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Expression of CD90 as a stem cell marker in hepatocarcinogenesis

its relation to different clinicopathological parameters and patient survival

Abd Allah, Mona Y.Y.a; El-Karef, Amro R.A.a; Askar, Waleed A.b

Egyptian Journal of Pathology: July 2018 - Volume 38 - Issue 1 - p 6–11
doi: 10.1097/01.XEJ.0000534710.66241.04

Background Hepatocellular carcinoma (HCC) is one of the most common neoplasms and it is attributable to the third common cancer-related deaths worldwide. It is frequently associated with chronic liver diseases such as cirrhosis. The incidence of HCC is increasing annually due to increased rates of hepatitis B and C viral infection. Cancer stem cells (CSCs) are the source of many solid tumor types. However, there is little information on CSC targeted therapy.

Materials and methods This retrospective study was carried out on 60 cases of HCC, of which 53.3% of the patients were in the age group of less than 50 years. Of the studied cases, 75% were men and 22 (36.6%) cases were smokers. Only 12 (20%) cases were associated with postoperative recurrence. Also, 54 (90%) cases were associated with hepatitis C virus infection. From all the studied cases, 54 (90%) cases occurred on a background of cirrhotic liver. Thirty-nine (65%) cases showed a tumor mass size of more than 5 cm in its greatest dimension. Of the studied HCC cases 53.3% (32 cases) were of grade II; 20 cases were of grade III; and only eight cases were of grade I. Only 12 (20%) cases were associated with capsular invasion and 38 (63.3%) cases were associated with lymphovascular tumor emboli. 36.7% of the studied cases were of stage II; 33.3% were of stage III; and 30% are of stage I.

Results CD90 showed an increased expression in HCC rather than the liver cirrhosis and normal liver. Furthermore, the hepatocytic staining pattern in both the cirrhotic cases versus carcinoma cases showed a statistically significant relationship (P=0.05). A statistically significant relation was observed between CD90 expression and patients’ age (P≤0.001), postoperative tumor recurrence (P≤0.001), vascular tumor emboli (P≤0.001), tumor size (P≤0.001), and tumor stage (P=0.00). On the other hand, there was a statistically insignificant relation between CD90 expression and sex (P=0.18), tumor grade (P=0.3), associated hepatitis (P=0.50), smoking (P=0.29), and capsular invasion (P=0.21). Also, the associated liver cirrhosis versus noncirrhotic (normal) liver tissue showed a statistically insignificant relationship (P=0.50). Among the 60 studied cases, 81.7% of all cases died during the period of follow-up and only 20% showed tumor recurrence. The patients with CD90 overexpression (score 3) had the least overall survival with statistically significant relationship between CD90 expression and overall patients’ survival (P=0.002).

Conclusion CD90 expression was found to be increased during the initiation and progression of HCC and it is associated with low overall survival.

aDepartment of Pathology

bDepartment of Surgery, Gastroenterology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Correspondence to Mona Y.Y. Abd Allah, MD, Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt Tel: +20 120 384 7773; e-mail:

Received October 27, 2017

Accepted November 18, 2017

©2018Egyptian Journal of Pathology
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