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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.
摘要：
背景和目的：肝细胞癌（HCC）是一种常见的恶性肿瘤，其特点是高死亡率和预后仍然不理想，很大程度上是由于治疗耐药机制。最近的研究涉及癌症干细胞（CSC），特别是那些表达上皮细胞粘附分子(EpCAM)的细胞，在肝癌进展和耐药。在本研究中,我们试图评估肝癌患者的EpCAM表达及其与各种临床病理参数的相关性。材料和方法：对42例HCC患者的组织样品进行免疫组织化学染色以评估EpCAM表达。获得了临床病理数据，包括大小，肿瘤的分级和分期，血管浸润状态，甲胎蛋白水平,和肝硬化状态。采用卡方检验和Fisher精确检验来评估分类组之间的关联。使用独立的Student-t检验或Mann-WhitneyU检验来研究连续患者特征与生存之间的关联。结果：免疫组织化学分析显示，在52.5％的HCC病例中EpCAM表达。EpCAM阳性肿瘤表现出指示侵袭性疾病的特征，包括较大的肿瘤大小（p=0.006），更大的肿瘤多重性（p=0.004），更高等级(p=0.002)，更高级的阶段(p=0.003)，血管侵犯（p=0.023），甲胎蛋白水平升高（p=0.013），和肝硬化（p=0.052）。生存分析表明，EpCAM表达与HCC患者较低的总体生存率和较高的复发率显着相关。结论：我们的研究结果表明，EpCAM表达可能作为HCC的预后生物标志物，在患者管理中具有潜在作用。靶向EpCAM阳性CSC可能代表克服治疗耐药性和改善HCC临床结果的有希望的方法。然而,有必要进一步研究EpCAM在HCC进展中的作用的分子机制,以促进个性化治疗干预措施的发展.
