Clinicopathological characterization of enteric glia in colorectal cancer: Insights from a population-based cohort

Enteric glia contribute to the regulation of mucosal homeostasis and intestinal immunity. Enteric glia dysfunction is linked to various gastrointestinal disorders. We aimed to characterize the phenotype of enteric glia in colorectal cancer (CRC) and examine their association with CRC patient characteristics. Healthy, adenoma, and tumor tissues from CRC patients were immunohistochemically stained for the glial markers S100B and glial fibrillary acidic protein (GFAP). GFAP-positive enteric glia were identified within carcinoma tissue stroma but were absent in normal mucosa or adenoma tissue from the same patients. S100B staining was detected in all sample types. Two CRC patient cohorts (n = 447 and n = 324) were analyzed for GFAP staining and to assess association of GFAP immunoreactivity with patient characteristics. This indicated that GFAP-positive cells might be associated with tumor localization and median survival. High-density GFAP staining was associated with improved survival in the study cohort (HR = 0.56; P = 0.030), but not the validation cohort (HR = 0.85; P = 0.606). These findings suggest that CRC induces GFAP expression in enteric glia. While prognostic value of GFAP could not be confirmed, future studies are needed to elucidate the role of enteric glia in CRC prognosis and progression.