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

  • Authors:
    • Yu Kou
    • Yuqing Wang
    • Runying Yang
    • Huizi Tang
    • Feng Gu
    • Baowei Han
    • Yunshuai Wang
  • View Affiliations / Copyright

    Affiliations: School of Traditional Chinese Medicine, Faculty of Medicine, Yangzhou University, Yangzhou, Jiangsu 225009, P.R. China, Luoyang Maternal and Child Health Hospital, Luoyang, Henan 471000, P.R. China, Department of General Surgery, Luoyang Central Hospital Affiliated with Zhengzhou University, Luoyang, Henan 471000, P.R. China
    Copyright: © Kou et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 16
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    Published online on: January 14, 2026
       https://doi.org/10.3892/mco.2026.2925
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Abstract

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.

View Figures

Figure 1

Detection of CD86, CD163, CD44 and
CD133 in low- and high-expressing CRCs using IHC staining. (A)
Representative IHC staining images of CD86. (B) Representative IHC
staining images of CD44. (C) Representative IHC staining images of
CD163. (D) Representative IHC staining images of CD133. CRC,
colorectal cancer; IHC, immunohistochemical.

Figure 2

Receiver Operating Characteristics
statistics were used to detect the cut-points of the IHC score for
CD86, CD163, CD44 and CD133. (A) CD86, (B) CD163, (C) CD44 and (D)
CD133 in colorectal cancer samples. AUC, area under the curve.

Figure 3

Aberrant expression of CD86, CD163,
CD44 and CD133 in tumors illustrates the prognosis of DFS in
patients with CRC. (A) Kaplan-Meier survival curves showing DFS in
71 patients. (B and C) High expression of CD86 and low expression
of CD163 correlate with favorable prognosis in human CRC samples.
(D and E) High expression of CD44 and CD133 was associated with
poor prognosis. P-values were derived by log-rank test. DFS,
disease-free survival; CRC, colorectal cancer.

Figure 4

Abnormal expression of CD86, CD163,
CD44 and CD133 in tumors illustrates the prognosis of patients with
CRC after surgery. (A) Kaplan-Meier survival curves showed overall
survival in 71 patients. (B and C) High expression of CD86 and low
expression of CD163 were associated with a favorable prognosis in
human CRC samples. (D and E) High expression of CD44 and CD133 was
associated with poor prognosis. P-values were obtained by log-rank
test. CRC, colorectal cancer.

Figure 5

The co-expression status of CD163 and
CD133 is associated with the prognosis of patients with CRC. (A)
Kaplan-Meier curves of disease-free survival in patients with
different expression level combinations of CD163 and CD133. (B)
Kaplan-Meier curves of overall survival in patients with different
expression level combinations of CD163 and CD133. P-values were
derived by log-rank test.
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Copy and paste a formatted citation
Spandidos Publications style
Kou Y, Wang Y, Yang R, Tang H, Gu F, Han B and Wang Y: <p>Prognostic value and predictive biomarkers of synergistic interaction between tumor‑associated macrophages and cancer stem cells in colorectal cancer</p>. Mol Clin Oncol 24: 16, 2026.
APA
Kou, Y., Wang, Y., Yang, R., Tang, H., Gu, F., Han, B., & Wang, Y. (2026). <p>Prognostic value and predictive biomarkers of synergistic interaction between tumor‑associated macrophages and cancer stem cells in colorectal cancer</p>. Molecular and Clinical Oncology, 24, 16. https://doi.org/10.3892/mco.2026.2925
MLA
Kou, Y., Wang, Y., Yang, R., Tang, H., Gu, F., Han, B., Wang, Y."<p>Prognostic value and predictive biomarkers of synergistic interaction between tumor‑associated macrophages and cancer stem cells in colorectal cancer</p>". Molecular and Clinical Oncology 24.3 (2026): 16.
Chicago
Kou, Y., Wang, Y., Yang, R., Tang, H., Gu, F., Han, B., Wang, Y."<p>Prognostic value and predictive biomarkers of synergistic interaction between tumor‑associated macrophages and cancer stem cells in colorectal cancer</p>". Molecular and Clinical Oncology 24, no. 3 (2026): 16. https://doi.org/10.3892/mco.2026.2925
Copy and paste a formatted citation
x
Spandidos Publications style
Kou Y, Wang Y, Yang R, Tang H, Gu F, Han B and Wang Y: <p>Prognostic value and predictive biomarkers of synergistic interaction between tumor‑associated macrophages and cancer stem cells in colorectal cancer</p>. Mol Clin Oncol 24: 16, 2026.
APA
Kou, Y., Wang, Y., Yang, R., Tang, H., Gu, F., Han, B., & Wang, Y. (2026). <p>Prognostic value and predictive biomarkers of synergistic interaction between tumor‑associated macrophages and cancer stem cells in colorectal cancer</p>. Molecular and Clinical Oncology, 24, 16. https://doi.org/10.3892/mco.2026.2925
MLA
Kou, Y., Wang, Y., Yang, R., Tang, H., Gu, F., Han, B., Wang, Y."<p>Prognostic value and predictive biomarkers of synergistic interaction between tumor‑associated macrophages and cancer stem cells in colorectal cancer</p>". Molecular and Clinical Oncology 24.3 (2026): 16.
Chicago
Kou, Y., Wang, Y., Yang, R., Tang, H., Gu, F., Han, B., Wang, Y."<p>Prognostic value and predictive biomarkers of synergistic interaction between tumor‑associated macrophages and cancer stem cells in colorectal cancer</p>". Molecular and Clinical Oncology 24, no. 3 (2026): 16. https://doi.org/10.3892/mco.2026.2925
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