Expression Of Tumor Stem Cells In Hepatocellular Carcinoma And Its Clinical Significance

Objective:To study CD133 expression in HCC and to investigate the association of CD133 expression with biological behavior and prognosis of HCC.Methods:(1) 101 of HCC radically surgical resection specimens and 55 of corresponding adjacent specimens were collected at Lishui Center Hospital,Zhejiang,China, from January 2000 to December 2006.We also collected 8 normal specimens and 15 cirrhotic liver specimens from the same hospital.(2) The percent of CD133 expression was analyzed by immunohistochemistry in different specimens.In patients with HCC,two groups were divided using the median value of CD 133 expression.The cliniclapathological parameters of 101 HCC were compared with increased CD133 expression usingχ~2 test. Disease-free and overall survival was calculated using the Kaplan-Meier method.The influence of various clinicopathological features on survival was assessed with the Cox proportional hazards regression model in a stepwise manner.P＜0.05 was considered significant.Results:(1) The median value of CD133 expression was 0.87%±0.71%and there were 42 patients with high CD133 expression and 59 patients with low CD133 expression in the HCC samples.(2) High CD133 expression was associated with preoperatively elevated serum AFP levels,vessel embolus,higher histological grade and advanced stage (P＜0.05 ).(3) Kaplan-Meier analysis and Log-rank test showed that one and five year disease free survival time and five year overall survival time was significantly shorter in patients with high CD133 expression than in those with low CD133 expression(P＜0.05).Multivariate analysis showed that CD133 expression status was an independently prognostic factor for HCC patients.Conclusion:(1) Our study demonstrates that although CD133 expression in HCC is very low,it is associated with malignant degree and prognosis of HCC.(2) CD133 can be a prognostic marker of HCC with characteristic of tumor stem cells.