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Objective:To investigate the distribution of M2 tumor-associated macrophage (TAM) in hepatocellular carcinoma (HCC) and their correlation with clinicopathological features, and the significance of programmed death-ligand 1 (PD-L1) expression.Methods:From January 1, 2012 to December 31, 2020, a total of 320 HCC patients who underwent surgical resection at the Third People′s Hospital of Nantong were included. The distribution of CD163 labeled and PD-L1 CD163 double-labeled M2 TAM in HCC tissues was detected by immunohistochemistry, and the cell density was calculated. The cell density> the average cell density (112/mm 2) was judged as high-density, the cell density≤ the average cell density was judged as low-density. The correlation between CD163 positive and PD-L1 CD163 double positive M2 TAM density and the clinical pathological characteristics of HCC and its impact on prognosis were analyzed. Chi-square test was used to analyze the correlation between M2 TAM expression and the clinical pathological characteristics of HCC. Kaplan-Meier method was used to draw survival curves, and log-rank test was used for inter group comparison. Univariate and multivariate Cox proportional hazards regression analysis was used to indentify the relevant factors affecting the prognosis of HCC. Results:TAM were mainly distributed in the tumor edge stroma and tumor sinusoids, CD163 positive M2 TAM were the main macrophage subtype. PD-L1 expression was observed in CD163 positive M2 TAM in HCC tissues, and PD-L1 positive M2 TAM were mainly distributed in the tumor edge stroma. The rate of high-density CD163 positive M2 TAM in HCC tissues was 44.4% (142/320). High-density CD163 positive M2 TAM was correlated with histological grade, TNM stage, and PD-L1 expression on tumor infiltrating immune cells in HCC tissues ( χ2=4.65, 6.72 and 42.19, P=0.031, =0.011 and <0.001). High-density PD-L1 and CD163 double positive M2 TAM in HCC tissues was correlated with microvascular invasion and TNM stage ( χ2=11.96 and 8.74, P=0.001 and 0.004). The median disease-free survival (DFS) time and overall survival (OS) time of patients with high-density CD163 positive M2 TAM were 21 and 36 months, respectively, which were lower than those of patients with low-density CD163 positive M2 TAM (50 and 103 months, respectively); the median DFS time and OS time of patients with high-density PD-L1 CD163 double-positive M2 TAM were 12 and 15 months, respectively, which were lower than those of patients with low-density PD-L1 CD163 double-positive M2 TAM (28 and 45 months, respectively), and the differences were statistically significant (all log-rank tests, all P<0.001). The results of multivariate Cox proportional hazards regression analysis showed that high-density CD163 positive M2 TAM, microvascular invasion and high TNM stage were independent risk factors for evaluating DFS and OS of patients with HCC (DFS time: HR=2.408 (95% confidence interval (95% CI) 1.778 to 3.261), 2.603 (95% CI 1.860 to 3.641), 4.032 (95% CI 2.833 to 5.747), all P<0.001. OS time: HR=2.007 (95% CI 1.457 to 2.764), 4.144 (95% CI 2.881 to 5.960), 4.292 (95% CI 2.915 to 6.329), all P<0.001). Conclusions:High-density of CD163 positive M2 TAM in HCC tissues indicates high malignancy and poor prognosis, and it is an independent prognostic risk factor. The expression of PD-L1 in M2 TAM suggests stronger tumor aggressiveness and worse prognosis in HCC.
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Objective@#To investigate the epidemiological characteristics of varicella in Yandu District, Yancheng City, Jiangsu Province from 2005 to 2021, so as to provide insights into the improvements of the varicella control strategy.@*Methods@#The data pertaining to cases in Yandu District from 2005 to 2021 were captured from the National Notifiable Diseases Network Reporting System, and the coverage of varicella vaccination in Yandu District from 2016 to 2021 was captured from the Jiangsu Provincial Immunization Planning System. The trends in incidence of varicella were analyzed using annual percent change (APC), the temporal, population and spatial distributions of varicella cases were descriptively analyzed, and the correlation between the cumulative first-dose varicella vaccination rate and incidence of varicella was examined among birth cohorts in Yandu District from 2005 to 2021.@*Results@#Totally 6 144 varicella cases were reported in Yandu District from 2005 to 2021, with annual mean reported incidence of 50.05/105. The incidence of varicella appeared a tendency towards a rise in Yandu District from 2012 to 2018, with APC of 77.97% (t=11.702, P<0.001), and the incidence appeared a tendency towards a decline from 2018 to 2021, with APC of -41.93% (t=-6.911, P<0.001). The incidence of varicella peaked during the period between November and January of the following year (45.95%), and during the period between May and June (20.35%). The mean incidence of varicella was higher among men than among women (54.72/105 vs. 45.00/105; χ2=57.858, P<0.001). The highest incidence of varicella was found among cases at ages of 6 to 9 years (543.78/105), and varicella predominantly occurred among primary school students (38.40%) and pre-school children (31.85%), with high annual mean incidence in the eastern urban areas (74.27/105).The cumulative first-dose varicella vaccination rate negatively correlated with the incidence of varicella among the birth cohorts in Yandu District in 2019 (r=-0.501, P<0.001), 2020 (r=-0.646, P<0.001) and 2021 (r=-0.602, P<0.001).@*Conclusions@#The incidence of varicella appeared a tendency towards a rise followed by a reduction in Yandu District from 2005 to 2021, and the incidence of varicella peaked in winter and at the turn from spring to summer, with varicella predominantly found among primary school students and preschool children.
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Objective:To explore the expression of programmed death receptor ligand 2 (PD-L2) in hepatocellular carcinoma (HCC) and its relationship with clinicopathological features and prognosis of patients.Methods:The data of 344 patients with HCC who underwent surgery in the Third People's Hospital of Nantong from January 2008 to December 2016 were retrospectively analyzed. Taking HCC tissue samples to make the tissue microarray, and the expression of PD-L2 protein was detected by immunohistochemical method. The relationship between PD-L2 protein expression and clinicopathological features was analyzed. Kaplan-Meier method was used to analyze the overall survival (OS) and disease-free survival (DFS) of patients, and the prognostic factors were analyzed by univariate and multivariate Cox proportional hazards model.Results:The positive expression rate of PD-L2 protein in 344 patients with HCC was 54.4% (187/344). The positive expression of PD-L2 protein was correlated with maximum tumor diameter >3 cm ( χ2 = 8.20, P < 0.01) and high histological grade ( χ2 = 9.46, P < 0.05); OS and DFS in PD-L2 positive expression group were worse than those in PD-L2 negative expression group (OS: P = 0.001; DFS: P = 0.015). PD-L2 positive expression was not an independent adverse influencing factor for OS and DFS (OS: HR = 1.321, 95% CI 0.955-1.829, P = 0.093; DFS: HR = 1.209, 95% CI 0.990-1.624, P = 0.209). Conclusions:PD-L2 is highly expressed in HCC tissues, which may be related to the degree of malignancy. PD-L2 is not an independent risk factor for the prognosis of HCC.
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Objective:To investigate the correlation between the expression of programmed death ligand-1 (PD-L1) and clinicopathological parameters and prognosis in hepatocellular carcinoma (HCC) tissues.Methods:From January 2008 to December 2016, 344 HCC patients underwent surgery in Nantong Third Hospital Affiliated to Nantong University were enrolled. The expression of PD-L1 in paraffin HCC tissues was detected by tissue microarray and immunohistochemistry. The correlation between the expression of PD-L1 in tumor cells, tumor-infiltrating immune cells and the clinicopathological parameters and prognosis of HCC patients were analyzed. And the related factors affecting the prognosis of patients were explored. Chi-square test, log-rank test and univariate and multivariate Cox regression analysis were used for statistical analysis.Results:Positive PD-L1 located in the membrane and/or cytoplasm of HCC tumor cells and tumor-infiltrating immune cells. The positive rate of PD-L1 expression in tumor cells was 21.8%(75/344). The expression of PD-L1 in tumor cells was related to histological grade and microvascular invasion, the positive rates of PD-L1 expression of patients with histological gradeⅠ, Ⅱ and Ⅲ were 7.7% (2/26), 16.5% (19/115) and 26.6% (54/203), respectively, the positive rates of PD-L1 expression of patients with or without microvascular invasion were 29.3% (34/116) and 18.0% (41/228), respectively, and the differences were statistically significant ( χ2=7.659 and 5.787, P=0.022 and 0.016). The positive expression rate of PD-L1 in tumor-infiltrating immune cells was 47.1% (162/344). The expression of PD-L1 in tumor-infiltrating immune cells was related with microvascular invasion, the positive rates of PD-L1 expression in patients with or without microvascular invasion were 56.9% (66/116) and 42.1% (96/228), respectively, and the differences were statistically significant ( χ2=6.751, P=0.009). The median survival time of patients with negative expression of PD-L1 in HCC tumor cells was 61 months (30 months, 92 months), while that of patients with positive PD-L1 expression was 16 months(6 months, 44 months), and the difference was statistically significant ( χ2=55.722, P<0.01). The expression of PD-L1 in HCC tumor cells was an independent risk factor affecting overall survival time (hazard ratio=3.090, P<0.01). Conclusions:The expression of PD-L1 in HCC tumor cells may be related to the malignancy and invasion of HCC, and may be a potential risk factor for prognosis.
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Background and purpose: Abnormal expression of arginase 2 (ARG2) in a variety of human malignant tumors was detected. Previous studies found that ARG2 significantly increased in hepatocellular carcinoma (HCC) and was related to histological grading of HCC. This study aimed to analyze the association of ARG2 expression with cell proliferation, apoptosis and prognosis in HCC. Methods: The expression levels of ARG2 mRNA in 14 samples of HCC, paracancerous liver tissues and 14 samples of normal liver were detected by reverse transcriptionpolymerase chain reaction (RT-PCR). Tissue sections from 158 HCC patients were examined immunohistochemically for protein expression of ARG2, proliferation-related proteins (Ki-67 and cyclin D1) and apoptosis-related proteins (activated caspase-3, caspase-8 and caspase-9). Immunofluorescence double labeling method was used to detect the coexpression of ARG2 and activated caspase-3, and the colocalization between ARG2 and apoptotic cells. Patients were followed up by telephone. Results: TThe expression of ARG2 mRNA was significantly increased in HCC compared with the paracancerous liver tissues and normal liver tissues (F=27.10, P＜0.01). The expression of ARG2 was positively correlated with the expression of Ki-67 and cyclin D1, respectively (r=0.247 8, P＜0.01; r=0.372 7, P＜0.01). The expression of ARG2 was positively correlated with the expression of activated caspase-3 and caspase-8, respectively (r=0.191 0, P＜0.05; r=0.180 5, P＜0.05), but not with the caspase-9 (r=0.108 9, P＞0.05). Immunofluorescence double labeling showed that ARG2 was coexpressed with the activated caspase-3 and colocalized with apoptotic cells. Kaplan-Meier survival curves showed that the median survival time was 32 months in ARG2(-) group, 18 months in ARG2(+) group and 15 months in ARG2(++) group. The log-rank test results showed that there were significant differences in median survival time between the groups, and the median survival time in ARG2(-) group was longer than that in ARG2(+) and ARG2(++) groups (χ2=12.278, P＜0.01). Conclusion: ARG2 may be involved in regulating the proliferation and apoptosis of HCC cancer cells. Detecting the expression of ARG2 in HCC tissues may indicate prognosis.
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Objective To develop a novel anti-Enterovirus 71 (EV71) vaccine as recombinant virus-like particles.Methods By utilizing the foreign antigen presentation and virus-like particles forming features of Norovirus casipid VP1 P domain (NoVP), two pET-28a (+)-based recombinant expression plasmids containing either NoVP alone or NoVP with three specific epitopes SP55, SP70 and VP2-28 of EV71 capsid proteins tandemly inserted at the surface loop site were constructed and transferred to Escherichia coli.The recombinant fusion proteins of NoVP + EV71-SP55-SP70-VP2-28 and NoVP were induced expression and confirmed by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), Western blot and transmission electron microscopy (TEM) observation.BALB/C mice were randomly divided into three groups:group A immunized with the recombinant fusion protein, group B immunized with NoVP and group C injected with 10 mmol/L Tris plus 20 mmol/L NaCl (pH 9.0).Enzymelinked immunosorbent assay (ELISA) was used to test specific antibodies in the serum of the mice, besides, the serums were mixed with the EV71 H3-TY strain and Vero cells, then specific antibody titer was examined by microneutralization test.One way ANOVA and Bonferroni test were used to analyze data.Results Both recombinant fusion protein and NoVP were expressed in Escherichia coli in inclusion bodies form.SDS-PAGE demonstrated that the relative molecular weights of recombinant fusion protein and NoVP protein were approximately 43 × 103 and 36 × 103, respectively;positive protein band of about 43 × 103 (relative molecular mass) was detected in recombinant fusion protein by Western Blot.Virus-like particles derived from the recombinant fusion proteins were observed under TEM.ELISA showed that absorbance 490 (A490) of mice serum added in SP70 peptide was significantly higher than those of group B and C (F =13.860,P ＜0.05).And microneutralization test demonstrated that the serum from group A was able to neutralize EV71 at a geometric mean titer above 1:38.Conclusion A novel virus-like particles vaccine against EV71 with good antigenicity and specificity has been prepared, which is able to induce high titer of neutralizing antibody against EV71 in mice.
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Objective To investigate the clinical curative effect of calcium hydroxide paste combined with root canal in treatment of pulpitis and apicitis.Methods A total of 76 patients with pulpitis and apicitis from Dec.2014 to Aug.2015 were collected and randomly divided into two groups, 38 cases in each group.Control group (65 tooth ) were treated by routine root canal therapy, with zinc oxide iodoform clove oil cement filling root canal;experimental group (71 tooth) were treated by routine root canal therapy, with calcium hydroxide paste filling root canal.Periodontal index, pain during root canal therapy ( IAE ) , serum inflammatory factors and clinical curative effect were observed and compared between two groups pre-and post-treatment.Results Compared with pre-treatment, periodontal index of PLI, BI, PD and GI in two groups were all lower (P<0.05), and IL-6, IL-8, IL-1βand TNF-αwere lower(P<0.05).Compared with control group, PLI, BI, PD and GI of experimental group were lower (P<0.05), IL-6, IL-8, IL-1βand TNF-αwere lower(P<0.05),too.The difference of IAE incidence between two groups was significant (P<0.01) and the clinical curative effect of experimental group was 88.73%, higher than 72.31% of control group (P<0.05).Conclusion Calcium hydroxide paste combine with root canal therapy in treatment of pulpitis and apicitis are effective, which can significantly improve periodontal condition of tooth, reduce the occurrence of pain during root canal therapy.
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Objective To investigate the prognostic value of arterial blood lactate(Lac) and lactate clearance rate(LCR) for severe neonatal asphyxia.Methods One hundred and fifteen cases of severe neo natal asphyxia admitted in NICU of our hospital from January 2011 to October 2014 were retrospectively analyzed.Lac and LCR values were measured at multiple time points and were compared between those died (27 cases,the death group) and those survived (88 cases, the survival group).The correlation between prognosis and Lac as well asLCR was investigated.Receiver operating characteristic(ROC) curves were drawn to evaluate the prognostic value of Lac and LCR at different time points.Results No significant differences in initial lactate levels and neonatal critical illness score (NCIS) were detected between the two groups (P ＞0.05), while Lac and LCR values at 1 h,2 h,and 6 h showed significant differences between the two groups (P ＜ 0.05).The low-LCR group showed a higher rate of multiple organ dysfunction syndrome and mortality rates than the high-LCR group (44.64％ vs.15.25 ％, P =0.001;32.14％ vs.15.25 ％, P =0.033, respectively).Post-treatment Lac level was positively correlated with prognosis, while LCR at 1 h,2 h, and 6 h were negatively correlated with prognosis.Areas under curve of Lac ROC at 1 h,2 h, and 6 h were 0.625,0.719,and 0.835 respectively, while areas under curve of LCR ROC at 1 h, 2 h, and 6 h were 0.676,0.784, and 0.898 respectively.Conclusion Low LCR for severe neonatal asphyxia predicts poor prognosis.Lac level and LCR at 6 h after emergency treatment is a prognostic indicator for severe neonatal asphyxia.
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Background and purpose: Arginase-1 (Arg-1) is an enzyme involved in the urea cycle. Research has shown that changed expression of Arg-1 plays an important role in the cellular metabolism and growth. The purpose of this research was to investigate the expression of Arg-1 in hepatocellular carcinoma (HCC) and to analyze its correlation with clinicopathological features. Methods: The expression of Arg-1 protein and mRNA in 31 samples of HCC, paracancerous liver tissues and 12 samples of normal liver was detected by Western blot and reverse transcription-polymerase chain reaction (RT-PCR). The expression profiles of Arg-1 at protein level in 158 samples of HCC and paracancerous liver tissues were detected with high-throughput tissue microarray technique and immunohistochemistry. The relationships between Arg-1 expression and clinicopathological features were also analyzed. Results:The expression of Arg-1 mRNA and protein was signiifcantly decreased in HCC compared with the paracancerous liver tissues and normal liver tissues (F=57.83, 160.89; all P<0.01). The expression of Arg-1 in HCC was related to differentiation degree (F=10.41, 30.03; all P<0.01). And with tumor differentiation decreased, the expression level down-regulated. Immunohistochemistry revealed that Arg-1 protein was mainly located in the cytoplasm and nuclear. The expression rates of Arg-1 were 88%, 98.7%and 100%in HCC, paracancerous tissues and normal liver tissues, respectively. Statistical analysis revealed that Arg-1 protein staining rate was signiifcantly lower in tumor tissues than that in paracancerous tissues (χ2=14.7416, P<0.01) and normal liver tissues (χ2=4.1415, P<0.05). The Arg-1 expression was correlated with differentiation degree of HCC, vascular invasion and recurrence after operation (χ2=22.8459, 10.2639, 10.6368 respectively;all P<0.05), but not correlated with age, gender, the hepatitis B virus, the level of serum AFP, liver cirrhosis, diameter of tumor and tumor number. Conclusion:The expression level of Arg-1 is much lower in HCC than that in the paracancerous liver and normal liver. Moreover, Arg-1 expression level is closely related to tumor differentiation degree, metastasis and relapse. These data demonstrate that Arg-1 may play a negative role in the development of HCC.
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Objective To explore the value of arginase-1(Arg-1) and glypican-3 (GPC-3) combined examination in the differential diagnosis of hepatocellular carcinoma (HCC),metastatic carcinoma (MC) of liver and intrahepatic cholangiocarcinoma (ICC).Methods From January 2005 to December 2011,a total of 54 patients with HCC were selected,including 10 cases with high differentiation,25 cases with moderate differentiation and 19 cases with poor differentiation.At the same time,25 patients with MC of liver and 20 patients with ICC were selected.A total of 31 normal liver specimens were set as control.The expressions of Arg 1 and GPC-3 in the above tissues were detected by immunohistochemistry method.The sensitivity and specificity of the examination in the diagnosis of HCC were analyzed.Chi-square test was performed for count data analysis.Results The positive expression rate of Arg-1 in HCC,MC of liver,ICC and normal liver tissues was 87.0％ (47/54),4.0％ (1/25),5.0％ (1/20) and 100.0％ (31/31),respectively.The Arg 1 positive expression rate in HCC tissues was higher than that in other tumor tissues of non-HCC,and the difference was statistically significant (x2 =66.98,P＜0.05).The positive expression rate of GPC-3 in HCC,MC of liver,ICC and normal liver tissues was 70.4％ (38/54),12.0％ (3/25),5.0％ (1/20) and 0 (0/31),respectively.The GPC-3 positive expression rate in HCC tissues was higher than that in other tumor tissues of non-HCC and the difference was statistically significant (x2=37.98,P＜0.05).The sensitivity and specificity of Arg-1 or GPC-3 positive in HCC diagnosis was 92.6％ (50/54) and 86.7％ (39/45).The sensitivity and specificity of both Arg 1 and GPC-3 positive in HCCdiagnosis was 64.8％ (35/54) and 100.0％ (45/45).Conclusion Arginase-1 and glypican-3 combined examination has an important value in HCC diagnosis and differential diagnosis.
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Objective To explore the value of shear wave elastrography (SWE) in diagnosis of prostate cancer.Methods SWE quantitative elastography was preformed in 55 patients with suspected prostate cancer,to obtain the elastic modulus (mean,maximum).Each patient underwent sonography-guided prostatic biopsy on the same day.With the pathologic results as reference,ROC curves were used to assess diagnostic performance.Results ①Pathological tests showed that 39 lesions were benign(hyperplasia) and 16 lesions were malignant.The mean elasticity value of benign lesions was (39.04 ± 8.22) kPa,and the maximum value was (54.10 ± 9.18)kPa,whereas of malignant ones were (53.31 ± 3.92)kPa and (68.71 ±2.57)kPa,respectively (P ＜0.05).② The area under the ROC curve (AZ) of the maximum and mean elasticity value was 0.951 and 0.944.Taking 48.07 kPa as the threshold of the mean elasticity value,the sensitivity was 91.8％ and the specificity was 89.7％.Then taking 65.50 kPa as the threshold of the maximum elasticity value,the sensitivity was 92.1％ and the specificity was 87.5％.Conclusions SWE is helpful to diagnose and differentiate prostate diseases by measuring elastic modulus.
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[Objective] To observe the relation between the fetus cerebral lateral fissure depth in middle pregnancy and gestational weeks and offer foundation for whether or not normal growth of fetus cerebral cortex in antenatal early evaluation. [Method] Observe the shape of fetus cerebral lateral fissure of 18~24w pregnant women 559 cases with ultrasound, and measure the depth at cerebel um cross section. [Result] The 559 cases of pregnant women ’s fetus cerebral lat-eral fissure depth increases with gestational weeks, the shape changes blunt from smooth. [Conclusion] The ultrasound observation of fetus cerebral lateral fis-sure depth which increases with gestational weeks can be taken to offer relative basis for early evaluation of whether or not normal cerebral cortex growth.
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ObjectiveTo explore the infulence and to look for an optimal management of delayed meconium exclusion to the premature infant,in order to offer the dependence of diminished neonatal complications.Methods 23 premature infants with delayed meconium were randomly assigned into treatment group and control group.12 premature infants with normal meconium were selected as a normal group.Using the 6F silicone rubber stomach tube help the premature infants exclusing meconium by high-frequency ultrasound in treatment group.2-3ml glycerin mixed with 10-20ml warmed normal saline was given every two days or when vomit,abdominal distension appeared in control group.ResultsThere are no significant differences in serum bilirubin level,recovering days of weight,occurence rate of vomiting,abdominal distension between the treatment group and the normal premature infants group (P ＞ 0.05 ).Oppositively,there were significant differences between the control group and the treatment group ( all P ＜ 0.01).ConclusionUsing high-frequency ultrasound to treat the delay meconium exclusion is an optimal management,it may reduce the complications and recovery the weight of the premature infants with delayed meconium exclusions.
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Objective To construct a recombinant immunotoxin expression vector composed of a single-chain Fv fragment of Sehistosorna japomicum and PE38KDEL gene,and identify the binding activity of the purified product with SEA antigen.Methods The V_H and V_L genes were amplified by PCR from the parent monoclonal antibody NP11-4.Then the amplified scFv and PE38KDEL genes were inserted into the expression vector pBAD/gIII A.The fusion protein expressed in E.coli Top10F' induced by L-arabinose.After purification,the activity of the immunotoxin was evaluated by Westem-blot and ELISA.Results The new recombinant immunotoxin expression vector pBAD/gIII A-scfv-PE38KDEL was constructed successfully.The main product was in inclusion bodies.ELISA assay showed that the refolding recombinant immunotoxin remained binding activity with SEA antigen.Conclusion A new recombinant expression plasmid pBAD/gIII A-scfv-PE38KDEL has been constructed and expressed successfully,which is useful in further study of the treatment of schistosomiasis japonica.
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Purpose:To discuss the function of Gd-BOPTA on the deferment of manifestation of MRI,which bring influence to the immune mensuration of antigen PCNA,PTEN.Materials and Methods:Scanning with MRI on the 35 patients with pathologically verified HCC the image were analyzed concretely.Pathologic diagnose was made with Edmondson pathologic classification standard,and it was expressed with index of PCNA and PTEN of immune quantitative analysis.Results: HCC was negatively related to the index of PCNA,and most patients with high index were lightly or not deferred enhanced(13/16),Patients with low index were evidently enhanced ( 10/19).The degree of HCC deferred enhancing was positively related to the expression of PTEN.Most HCCs( 15/17) with negative PTEN were lightly or not deferred enhanced,while positive patients of PTEN were mostly enhanced obviously(11/18).Conclusion: Deferment of Gd-BOPTA can be used to basically estimate the tincture of tumor biology,therefore,the enhanced degree of which,the PCNA,PTEN,can offer great help in choosing the therapuetic method and estimating the outcome of the the therapy.
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The cancer stem cell (CSC) hypothesis presumes a small part of cells with the properties of stem cells are tu-morigenic and possess the metastatic potential and they play an important role in the genesis development and metastasis of tumor.Many studies documents show that the CSCs exit in some solid tumors,as well as in human leukemia.As one of the most common cancers,mnre and more evidences have proved that there are CSCs in hedatocellular carcinoma.