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Background: Colorectal cancer is the fourth common tumor in Egypt after lymphoid, breast and urinary tumors. The aim of the study to assess the expression of Lgr5 and CD133 in pre-malignant (adenomatous polyps and IBD), malignant colorectal lesions and normal colonic mucosa by immunohistochemicalstaining.0 Material and Methods: This prospective study was done on 100 patients presenting with colonic symptoms, patients were divided into four groups; Group I including 20 patients in the control group, Group II including 20 Ulcerative Colitis (U.C) patients, Group III including 20 patients with adenomatous polyps and Group IV including 40 patients with Colorectal Cancer (CRC). Results: Lgr5 and CD133 expression was significantly higher in carcinoma than in adenomas, IBD and normal mucosa (p<0.001). Lrg5 and CD133 was positivelycorrelated with histological grade (p=0.001), depth of invasion (p=0.001), lymph node metastasis (p<0.001), distant metastasis (p<0.004) and TNM stage (p<0.001). Conclusion: Role of Lgr5 and CD133 as stem cell marker was expressed and presented with different expression in normal colonic mucosa, adenoma and CRC and showed increased expression in advanced stage of CRC. This may suggest its possible involvement in colorectal tumorigenesis and invasion.

Immunohisto chemical Study of Colonic Stem Cells Using Lgr5 and CD133 Proteins in Malignant and Pre Malignant Colonic Lesions