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El-Kholy MA, Abu-Seadah SS, Hasan A, Elhussiny MEA, Abdelwahed MS, Hanbazazh M, Samman A, Alrashdi SA, Rashed ZF, Ashmawy D, Othman AE, Abdelaleem MF, Abo-Saif AIA, Abdel-Maqsoud RR, Attiah SM, Assiri ES, Nasr M, Ismail KA, Saad DZ, El-Mosely MM. The Role of Epithelial Cell Adhesion Molecule Cancer Stem Cell Marker in Evaluation of Hepatocellular Carcinoma. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:915. [PMID: 38929532 PMCID: PMC11205386 DOI: 10.3390/medicina60060915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/16/2024] [Accepted: 05/28/2024] [Indexed: 06/28/2024]
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.
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Affiliation(s)
- Marwa A. El-Kholy
- Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo 11884, Egypt
| | - Shimaa S. Abu-Seadah
- Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo 11884, Egypt
| | - Abdulkarim Hasan
- Pathology Department, Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt
| | - Mohammed E. A. Elhussiny
- General Medicine Practice Program, Histology Department, Batterjee Medical Collage, Aseer 61421, Saudi Arabia
- Histology Department, Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt
| | - Mohammed S. Abdelwahed
- Pathology Department, Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt
- Pathology Department, Faculty of Medicine, University of Jeddah, Jeddah 23218, Saudi Arabia
| | - Mehenaz Hanbazazh
- Pathology Department, Faculty of Medicine, University of Jeddah, Jeddah 23218, Saudi Arabia
| | - Abdulhadi Samman
- Pathology Department, Faculty of Medicine, University of Jeddah, Jeddah 23218, Saudi Arabia
| | - Saeed A. Alrashdi
- Laboratory Department, Al-Mezailef General Hospital, Ministry of Health, Al-Mezailef 21912, Saudi Arabia
| | - Zaky F. Rashed
- Anesthesia Department, College of Applied Sciences, AlMaarefa University, Riyadh 71666, Saudi Arabia
- Anesthesia, Intensive Care and Pain Management Department, Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt
| | - Diaa Ashmawy
- Pathology Department, Faculty of Medicine, Al-Azhar University, Damietta 34517, Egypt
| | - Alyaa E. Othman
- Infectious Diseases Department, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
| | | | - Amany I. A. Abo-Saif
- Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo 11884, Egypt
| | - Rania R. Abdel-Maqsoud
- Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo 11884, Egypt
| | - Samah M. Attiah
- Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo 11884, Egypt
| | - Eissa Saeed Assiri
- Laboratory Department, Aseer Central Hospital, Ministry of Health, Abha 62523, Saudi Arabia
| | - Mohamed Nasr
- Histology Department, Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt
| | - Khadiga Ahmed Ismail
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif 21944, Saudi Arabia
| | - Diana Z. Saad
- Pathology Department, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt
| | - Marwa M. El-Mosely
- Pathology Department, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt
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Bao Y, Zhang D, Guo H, Ma W. Beyond blood: Advancing the frontiers of liquid biopsy in oncology and personalized medicine. Cancer Sci 2024; 115:1060-1072. [PMID: 38308498 PMCID: PMC11007055 DOI: 10.1111/cas.16097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/08/2024] [Accepted: 01/16/2024] [Indexed: 02/04/2024] Open
Abstract
Liquid biopsy is emerging as a pivotal tool in precision oncology, offering a noninvasive and comprehensive approach to cancer diagnostics and management. By harnessing biofluids such as blood, urine, saliva, cerebrospinal fluid, and pleural effusions, this technique profiles key biomarkers including circulating tumor DNA, circulating tumor cells, microRNAs, and extracellular vesicles. This review discusses the extended scope of liquid biopsy, highlighting its indispensable role in enhancing patient outcomes through early detection, continuous monitoring, and tailored therapy. While the advantages are notable, we also address the challenges, emphasizing the necessity for precision, cost-effectiveness, and standardized methodologies in its broader application. The future trajectory of liquid biopsy is set to expand its reach in personalized medicine, fueled by technological advancements and collaborative research.
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Affiliation(s)
- Ying Bao
- Key Laboratory for Translational MedicineThe First Hospital Affiliated with Huzhou UniversityHuzhouChina
| | - Dejing Zhang
- Department of General SurgeryPuyang Oilfield General HospitalPuyangChina
| | - Huihui Guo
- Key Laboratory for Translational MedicineThe First Hospital Affiliated with Huzhou UniversityHuzhouChina
| | - Wenxue Ma
- Department of Medicine, Moores Cancer Center, and Sanford Stem Cell InstituteUniversity of California San DiegoLa JollaCaliforniaUSA
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