue compared with paired non-invaded peritumor samples in eight cases (13.73%), whilst in eight cases (13.73%) the expression was higher in non-malignant peritumor tissue. Total CD44 expression was higher in tumor tissue compared with paired non-invaded peritumor samples in 47 cases (78.95%). In the remaining cases the difference between paired samples was biologically insignificant. In conclusion, our study suggests that qRT-PCR is feasible in assessing the gene expression profiles of CSCs from CRC, and a promising pathway to be followed for determining how often a person needs screening by colonoscopy and at which age to start. This could improve CRC diagnosis and early patient stratification, and open the way for new oncologic treatment development. [ABSTRACT FROM AUTHOR]

Endoscopic ultrasound tissue acquisition, in the form of fine needle biopsy (EUS-FNB) was designed to provide a proper quantitative sample for determining the histologic architecture and further immunohistochemical staining. This study aimed to investigate the contribution of associating contrast-enhanced ultrasound imaging (CEUS) with EUS-FNB for differentiating solid pancreatic lesions without on-site cytopathology. Patients from our institutional database who underwent CE-FNB-EUS for the evaluation of a solid pancreatic lesion were retrieved. Micro vascularization of the tumor was evaluated over 2 min during CEUS after intravenous injection of 4.8 mL SonoVue and was classified as hypervascular, isovascular or hypovascular during both arterial and venous phase. Final diagnosis was based on histopathology of surgical specimens or EUS-guided tissue acquisition and clinical follow-up. Our retrospective study (2018-2021) enrolled 46 patients with a mean age of 58, female to male ratio 1:2, mass location: 2/3 head, 1/3 body and tail of the pancreas, average mass size 3.5 cm, mean number of needle passes (fanning technique): 2. Final pathology revealed pancreatic ductal adenocarcinoma-PDAC (26), mass-forming pancreatitis-MFP (10), pancreatic neuroendocrine tumors-pNETs (4), undifferentiated carcinoma (3), mucinous carcinoma (1), pancreatic metastasis (1). Hypo-enhancement was noted in 67% of the patient, and the final diagnosis was malignancy in all those cases. Regarding the enhancement patterns: hypovascularity in both arterial and venous phase was associated to PDAC, hypervascularity or isovascularity in both phases were associated to either MFP or NETs, while the carcinomas were hypervascular. A heterogeneous appearance with non-enhancing areas was noted in a small percentage of the hypo-enhancing lesions and it might suggest necrosis. The overall diagnostic accuracy was 91%. CE-EUS allows detailed visualization of the dynamic enhancement patterns hence it helps to identify the target of EUS-FNB among different pathological areas of the lesions. CE-FNB-EUS can be used for the differential diagnosis and adequate sampling of solid pancreatic lesions without on-site cytopathology. [ABSTRACT FROM AUTHOR]