title: Association Between Expression of Cancer Stem Cell Markers and Poor Differentiation of Hepatocellular Carcinoma: A Meta-Analysis (PRISMA).
abstract: The role of cancer stem cell (CSC) markers in differentiation of hepatocellular carcinoma (HCC) remains uncertain. We conducted a meta-analysis to first investigate the association between expression of CSC markers (CD133, CD90, CD44, and EpCAM) and poor differentiation of HCC, and second, to determine if these CSC markers can be classified as biomarkers for patient classification and HCC differentiated therapy.The relevant literature was searched using PubMed, EMBASE, Elsevier, and Chinese Biological Medicine databases for association between CSC markers and HCC from January 1, 2000 to June 30, 2014. Data were synthesized using random-effect or fixed-effect models. The effect sizes were estimated by measuring odds ratios (OR) with 95% confidence interval (CI).The meta-analysis included 27 studies consisting of 2897 patients with HCC. The positive expression of CSC markers was associated with poor differentiation (OR = 2.37, 95% CI = 2.03-2.77, P < 0.00001). Similarly, the positive expression of CSC markers was only associated with HCC tissues compared with noncancerous liver tissues (OR = 9.26, 95% CI = 3.10-27.65, P < 0.0001). CD90 has a specificity of 91.9% for HCC and a sensitivity of 48.22% in predicting poor differentiation.The positive expression of CSC markers is associated with poor differentiation and aggressive phenotype of patients with HCC. The CD90 marker might be a promising target for patient with HCC classification and differentiation therapy.
authors.affiliation: From the Department of Oncology, The First Affiliated Hospital, College of Medicine of Xi'an Jiaotong University, Xi'an, Shaanxi Province, P.R. China (RL, KN, TW, JG, ML, HG) and Department of Epidemiology and Statistics (YS, BM) and Department of Hepatobiliary and Pancreatic Surgery, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi Province, P.R. China (YL).
authors.forename: Rui
authors.initials: R
authors.lastname: Liu
authors.forename: Yuan
authors.initials: Y
authors.lastname: Shen
authors.forename: Kejun
authors.initials: K
authors.lastname: Nan
authors.forename: Baibing
authors.initials: B
authors.lastname: Mi
authors.forename: Tao
authors.initials: T
authors.lastname: Wu
authors.forename: Jinyue
authors.initials: J
authors.lastname: Guo
authors.forename: Miaojing
authors.initials: M
authors.lastname: Li
authors.forename: Yi
authors.initials: Y
authors.lastname: Lv
authors.forename: Hui
authors.initials: H
authors.lastname: Guo
mesh_terms: D015703:Antigens, CD / Q000378:metabolism; D000951:Antigens, Neoplasm / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D006528:Carcinoma, Hepatocellular / Q000378:metabolism* / Q000473:pathology*; D015815:Cell Adhesion Molecules / Q000378:metabolism; D000071858:Epithelial Cell Adhesion Molecule; D006801:Humans; D008113:Liver Neoplasms / Q000378:metabolism* / Q000473:pathology*; D014411:Neoplastic Stem Cells / Q000502:physiology*
chemical_list: D015703:Antigens, CD; D000951:Antigens, Neoplasm; D015415:Biomarkers; D015815:Cell Adhesion Molecules; C499379:EPCAM protein, human; D000071858:Epithelial Cell Adhesion Molecule