Cancer stem cell markers correlate with early recurrence and survival in hepatocellular carcinoma

• Published in: World journal of gastroenterology : WJG Vol. 20; no. 8; pp. 2098 - 2106
• Main Author: Guo, Zhe
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Co., Limited 28.02.2014
• Subjects: AC133 Antigen; Adult; Antigens, CD - metabolism; Antigens, Neoplasm - metabolism; Brief; Cancer; carcinoma; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - surgery; Case-Control Studies; CD133; Cell Adhesion Molecules - metabolism; cells; Cohort Studies; Disease Progression; Epithelial Cell Adhesion Molecule; Follow-Up Studies; Glycoproteins - metabolism; Hepatectomy; Hepatocellular; Humans; Immunohistochemistry; Liver - metabolism; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Middle Aged; Neoplasm Recurrence, Local; Neoplastic Stem Cells - cytology; Peptides - metabolism; Prognosis; stem; Thy-1 Antigens - metabolism; Treatment Outcome; Epithelial cell adhesion molecule; Hepatocellular carcinoma; Cancer stem cells; CD90; CD133
• DOI: 10.3748/wjg.v20.i8.2098
• ISSN: 1007-9327; 2219-2840

AIM:To investigate whether expression of cancer stem cell(CSC)markers is associated with recurrence and survival in hepatocellular carcinoma(HCC)patients.METHODS:A consecutive series of 90 HCC patients who underwent curative hepatectomy between April2007 and April 2009 were analyzed.Of the 90 patients,38(42%)experienced recurrence within two years of surgery.To adjust for baseline differences between this early recurrence group and the other patients,propensity-score matching was used to generate 25 pairs of patients.Immunohistochemistry was used to compare expression of CD133,CD90,and epithelial cell adhesion molecule(EpCAM)in liver tissues from propensity score-matched patients and from 10 healthy adults.Associations of the three markers with HCC,clinicopathological characteristics,early recurrence,and survival time were explored.RESULTS:The expression of all three CSC markers was significantly higher in HCC tissue than in healthy liver tissue(P<0.001 for all).Among the HCC clinicopathology characteristics examined,the absence of tumor capsule was associated with CD133 expression(P=0.005);higher histopathology grade and larger tumor size were associated with CD90 expression(P=0.010 and 0.034,respectively);and elevated serum alpha-fetoprotein levels were associated with EpCAM expression(P=0.021).Expression of CD90 and EpCAM was significantly higher in the early recurrence group than in other patients(P=0.001 and 0.045,respectively),whereas CD133 expression was not significantly different between the two groups(P=0.440).Multivariate analysis identified only CD90 expression as significantly associated with early recurrence.Log-rank analysis identified expression of both CD90 and EpCAM as significantly associated with survival time of HCC patients.Cox regression identified EpCAM expression as an independent predictor of survival time.CONCLUSION:Expression of CD133,CD90,and EpCAM CSC markers may be linked to HCC tumor onset and/or progression.In addition,EpCAM expression is associated with shorter survival time,while CD90 expression is associated with early HCC recurrence.