Cellular and Molecular Biology of Cancer Stem Cells of Hepatocellular Carcinoma

Kuo Shyang Jeng*, Chiung Fang Chang, I. Shyang Sheen, Chi Juei Jeng, Chih Hsuan Wang

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

14 Scopus citations


Hepatocellular carcinoma (HCC) is one of the leading causes of cancer death globally. The cancer stem cells (CSCs) of HCC are responsible for tumor growth, invasion, metastasis, recurrence, chemoresistance, target therapy resistance and radioresistance. The reported main surface markers used to identify liver CSCs include epithelial cell adhesion/activating molecule (EpCAM), cluster differentiation 90 (CD90), CD44 and CD133. The main molecular signaling pathways include the Wnt/β-catenin, transforming growth factors-β (TGF-β), sonic hedgehog (SHH), PI3K/Akt/mTOR and Notch. Patients with EpCAM-positive alpha-fetoprotein (AFP)-positive HCC are usually young but have advanced tumor-node-metastasis (TNM) stages. CD90-positive HCCs are usually poorly differentiated with worse prognosis. Those with CD44-positive HCC cells develop early metastases. Those with CD133 expression have a higher recurrence rate and a shorter overall survival. The Wnt/β-catenin signaling pathway triggers angiogenesis, tumor infiltration and metastasis through the enhancement of angiogenic factors. All CD133+ liver CSCs, CD133+/EpCAM+ liver CSCs and CD44+ liver CSCs contribute to sorafenib resistance. SHH signaling could protect HCC cells against ionizing radiation in an autocrine manner. Reducing the CSC population of HCC is crucial for the improvement of the therapy of advanced HCC. However, targeting CSCs of HCC is still challenging.

Original languageEnglish
Article number1417
JournalInternational Journal of Molecular Sciences
Issue number2
StatePublished - 11 01 2023

Bibliographical note

Publisher Copyright:
© 2023 by the authors.


  • cancer stem cells
  • chemoresistance
  • hepatocellular carcinoma
  • radioresistance
  • surface markers
  • Epithelial Cell Adhesion Molecule/genetics
  • Molecular Biology
  • Hedgehog Proteins/metabolism
  • Humans
  • Phosphatidylinositol 3-Kinases/metabolism
  • Neoplastic Stem Cells/metabolism
  • Cell Line, Tumor
  • Carcinoma, Hepatocellular/metabolism
  • Wnt Signaling Pathway
  • Liver Neoplasms/metabolism


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