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Expression of stemness markers ( CD 133 and Ep CAM ) in prognostication of hepatocellular carcinoma
Author(s) -
Chan Anthony W H,
Tong Joanna H M,
Chan Stephen L,
Lai Paul B S,
To KaFai
Publication year - 2014
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.12342
Subject(s) - hazard ratio , hepatocellular carcinoma , medicine , stage (stratigraphy) , immunohistochemistry , oncology , proportional hazards model , carcinoma , gastroenterology , risk factor , pathology , confidence interval , biology , paleontology
Aims The expression of stemness markers in hepatocellular carcinoma ( HCC ) is suggested to be associated with poor clinical outcome after surgical resection. There are few data on their independent prognostic role in addition to the existing AJCC TNM staging system. Methods and results The immunohistochemical expression of CD 133, Ep CAM , CK 19 and CD 56 was studied in a cohort of 282 surgical specimens collected from patients undergoing resection of primary HCC . CD 133‐positive HCC s were usually smaller in size ( P = 0.002) and arose more frequently in cirrhotic liver ( P = 0.002). CD 133 expression was an independent prognostic factor for overall survival (hazard ratio 2.30, P < 0.001), and a highly potent prognostic factor in patients with stage I disease (hazard ratio 3.91, P = 0.001). Ep CAM expression was associated with younger age ( P < 0.001), smaller tumour size ( P = 0.018) and poorer histological differentiation ( P = 0.042). Ep CAM immunoreactivity was an independent factor for disease‐free survival in HCC s at all stages (hazard ratio 2.05, P = 0.001), stage II (hazard ratio 3.66, P = 0.010) and stages III / IV (hazard ratio 3.22, P = 0.001). Neither CK 19 nor CD 56 offered any independent prognostic value. Conclusion The prognostic role of CD 133 was most significant in TNM stage I disease, while the prognostic role of Ep CAM was more apparent in more advanced TNM stages.