7%), whereas only 3 HCCs contained definite CD133+ cells (20%) (Table 2). CD90+ cells were detected at variable frequencies in all 15 HCCs

analyzed. To explore the status of these CSC marker-positive cells in HCC in a large cohort, we utilized oligo-DNA microarray data from 238 HCC cases (GEO accession no.: GSE5975) to evaluate the expression of EPCAM (encoding EpCAM and CD326), THY1 (encoding CD90), and PROM1 (encoding CD133) in whole HCC tissues and nontumor (NT) tissues. Because previous studies demonstrated that CD133+ and CD90+ Erlotinib cells were detected at low frequency (∼13.6% by CD133 staining and ∼6.2% by CD90 staining) in HCC, but were almost nonexistent in NT liver (4, 5),4, 5 we utilized tumor/nontumor (T/N) gene-expression ratios to detect the existence of marker-positive CSCs in tumor. Accordingly, we showed that a 2-fold cutoff of T/N ratios of EPCAM successfully stratifies HCC samples with EpCAM+ liver CSCs.9, 10 A total of 95 (39.9%), 110 (46.2%),

and 31 (13.0%) of the 238 HCC cases were thus regarded as EpCAM+, CD90+, and CD133+ HCCs (T/N ratios: ≥2.0), respectively. As observed in the FACS data described above, we detected coexpression of EpCAM and CD90 in 45 HCCs (18.9%), EpCAM and CD133 in five HCCs (2%), CD90 and CD133 in five HCCs (2%), and EpCAM, CD90, and CD133 in 11 HCCs (4.6%). To clarify the characteristics of gene-expression signatures specific to stem cell marker expression status, we selected 172 HCC buy Pembrolizumab cases expressing a single CSC marker (34 EpCAM+ CD90− CD133−, 49 EpCAM− CD90+ CD133−, and 10 EpCAM− CD90− CD133+) or all marker-negative HCCs (79 EpCAM− CD90− CD133−). A class-comparison analysis

with univariate F tests and a global permutation test (×10,000) yielded a total of 1,561 differentially expressed genes. Multidimensional scaling (MDS) analysis using this gene set indicated that HCC specimens were clustered in specific groups with statistical significance (P < 0.001). Close examination of MDS plots revealed three major HCC subtype clusters: all marker-negative HCCs (blue spheres); EpCAM single-positive HCCs (red spheres); and CD90 single-positive HCCs (light blue spheres). CD133+ HCCs (orange spheres) were rare, medchemexpress relatively scattered, and not clustered (Fig. 1B). We examined the expression of representative hepatic stem/progenitor cell markers AFP, KRT19, and DLK1 in HCCs with regard to the gene-expression status of each CSC marker (Fig. 1C). All three markers were up-regulated in EpCAM+ and CD133+ HCCs, compared with all marker-negative HCCs, consistent with previous findings.10, 11 However, we found no significant overexpression of AFP, KRT19, and DLK1 in CD90+ and all marker-negative HCCs. Hierarchical cluster analyses revealed three main gene clusters that were up-regulated in EpCAM+ HCCs (cluster A, 706 genes), EpCAM+ or CD133+ HCCs (cluster B, 530 genes), and CD90+ or CD133+ HCCs (cluster C, 325 genes) (Fig. 1D).