Objective  To evaluate the expression of B7-H3 and CD133 in colorectal cancer (CRC), colorectal polyps, and normal colorectal mucosa and investigate their roles in the development and prognosis of CRC.

Methods  Immunohistochemistry was used to detect the expression of B7-H3 and CD133 in 195 CRC, 76 villous/tubulovillous adenoma, 64 tubular adenoma, 30 non-adenomatous polyp, and 10 normal colorectal mucosa samples obtained from The Second Affiliated Hospital of Zhengzhou University between October 2012 and April 2017 and Pengan County People’s Hospital between January 2017 and May 2019. Patient age, sex, and immunohistochemical staining results of B7-H3, CD133, and carcinoembryonic antigen were incorporated as risk factors to establish a CRC survival prediction model.

Results B7-H3 and CD133 expression showed an increasing trend from normal mucosa to non-adenomatous polyps, tubular adenomas, villous/tubulovillous adenomas, and CRC (P<0.05), and correlated with adenoma size. It was also associated with CRC metastasis and shorter survival (P<0.05). Furthermore, the expressions of B7-H3 and CD133 demonstrated a value in the CRC survival prediction model, in the training as well as validation set.

Conclusions The immune regulator B7-H3 and cancer stem cell marker CD133 are associated with poor prognosis in CRC, and their expressions may serve as predictive factors for CRC prognosis.