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Abstract Colorectal cancer is the third most common cancer in Egypt with high mortality rates in the advanced stages. CRC incidence among the younger people is likely to increase in recent years. Surgical techniques and therapeutic interventions during the past few decades have markedly developed however; CRC remains a major health problem worldwide due to resistance to therapy. Discovery of additional prognostic markers might help the development of better management regimens for CRC. Among those markers, Gal-3 seems to be promising. The present study aimed to determine Gal-3 expression in colorectal adenocarcinoma and correlate its expression with the main prognostic clinicopathological factors. This work was undertaken on formalin-fixed paraffin embedded (FFPE) tissue blocks from: 5 adenomas colonoscopically excised and fifty colorectal carcinoma (with 2 free margins for control purposes) specimens surgically managed by colectomy in Surgery department, Medical Research Institute, Alexandria University. The tissue blocks were retrospectively selected between December 2016, and December 2018 for which clinical data including age, sex, tumor size, site and stage were collected from the archive of Pathology department, Medical Research Institute, Alexandria University, Egypt. In the present study, cancer of the right side of the colon occurred in relatively younger male patients with flat morphology, larger tumour size, poorly differentiated histology, node positive and lymph/vascular invasion positive tumours. Whereas, Lt sided tumours occurred in older female patients, had polypoid morphology and well differentiated node negative tumours. As regards Gal-3 expression, it was positive score 2 in normal colonic mucosa and was negative score 1 in adenomas. The colonic specimens showed 44% of the total malignant cases with score 1 (negative or weak), whereas there were 56% of score 2 (moderate or strong) ;( FEp=0.023*). Significant association was found between Gal-3 expression and old patients’ age, female gender and Lt tumor location (P =0.034*, 0.033*, and 0.002*, respectively). As regard histological type and grade of colorectal cancer, there was higher expression of Gal-3 (score2) in mucinous adenocarcinoma and all grade I adenocarcinoma. All grade III tumours had score 1 Gal-3 expression. The present study showed that, there was a significant association between high tumor stage T4 and Gal-3 expression (P=0.037*). In this work, there was a significant association found between Gal-3 expression and lymph node metastasis (p=0.045*). Lymph/vascular invasion positive cases were significantly more frequently Gal-3 score 2 than lymph/vascular invasion negative cases. P=0.014* In the present work, the tumour budding at the invasive front of CRC cases were all score 2 Gal-3 positive. The current work identified higher expression of Gal-3 in the invasive front of the tumour more than in the central or superficial part. |