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Review
. 2017 Jul 5;18(7):1446.
doi: 10.3390/ijms18071446.

Multifaceted Interpretation of Colon Cancer Stem Cells

Yuichiro Hatano  1 , Shinya Fukuda  2 , Kenji Hisamatsu  3 , Akihiro Hirata  4 , Akira Hara  5 , Hiroyuki Tomita  6
Affiliations
Review

Multifaceted Interpretation of Colon Cancer Stem Cells

Yuichiro Hatano et al. Int J Mol Sci. .

Abstract

Colon cancer is one of the leading causes of cancer-related deaths worldwide, despite recent advances in clinical oncology. Accumulating evidence sheds light on the existence of cancer stem cells and their role in conferring therapeutic resistance. Cancer stem cells are a minor fraction of cancer cells, which enable tumor heterogeneity and initiate tumor formation. In addition, these cells are resistant to various cytotoxic factors. Therefore, elimination of cancer stem cells is difficult but essential to cure the malignant foci completely. Herein, we review the recent evidence for intestinal stem cells and colon cancer stem cells, methods to detect the tumor-initiating cells, and clinical significance of cancer stem cell markers. We also describe the emerging problems of cancer stem cell theory, including bidirectional conversion and intertumoral heterogeneity of stem cell phenotype.

Keywords: bidirectional conversion; cancer stem cell; colon cancer; epigenetics; genetics; intestinal stem cell; tumor heterogeneity.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Various methods to detect colon cancer stem cells. Colon cancer stem cells are detectable on the basis of common cancer stem cell markers (Section 2.1), intestinal stem cell markers (Section 2.2 and Section 2.3), side population (Section 2.5), aldehyde dehydrogenase (ALDH1) activity (Section 2.6), and hormone regulators (Section 2.7). Considering the multifaceted nature of cancer stem cells, there must be unknown factors that mark cancer stem cells (for example, epithelial–mesenchymal transition (EMT) inducers, Section 2.4).
Figure 2
Figure 2
Conventional and prospective targets in cancer therapy: (A) Conventional therapy targets exclusively cancer cells without any distinction of cancer stemness. (B) On the other hand, prospective therapy involves microenvironment and endocrine status, which induce cancer stemness. Forced shrinking of cancer stem cell population by alteration of external signals is a possible approach for achieving complete response.
Figure 2
Figure 2
Conventional and prospective targets in cancer therapy: (A) Conventional therapy targets exclusively cancer cells without any distinction of cancer stemness. (B) On the other hand, prospective therapy involves microenvironment and endocrine status, which induce cancer stemness. Forced shrinking of cancer stem cell population by alteration of external signals is a possible approach for achieving complete response.
See this image and copyright information in PMC

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