الفهرس 
Hepatocellular CarcinomaOnly 14 pages are availabe for public view
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Abstract
ckground: Several studies were carried out on the crosstalk between cancer-associated fibroblasts (CAFs) and cancer stem cells (CSCs) and their role in the development, tumorigenesis and metastasis of many malignancies, including hepatocellular carcinoma (HCC). Identification of CAFs and CSCs in these studies has typically been carried out based on their markers’ expression in tumor tissues.
Aim of the Work: This work aimed to study the expression of both CSC markers (CD133 and CD44), and CAFs (α-SMA and COL11A1), in the peripheral blood as non-invasive diagnostic and prognostic tools for HCV induced fibrosis and carcinogenesis in Egyptian patients.
Patients and Methods: This case-control study was conducted on 100 subjects recruited from the outpatient clinic and inpatient wards of the Hepato-Gastroenterology Department, Theodor Bilharz Research Institute. They were divided into four groups: (1) CHC-HCC group: 25 patients of HCC on top of chronic hepatitis C (CHC); (2) CHC-cirrhotic group: 25 patients; (3) CHC-non-cirrhotic group: 25 patients; and (4) healthy control group: 25 healthy controls. Peripheral blood detection of LCSC markers (CD133 & CD44) was done by Flow cytometric analysis, and determination of plasma levels of CAFs markers (α-SMA and COL11A1) was done using ELISA technique.
Results: Data of patient groups and the healthy control group were analysed and compared. CD133 and CD44 showed significant increases in CHC patients compared to healthy controls, with the highest levels observed in the CHC-HCC group (p<0.001). α-SMA levels were elevated in CHC-non-cirrhotic patients (p<0.05) but decreased in CHC-cirrhotic and CHC-HCC patients (p<0.01) compared to healthy controls. COL11A1 levels were significantly increased in all CHC groups compared to healthy controls (p<0.001), but no significant differences were observed between the different CHC groups (p>0.05). ROC analysis showed that CD133 exhibited the highest sensitivity and specificity for detecting HCC, followed by COL11A1.
Conclusion: CD133 showed the most promise as a diagnostic marker for HCC, while COL11A1 demonstrates a potential for HCC diagnosis. CD44 and α-SMA may have limited effectiveness as separate markers for HCC diagnosis. Additionally, CD133 and CD44 may serve as prognostic markers in patients with liver cirrhosis.