Published online Nov 21, 2021. doi: 10.3748/wjg.v27.i43.7546
Peer-review started: May 23, 2021
First decision: June 12, 2021
Revised: July 19, 2021
Accepted: October 27, 2021
Article in press: October 27, 2021
Published online: November 21, 2021
Circulating tumor cells (CTCs), which are also known as liquid biopsy, are mainly used as a predictor to monitor the recurrence and metastasis of tumors including hepatocellular carcinoma (HCC). Survivin is an anti-apoptotic protein that plays an important role in inhibiting apoptosis and is overexpressed in many tumors, including HCC. No study has analyzed the value of survivin-expressing CTCs in HCC.
We aimed to study the expression of survivin in CTCs of HCC and indicate the role of survivin-expressing CTCs as a marker for EMT and cancer progression in HCC.
To explore the prognostic value of survivin-expressing CTCs in HCC, and estimate survivin-positive CTCs as a potential predictor of metastasis in HCC patients.
We examined the survivin expression patterns in CTCs of HCC patients, and investigated the in vitro effects of survivin silencing and overexpression on the proliferation and invasion of HCC cells. We also analysed the survivin protein expression in HCC tissue. And we observed the dynamic changes in survivin-positive CTC count following surgery and its prognostic significance.
The CTC and survivin-positive CTC counts were significantly higher in the HCC patients than in the normal controls. Further, survivin overexpression was found to induce HepG2 cell proliferation, reduce apoptosis, and improve invasive ability. Additionally, log-rank test revealed that the recurrence free survival rate was significantly associated with survivin-positive CTC count.
Survivin-positive CTCs are promising as a predictor of HCC prognosis and metastasis.
The dynamic monitoring of survivin-positive CTC count would help clinical therapy and improve the prognosis of HCC patients.