Investigation of Cancer Stem Cell Surface Markers In The Tumor Tissues of Patients Who Had Liver Transplantation Due To Hepatocellular Cancer And Evaluation of The Effect of These Markers on Prognosis

Abstract

Purpose: To investigate the relevance between cancer stem cell(CSC) markers and tumor progression in hepatocellular carcinoma(HCC). Methods: Data of patients who underwent liver transplantation(LT) for HCC between February 1998 and September 2018 were collected. Patients over 18 years of age were included. Immunohistochemical staining were performed in paraffin blocks of liver explants containing HCC in terms of CSC markers, CD13, CD44, CD47, CD90 and EpCAM. Follow-up period, cancer recurrence, disease-free and overall survival were investigated. Results: There were 71 patients who met the inclusion criteria. Optimal evaluation conditions were not met for CD13 and CD90 staining. Disease recurrence was found to be more frequent in CD 44+ cases (p=0.008). Disease-free survival was significantly longer in CD44- group(160.2 vs 103.0 months, p=0.043). Overall survival was significantly shorter in CD44+ cases(171.7 vs 107.8 months, p=0.018). No statistically difference was found between CD47+/- or EpCAM+/- groups in terms of recurrence (p=0.27, p=0.24). There was no significant difference in disease-free and overall survival in CD47+/- or EpCAM+/- cases, respectively (CD47+/-; p=0.82, p=0.90, EpCAM; p=0.76, p=0.69). Conclusion: Positive CD44markers in HCC is associated with a more aggressive course of disease. Targeted therapies for CD44antigens of CSCs may prevent disease recurrence and increase survival.

Keywords

• Hepatocellular Cancer
• cancer stem cell
• tumor markers
• liver transplantation

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