Evaluation of the role of hepatic expression Of CD44 as a marker of cancer stem cells in hepatocellular carcinoma patients

Abstract

Background It is very important to understand the molecular pathogenesis of hepatocellular carcinoma (HCC) and to elucidate the possible role of cancer stem cells in this process. Material and methods This study included 20 patients, who had HCC that was related with HCV. They were between the ages of 50 and 83, with an average age of 66.9±7.8 years. Twenty patients, 15 male and 5 female, with HCV-related cirrhosis without HCC were compared to them. Twenty healthy individuals served as controls; these were ranging in age from 38 to 83 years old with an average age of 61.9±11.9. Their mean ± SD was 63.7±11.1 years, and their ages varied from 50 to 75 years. The use of immunohistochemistry allowed for the evaluation of CD44 protein expression in the liver. Results Cirrhotic patients with hepatocellular carcinoma (HCC) showed significantly higher levels of CD44 expression in the liver compared to healthy controls and cirrhotic patients without HCC. There was a robust positive correlation between the levels of alpha-fetoprotein (AFP) in the blood and the expression of CD44 in the liver (r = 0.29; p = 0.029).In addition, a correlation coefficient of 0.33 and a p-value of 0.011 were observed between smoking exposure and the hepatic expression of CD44. Vascular invasion was more common in cases where there was elevated CD44 expression in the liver (93.7% vs. 6.25%; p = 0.001). Conclusion Regardless of the liver's functional state, increased hepatic expression of CD44 may worsen the prognosis, aggression, and development of HCV-associated HCC.