Cancer Stem Cells in Hepatocellular Carcinoma

Hepatocellular carcinoma is one of the most common cancers and the second leading cause of cancer-related deaths worldwide. Only a small proportion of patients benefit from curative treatment and the prognosis is very poor for the majority of cases due to late presentation, resistance to chemotherapy and high recurrence rate. In recent years, progress in stem cell biology allowed us to explain that hierarchically organized cancer stem cells (CSCs) drive histological and functional heterogeneity of hematological malignancies and solid tumors.

Also referred to as tumor-initiating cells, CSCs have been isolated from both hepatocellular carcinoma (HCC) cell lines and primary tumors by using hepatic progenitor markers. Although there is still no consensus on cancer stem cell phenotype in HCC, single or combined use of CSC markers defines a minor population of tumor cells with the capacity of self-renewing and the ability to recapitulate the original tumor heterogeneity.

This review focuses on the biological features of CSCs and their potential as diagnostic/prognostic tools and therapeutic targets in HCC.