Associations between CD133, CK19 and G2/M in cirrhotic HCV (genotype-4) patients with or without accompanying tumor

Hepatitis C virus (HCV)-cirrhotic patients have the highest threat of developing hepatocellular carcinoma (HCC) and may be at risk of extra hepatic cancer. The present study was designed to investigate CD133 and CK19 in HCV (genotype-4)-cirrhotic patients with/without HCC or extra hepatic cancer, to assess the degree of their correlation with cell cycle abnormalities and finally to assess the role of their combination as diagnostic tool for discrimination of cirrhotic patients with HCC from those with extra hepatic cancer. The study included 77 HCV-cirrhotic patients and 20 healthy non-disease control group. Patients were categorized histo-pathologically into: 24 have only liver cirrhosis, 26 with HCC, and 27 patients with extra hepatic cancer. Cell cycle abnormalities, CD133 and CK19 were determined by flow cytometry technique. CD133 and CK19 showed marked elevation in HCC and extra hepatic cancer compared with liver cirrhosis and control subjects (p<0.0001). Positive associations were noted between CK19, CD133 and G2/M. They were gradually increased with progression from liver cirrhosis to HCC. Combination of the three showed the best AUC (0.978) and accuracy (92.5%) for discrimination of HCC from extra hepatic cancer. Combined CD133 with G2/M and CK19 comprises an excellent diagnostic panel for discrimination of HCV-cirrhotic patients with HCC from those with extra hepatic cancer.