Prognostic value and predictive biomarkers of synergistic interaction between tumor-associated macrophages and cancer stem cells in colorectal cancer.

Cancer stem cells (CSCs) and tumor-associated macrophages (TAMs) are associated with the prognosis of colorectal cancer (CRC). Emerging studies indicate active crosstalk between CSCs and TAMs within the tumor microenvironment. However, the prognostic implications of integrating CSC- and TAM-associated markers for risk stratification remain incompletely defined in CRC. Expression levels of CD86, CD163, CD44 and CD133 were assessed by immunohistochemistry. Pearson s chi-square test was employed to analyze correlations between marker expression and clinicopathological parameters. The Kaplan-Meier method and log-rank test were used to determine survival differences and identify potential prognostic factors. Variables achieving statistical significance (P<0.05) in the univariate analysis were subsequently included in a multivariate Cox proportional hazards regression model to analyze independent predictors of overall survival. The results demonstrated that a combined expression profile of high CD86 with low CD163, CD44 and CD133 was significantly associated with prolonged survival. CD86 expression was negatively correlated with CD133 and CD44, while CD163 showed positive correlations with both markers. In addition, elevated CD163 and CD133 levels were positively correlated with poorer prognosis in patients with CRC. In conclusion, it was suggested that different TAM phenotypes in combination with CSC-related biomarkers serve as potential biomarkers for CRC onset and progression.