Back ground: Hepatocellular carcinoma (HCC) is the most common primary liver cancer. Globally it is the sixth most common cancer worldwide and the third most common cause of cancer death. In Egypt, HCC constitutes 70.48% of all liver tumors among Egyptians. Liver cancer is the first most common cancer in men and the second in women. One of the postulated models for pathogenesis of HCC is the role of CSCs which are responsible for tumor initia¬tion, maintenance, growth, metastasis, and relapse after thera¬py. There were several proposed stem cells markers in such as epithelial cell adhesion molecule (EpCAM), CD90, CD13, Cytoketain 19 (CK19), CD133, and CD56.
Aim of the study: To evaluate expression of EpCAM and CK19 in cases of chronic hepatitis, chronic liver disease with HCC and hepatocellular carcinoma. In addition, studying the relation between their expression and clinicopathological data.
Materials and Methods: A retrospective study was performed on paraffin sections of 81 specimens of liver tissues including 6 specimens of normal liver, 24 specimens of chronic hepatitis C and 51 specimens of HCC, 39 cases of non-tumour tissue adjacent to Hepatocellular (HCC). All sections subjected to: Hematoxylin and eosin stain for histopathological assessment to confirm diagnosis and immunohistochemical staining for evaluation of EpCAM and CK19 expression
Results: All cases of studied normal group were negative for EpCAM and CK19 expression. Regarding to EpCAM, There was statistical significant increase in EpCAM expression from chronic hepatitis to adjacent non tumor tissue (chronic liver disease with HCC) then decrease in HCC. There was statistical significant relation between EpCAM with AFP level only. Regarding CK19 expression, There was statistical significant difference between +ve CK-19 hepatocytes in all groups as it is only present in HCC group (3.2±14.2) and between +ve CK19 cells with LPC morphology in all groups as the highest levels in non-tumor adjacent group. There was statistical significant relation between CK19 expression in chronic hepatitis group with activity and fibrosis, while in HCC group, there was statistical significant relation between CK19 expression and AFP level and grade.
Conclusion: Stem cells have a role in early hepatocarcinogenesis as EpCAM and CK19 increased in both chronic liver disease with or without HCC and decrease in HCC. Increased CK19 expression associated with higher serum AFP level and higher grade of HCC, so it may serve a tool for prognosis of HCC. |
