// Yang Zhao 1, 2, * , Jing Peng 1, * , Enlong Zhang 1 , Ning Jiang 2 , Jiang Li 1 , Qi Zhang 1 , Xuening Zhang 1 , Yuanjie Niu 2 1 Department of Radiology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China 2 Sex Hormone Research Center, Tianjin Institute of Urology, Tianjin 300211, China * These authors have contributed equally to this work Correspondence to: Xuening Zhang, e-mail: luckyxn@qq.com Yuanjie Niu, e-mail: niuyuanjie68@126.com Keywords: cancer stem cell, tumor recurrence, tumor genesis, CD133, meta-analysis Received: August 18, 2015 Accepted: December 08, 2015 Published: January 28, 2016 ABSTRACT We performed a meta-analysis of CD133-related clinical data to investigate the role of cancer stem cells (CSCs) in the clinical outcomes of colorectal cancer (CRC) patients, analyzing the effectiveness of various therapeutic strategies and examining the validity of the CSC hypothesis. For 28 studies (4546 patients), the relative risk (RR) to survival outcomes associated with CD133 + CRCs were calculated using STATA 12.0 software. Pooled results showed that CD133 High patients had poor 5-year overall survival (RR 0.713, 95% CI 0·616–0·826) and 5-year disease free survival (RR 0·707, 95% CI 0·602–0·831). Both associations were consistently observed across different races, research techniques and therapeutic strategies. In a subgroup receiving adjuvant therapy, CD133 Low patients achieved significantly better survival than CD133 High patients. The findings suggest that CD133 could serve as a predictive marker of poor prognosis and treatment failure in CRC. CD133 Low patients could benefit from adjuvant treatments, while CD133 High patients should be given novel treatments besides adjuvant therapy. Our results also provide evidence in support of the CSC hypothesis.
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