0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Invited Critique |

Colorectal Cancer Stem Cells—Hype or Real?  Comment on “Combined CD133+/CD44+ Expression as a Prognostic Indicator of Disease-Free Survival in Patients With Colorectal Cancer”

Nita Ahuja, MD
Arch Surg. 2012;147(1):24-25. doi:10.1001/archsurg.2011.1218.
Text Size: A A A
Published online

Extract

The article by Galizia et al1 is an intriguing, well-designed, and timely study that lends credence to the controversial concept of colorectal cancer stem cells (CSCs). In recent years, the traditional model of colorectal carcinogenesis is being challenged by the CSC model. In the traditional clonal model of carcinogenesis, each differentiated cell in a cancer has the potential to form a cancer, whereas the CSC model holds that only the long-lived stem cells have the potential to accumulate all the needed mutations. Cancer stem cells are characterized by self-renewal and pluripotency whereby each CSC can differentiate into mature and diverse cancer cells, which are then capable of tumor initiation, growth, invasion, and metastasis.24 This paradigm shift has obvious clinical connotations because CSC may also account for the failure of current chemotherapeutic regimens to cure metastatic colorectal cancers. Conventional cytotoxic chemotherapy targets only rapidly dividing cells, while the slowly proliferating CSCs may escape cell death, resulting in eventual cancer recurrence and metastasis. These CSCs are also enriched with multidrug-resistant proteins that may allow them to survive. On the bright side, a better understanding of CSCs will allow us to target these subpopulations and potentially eradicate tumors. The evidence for the CSC model is strongest in acute myeloid leukemias,3,4 but results of recent studies3 in brain, breast, and colorectal cancers have been promising. However, there is widespread controversy within the cancer field because the marks that identify these CSCs keep evolving and because most investigators have used mouse xenograft models rather than primary human models.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com

Users' Guides to the Medical Literature
Clinical Resolution

Users' Guides to the Medical Literature
Clinical Scenario

brightcove.createExperiences();