Published online Apr 7, 2016. doi: 10.3748/wjg.v22.i13.3547
Peer-review started: December 22, 2015
First decision: January 28, 2016
Revised: February 12, 2016
Accepted: March 2, 2016
Article in press: March 2, 2016
Published online: April 7, 2016
Cancer stem cells (CSCs) are a small subpopulation in cancer, have been proposed to be cancer-initiating cells, and have been shown to be responsible for chemotherapy resistance and cancer recurrence. The identification of CSC subpopulations inside a tumor presents a new understanding of cancer development because it implies that tumors can only be eradicated by targeting CSCs. Although advances in liver cancer detection and treatment have increased the possibility of curing the disease at early stages, unfortunately, most patients will relapse and succumb to their disease. Strategies aimed at efficiently targeting liver CSCs are becoming important for monitoring the progress of liver cancer therapy and for evaluating new therapeutic approaches. Herein, we provide a critical discussion of biological markers described in the literature regarding liver cancer stem cells and the potential of these markers to serve as therapeutic targets.
Core tip: Liver cancer is the fifth most common cancer and the third leading cause of cancer-related mortality worldwide despite remarkable progress in understanding hepatocarcinogenesis and new therapeutic approaches. Recently, the presence of highly resistant cancer stem cells (CSCs) in liver cancer has been proposed to be responsible for tumor growth, invasion, metastasis and recurrence. CSC involvement in liver cancer pathogenesis also highlights them as preferential targets for therapy. This review specifically focuses on the markers used to define human liver cancer stem cells, the therapeutic implications of the expression of these markers in patient’s primary tumors, and the potential of the markers to serve as therapeutic targets.