The Role of Epithelial Cell Adhesion Molecule Cancer Stem Cell Marker in Evaluation of Hepatocellular Carcinoma

Author:

El-Kholy Marwa A.1,Abu-Seadah Shimaa S.1,Hasan Abdulkarim2ORCID,Elhussiny Mohammed E. A.34,Abdelwahed Mohammed S.25,Hanbazazh Mehenaz5,Samman Abdulhadi5,Alrashdi Saeed A.6,Rashed Zaky F.78,Ashmawy Diaa9,Othman Alyaa E.10,Abdelaleem Mohamed F.11,Abo-Saif Amany I. A.1,Abdel-Maqsoud Rania R.1,Attiah Samah M.1,Assiri Eissa Saeed12,Nasr Mohamed4,Ismail Khadiga Ahmed13ORCID,Saad Diana Z.14,El-Mosely Marwa M.15

Affiliation:

1. Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo 11884, Egypt

2. Pathology Department, Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt

3. General Medicine Practice Program, Histology Department, Batterjee Medical Collage, Aseer 61421, Saudi Arabia

4. Histology Department, Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt

5. Pathology Department, Faculty of Medicine, University of Jeddah, Jeddah 23218, Saudi Arabia

6. Laboratory Department, Al-Mezailef General Hospital, Ministry of Health, Al-Mezailef 21912, Saudi Arabia

7. Anesthesia Department, College of Applied Sciences, AlMaarefa University, Riyadh 71666, Saudi Arabia

8. Anesthesia, Intensive Care and Pain Management Department, Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt

9. Pathology Department, Faculty of Medicine, Al-Azhar University, Damietta 34517, Egypt

10. Infectious Diseases Department, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt

11. Preventive Medicine, Ministry of Health, Cairo 51222, Egypt

12. Laboratory Department, Aseer Central Hospital, Ministry of Health, Abha 62523, Saudi Arabia

13. Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif 21944, Saudi Arabia

14. Pathology Department, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt

15. Pathology Department, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt

Abstract

Background and Objectives: Hepatocellular carcinoma (HCC) is a prevalent form of malignancy that is characterized by high mortality rates and prognosis that remain suboptimal, largely due to treatment resistance mechanisms. Recent studies have implicated cancer stem cells (CSCs), particularly those expressing epithelial cell adhesion molecule (EpCAM), in HCC progression and resistance. In the present study, we sought to assess EpCAM expression in HCC patients and its correlation with various clinicopathological parameters. Materials and Methods: Tissue samples from 42 HCC patients were subjected to immunohistochemical staining to evaluate EpCAM expression. Clinicopathological data were obtained including the size, grade and stage of tumors, vascular invasion status, alpha-fetoprotein levels, and cirrhosis status. The Chi square and Fisher’s exact tests were employed to assess the association between categorical groups. Independent Student-t test or Mann–Whitney U test was used to investigate the association between continuous patient characteristics and survival. Results: Immunohistochemical analysis revealed EpCAM expression in 52.5% of HCC cases. EpCAM-positive tumors exhibited characteristics indicative of aggressive disease, including larger tumor sizes (p = 0.006), greater tumor multiplicity (p = 0.004), higher grades (p = 0.002), more advanced stages (p = 0.003), vascular invasion (p = 0.023), elevated alpha-fetoprotein levels (p = 0.013), and cirrhosis (p = 0.052). Survival analysis demonstrated that EpCAM expression was significantly associated with lower overall rates of survival and higher rates of recurrence in HCC patients. Conclusions: Our findings suggest that EpCAM expression may serve as a prognostic biomarker for HCC with a potential role in patient management. Targeting EpCAM-positive CSCs may represent a promising approach to overcome treatment resistance and improve clinical outcomes in HCC. However, further investigation into the molecular mechanisms underlying EpCAM’s role in HCC progression is warranted to facilitate the development of personalized therapeutic interventions.

Funder

Taif University, Saudia Arabia

Publisher

MDPI AG

Reference40 articles.

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3. Asafo-Agyei, K.O., and Samant, H. (2023). Hepatocellular Carcinoma. StatPearls, StatPearls Publishing. Available online: https://www.ncbi.nlm.nih.gov/books/NBK559177/.

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