Biomarker Identification via Spatial Transcriptomics Profiling of Colorectal Cancer and Colorectal Cancer with Liver Metastasis Stem Cells

The survival rate of patients with colorectal cancer (CRC) declines sharply with recurrence and metastasis. Cancer stem cells play a crucial role in the initiation, progression, recurrence, and metastasis of colorectal cancer. Therefore, in this study, we aimed to identify the CRC-associated genes via spatial analyses of normal colon tissue, colorectal cancer tissue, and colorectal cancer liver metastasis using NanoString GeoMx digital spatial profiling. Overall design: The TMA slide comprised 59 samples, including 40 cores of CRC (primary cancer), 10 cores of CRC with liver metastasis, and nine cores of normal colon tissue (adjacent to cancer). We selected samples from patients with CRC who had normal colon tissue, primary colorectal cancer tissue, and colorectal cancer with liver metastasis tissue. To identify tumors and cancer stem cells, CD44 and EpCAM staining was performed. EpCAM+/CD44- cells were used as markers to identify non-CRCSCs, and EpCAM+/CD44+ cells were used as markers to identify CRCSCs.