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Background  Leucine-rich repeat-containing G-protein-coupled receptor 5 (LGR5) is a promising intestinal stem cell and carcinoma stem cell marker. We examined the relationship between mismatch repair (MMR) protein deficiency and  LGR5  expression in poorly differentiated (PD) colorectal carcinoma (CRC).    Methods  In 29 cases of PD-CRC, deficiencies in MMR proteins (MLH1, PMS2, MSH2, MSH6) and β-catenin expression were identified by immunohistochemistry (IHC).  LGR5  expression was examined by the RNAscope assay in tissue microarrays.    Results   LGR5  H-scores in MMR-deficient (MMR-D) cases were significantly lower than those in MMR-proficient (MMR-P) cases ( P  = 0.0033). Nuclear β-catenin IHC scores in MMR-D cases were significantly lower than those in MMR-P cases ( P  = 0.0024). In all cases, there was a positive correlation between  LGR5  H-score and nuclear β-catenin IHC score (r = 0.6796,  P  < 0.001). Even in MMR-D and MMR-P cases, there was a positive correlation between  LGR5  H-score and nuclear β-catenin IHC score (r = 0.7180,  P  < 0.0085 and r = 0.6574,  P  < 0.003, respectively). MMR-D CRC cases showed low expression of  LGR5 , which may be due to low activation of the Wnt/β-catenin signaling pathway.    Conclusions  Our results reveal the relationship between  LGR5  expression and MMR protein profiles in PD-CRC. A further study is warranted to confirm these findings.

Characterization of LGR5 expression in poorly differentiated colorectal carcinoma with mismatch repair protein deficiency