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2015 ; 142
(4
): 391-8
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Cancer stem cells in hepatocellular carcinoma--an immunohistochemical study with
histopathological association
#MMPMID26609030
Matthai SM
; Ramakrishna B
Indian J Med Res
2015[Oct]; 142
(4
): 391-8
PMID26609030
show ga
BACKGROUND & OBJECTIVES: Cancer stem cells (CSCs) may be responsible for tumour
recurrence and resistance to chemotherapy in hepatocellular carcinoma (HCC). This
study was carried out to evaluate the association between histological parameters
and liver CSCs (LCSC) in HCC, and to compare distribution of liver CSCs in HCC
associated with and without hepatitis B virus (HBV) infection. METHODS: Seventy
nine tumours (49 surgical resections from 46 patients, and 30 from autopsy) were
reviewed. Immunohistochemical staining for the LCSC marker EpCAM (epithelial cell
adhesion molecule), liver progenitor cell (LPC) markers CK19 (cytokeratin 19) and
neural cell adhesion molecule (NCAM) were performed and were associated with
histological features of tumour behaviour. RESULTS: Thirty three tumours (41.8%)
showed positive staining for EpCAM. CK19 and NCAM expression were seen in 26
(32.9%) and four (5.1%) tumours, respectively. The expression of EpCAM and CK19
was significantly associated with each other ( P<0.001). EpCAM expression was
significantly associated with clinical and histological features indicating
aggressive tumour behaviour, including younger age of onset, higher serum alpha
foetoprotein (AFP) levels, tumour cell dedifferentiation, increased mitotic
activity, and vascular invasiveness. There was no significant difference in
expression of EpCAM, CK19 and NCAM between HBV positive and negative HCC.
INTERPRETATION & CONCLUSIONS: The LCSC marker EpCAM was expressed in less than
half of HCC, was independent of HBV aetiology, and was strongly associated with
clinical and histological features of aggressive tumour behaviour. Positive
staining for CK19 suggests a possible LPC origin of the EpCAM positive HCCs.