Expression of liver cancer stem cell markers and association with recurrence and survival in hepatocellular carcinoma

doi:10.4252/wjsc.v18.i5.119123

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World Journal of Stem Cells

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1948-0210

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Stem Cells. May 26, 2026; 18(5): 119123
Published online May 26, 2026. doi: 10.4252/wjsc.v18.i5.119123

Table 1 Baseline characteristics of patients stratified by different levels of cancer stem cell expression, n (%)

Indices	CSC low expression (n = 76)	CSC high expression (n = 56)	Statistic	P value
Age (years)	55.05 ± 9.46	53.96 ± 9.76	t = 0.638	0.525
Gender
Male	59 (77.63)	40 (71.43)	χ² = 0.672	0.412
Female	17 (22.37)	16 (28.57)	χ² = 0.672	0.412
HBV infection
Yes	49 (64.47)	43 (76.79)	χ² = 2.369	0.124
No	27 (35.53)	13 (23.21)	χ² = 2.369	0.124
Liver cirrhosis
Yes	43 (56.58)	32 (57.14)	χ² = 0.004	0.948
No	33 (43.42)	24 (42.86)	χ² = 0.004	0.948
AFP (ng/mL)	97.71 (55.82-204.30)	106.71 (51.90-185.17)	Z = 2.230	0.640
AFP
< 400 ng/mL	66 (86.84)	54 (96.43)	χ² = 3.216	0.073
≥ 400 ng/mL	10 (13.16)	2 (3.57)	χ² = 3.216	0.073
Tumor maximum diameter (cm)	4.98 ± 2.43	5.62 ± 2.31	t = -1.537	0.127
Tumor maximum diameter
≤ 5 cm	42 (55.26)	21 (37.50)	χ² = 4.338	0.037
> 5 cm	34 (44.74)	35 (62.50)	χ² = 4.338	0.037
Multifocal
Yes	16 (21.05)	17 (30.36)	χ² = 1.452	0.228
No	60 (78.95)	39 (69.64)	χ² = 1.452	0.228
Microvascular invasion
Yes	26 (34.21)	26 (46.43)	χ² = 2.066	0.151
No	50 (65.79)	30 (53.57)	χ² = 2.066	0.151
Edmondson classification
Class I-II	49 (64.47)	25 (44.64)	χ² = 5.199	0.023
Class III-IV	27 (35.53)	31 (55.36)	χ² = 5.199	0.023

CSC: Cancer stem cell; HBV: Hepatitis B virus; AFP: Alpha-fetoprotein.

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Table 2 Positive rate of cancer stem cell markers and correlation with invasive characteristics

Marker	Expression status	n (%)	MVI positive, n (%)	Edmondson III-IV, n (%)	AFP ≥ 400, n (%)
EpCAM	Positive	45 (34.09)	17 (37.78)	22 (48.89)	5 (11.11)
	Negative	87 (65.91)	35 (40.23)	36 (41.38)	9 (10.34)
	χ²		0.444	1.902	0.068
	P value		0.505	0.168	0.794
CD133	Positive	42 (31.82)	17 (40.48)	25 (59.52)	6 (14.29)
	Negative	90 (68.18)	35 (38.89)	33 (36.67)	8 (8.89)
	χ²		0.000	3.609	0.734
	P value		0.986	0.057	0.392
CK19	Positive	31 (23.48)	19 (61.29)	17 (54.84)	6 (19.35)
	Negative	101 (76.52)	33 (32.67)	41 (40.59)	8 (7.92)
	χ²		6.982	1.418	2.741
	P value		0.008	0.234	0.098
CD44	Positive	62 (46.97)	30 (48.39)	33 (53.23)	8 (12.90)
	Negative	70 (53.03)	22 (31.43)	25 (35.71)	6 (8.57)
	χ²		3.282	2.238	0.475
	P value		0.070	0.135	0.491

Edmondson III-IV demonstrated a moderate to low differentiation tendency. MVI: Microvascular invasion; AFP: Alpha-fetoprotein.

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Table 3 Multivariate Cox regression analysis (recurrence-free survival)

Variable	β	SE	Wald χ²	HR (95%CI)	P value
EpCAM positive	0.542	0.264	4.226	1.72 (1.03-2.88)	0.040
CD133 positive	0.140	0.278	0.254	1.15 (0.67-1.98)	0.614
CK19 positive	0.769	0.285	7.261	2.16 (1.23-3.78)	0.007
CD44 positive	0.115	0.270	0.183	1.12 (0.66-1.91)	0.669
Microvascular invasion	0.700	0.256	7.491	2.01 (1.22-3.32)	0.006
Tumor maximum diameter > 5 cm	0.447	0.262	2.916	1.56 (0.94-2.61)	0.088
Multifocal	0.116	0.281	0.170	1.12 (0.65-1.95)	0.680
AFP ≥ 400 ng/mL	0.208	0.450	0.214	1.23 (0.51-2.97)	0.644
Edmondson III-IV	-0.385	0.276	1.947	0.68 (0.40-1.17)	0.163

HR: Hazard ratio; CI: Confidence interval; AFP: Alpha-fetoprotein.

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Table 4 Multivariate Cox regression analysis (overall survival)

Variable	β	SE	Wald χ²	HR (95%CI)	P value
EpCAM positive	0.458	0.331	1.932	1.58 (0.83-3.03)	0.165
CD133 positive	0.824	0.330	6.220	2.28 (1.19-4.35)	0.013
CK19 positive	0.698	0.345	4.073	2.01 (1.02-3.95)	0.044
CD44 positive	-0.117	0.338	0.115	0.89 (0.46-1.73)	0.734
Microvascular invasion	0.626	0.323	3.744	1.87 (0.99-3.52)	0.053
Tumor maximum diameter > 5 cm	0.855	0.339	6.358	2.35 (1.21-4.58)	0.012
Multifocal	0.357	0.342	1.110	1.43 (0.73-2.80)	0.292
AFP ≥ 400 ng/mL	0.000	0.629	0.000	1.00 (0.29-3.43)	0.999
Edmondson III-IV	0.077	0.322	0.063	1.08 (0.58-2.04)	0.801

HR: Hazard ratio; CI: Confidence interval; AFP: Alpha-fetoprotein.

Full Size Table

Citation: Jia XQ, Han S, Shang YS, Kong FG, Qi L, Wang CL, Xiong WJ. Expression of liver cancer stem cell markers and association with recurrence and survival in hepatocellular carcinoma. World J Stem Cells 2026; 18(5): 119123
URL: https://www.wjgnet.com/1948-0210/full/v18/i5/119123.htm
DOI: https://dx.doi.org/10.4252/wjsc.v18.i5.119123

Jia XQ, Han S, Shang YS, Kong FG, Qi L, Wang CL, Xiong WJ. Expression of liver cancer stem cell markers and association with recurrence and survival in hepatocellular carcinoma. World J Stem Cells 2026; 18(5): 119123 [DOI: 10.4252/wjsc.v18.i5.119123]

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