Abstract
Epidemiology of hepatocellular carcinoma (HCC) showed a correlation between incidence and geographical-relevant risk factors. This study aims to compare the distributions of cancer stem cells (CSC) in two distant populations in Asia and Europe. We analyzed 52 and 43 selected HCC patients undergoing hepatectomy in Ho Chi Minh City (Vietnam) and Trieste (Italy). Each patient sample consisted of HCC, peri-HCC, and non-tumoral (distal) tissue. Demographic data were recorded together with clinical findings. The protocol for the collection of tissue samples and RNA was standardized in both laboratories and gene expression analysis was performed in a single laboratory with identical PCR conditions. Baseline data showed comparable laboratory findings between the two cohorts. mRNA distribution showed a comparable pattern of all CSC markers analyzed with the expression of CD90 progressively increasing from distal and peri-HCC to be highest in HCC (p < 0.001), confirmed by immunofluorescence data. CD90 mRNA distribution was related to HBV-related HCC and a tumor diameter less than 5 cm. Patients with high tumoral CD90 mRNA had a shorter time (p < 0.05) to tumor recurrence compared to patients with lower CD90. This comparative study showed that CD90 mRNA expressions are comparable between Eastern and Western HCC cases.
Highlights
Liver cancer is one of the most common cancers, being the second cause of cancer-related death worldwide in which hepatocellular carcinoma (HCC) accounts for about 90% of liver cancer cases [1,2].The incidence of HCC is closely associated with its known underlying etiologies, mostly due to liver cirrhosis caused by chronic viral hepatitis B and C infection, alcohol abuse, and aflatoxin exposure [3].In Eastern Asia and Africa, the highest factor is a chronic infection of hepatitis B virus (HBV), whereas, in Western countries and Japan, chronic infection of hepatitis C virus is the highest risk factor [4]
Since HCC is multi-factorial and geographically-specific, in this study we demonstrated that the mRNA expression patterns of cancer stem cells (CSC) markers, especially CD90, can be used to study both Western and Eastern populations, showing their relevance in hepatocarcinogenesis
In the Eastern cohort, the mean age was significantly younger (p < 0.001), and as for HCC etiology, as expected, it was majorly related to HBV infection as compared to HCV/metabolic in Italian patients (p < 0.0001)
Summary
Liver cancer is one of the most common cancers, being the second cause of cancer-related death worldwide in which hepatocellular carcinoma (HCC) accounts for about 90% of liver cancer cases [1,2].The incidence of HCC is closely associated with its known underlying etiologies, mostly due to liver cirrhosis caused by chronic viral hepatitis B and C infection, alcohol abuse, and aflatoxin exposure [3].In Eastern Asia and Africa, the highest factor is a chronic infection of hepatitis B virus (HBV), whereas, in Western countries and Japan, chronic infection of hepatitis C virus is the highest risk factor [4]. Liver cancer is one of the most common cancers, being the second cause of cancer-related death worldwide in which hepatocellular carcinoma (HCC) accounts for about 90% of liver cancer cases [1,2]. The incidence of HCC shows a significant geographical distribution, with the highest number of cases in Eastern Asia predominantly being HBV-related. HCC is a vast heterogeneous tumor, mostly caused by various etiological factors and oncogenic transformations, which lead to histological diversity, varied tumor progression, and distinct molecular signatures [5,6]. The search for a common biomarker that could represent hepatocarcinogenesis in diverse HCC cases will be useful in a basic study and in the development of diagnostic tools or potential treatment
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