Cluster of Differentiation 47 (CD47), an innate immune checkpoint, facilitates immune escape by binding signal regulatory protein alpha (SIRPα) to inhibit macrophage phagocytosis. Its significance in colorectal cancer (CRC) has garnered heightened interest. This review summarizes five immunohistochemistry (IHC) studies and complementary transcriptomic analyses assessing CD47 in CRC. IHC results consistently indicated membrane overexpression, though positivity rates varied widely (16–91%) due to methodological heterogeneity. Transcriptomic results confirmed CD47 upregulation, especially in Consensus Molecular Subtype 1 (CMS1) and CMS4 subtypes and revealed co-expression with immune checkpoints and oncogenic pathways. Clinically, high CD47 levels were associated with advanced TNM stage, metastasis, poor differentiation, and altered immune infiltration; however, the prognostic significance varied among cohorts. Overall, CD47 appears to be a promising biomarker and therapeutic target, but clinical translation requires standardized evaluation, including harmonized antibody selection and scoring cut-offs, and prospective validation.
分化簇47（CD47）作为一种先天性免疫检查点，通过与信号调节蛋白α（SIRPα）结合抑制巨噬细胞吞噬作用，从而促进免疫逃逸。其在结直肠癌（CRC）中的重要性已引起广泛关注。本文综述了五项评估CD47在CRC中表达情况的免疫组织化学（IHC）研究及补充转录组学分析。IHC结果一致显示CD47存在膜过表达，但由于方法学异质性，阳性率差异显著（16%-91%）。转录组学结果证实CD47表达上调，尤其在共识分子亚型1（CMS1）和CMS4亚型中，并揭示其与免疫检查点及致癌通路存在共表达现象。临床分析表明，高CD47水平与晚期TNM分期、转移、低分化及免疫浸润改变相关；然而其预后意义在不同研究队列中存在差异。总体而言，CD47有望成为重要的生物标志物和治疗靶点，但临床转化需要建立标准化评估体系，包括统一抗体选择与评分阈值，并进行前瞻性验证。
Expression and Clinical Significance of CD47 in Colorectal Cancer: A Review
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