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World J Stem Cells. Aug 26, 2021; 13(8): 1127-1133
Published online Aug 26, 2021. doi: 10.4252/wjsc.v13.i8.1127
Regulators of liver cancer stem cells
Kai Liu, Jing-Hsiung James Ou
Kai Liu, Beijing Institute of Hepatology, Beijing You An Hospital, Capital Medical University, Beijing 100069, China
Jing-Hsiung James Ou, Department of Molecular Microbiology and Immunology, University of Southern California, Keck School of Medicine, Los Angeles, CA 90033, United States
Author contributions: Both Liu K and Ou JHJ wrote the manuscript; both authors have read and approve the manuscript.
Supported by National Institutes of Health Grants, No. DK094652 and No. AI148304.
Conflict-of-interest statement: The authors declare that there is no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing-Hsiung James Ou, PhD, Professor, Department of Molecular Microbiology and Immunology, University of Southern California, Keck School of Medicine, 2011 Zonal Avenue, HMR-401, Los Angeles, CA 90033, United States. jamesou@usc.edu
Received: March 1, 2021
Peer-review started: March 1, 2021
First decision: April 19, 2021
Revised: June 6, 2021
Accepted: July 30, 2021
Article in press: July 30, 2021
Published online: August 26, 2021
Processing time: 171 Days and 23.3 Hours
Abstract

Hepatocellular carcinoma (HCC) is a leading cause of cancer deaths. It is often detected at a stage when there are few therapeutic options. Liver cancer stem cells (LCSCs) are highly tumorigenic and resistant to chemotherapy and radiation therapy. Their presence in HCC is a major reason why HCC is difficult to treat. The development of LCSCs is regulated by a variety of factors. This review summarizes recent advances on the factors that regulate the development of LCSCs. Due to the importance of LCSCs in the development of HCC, a better understanding of how LCSCs are regulated will help to improve the treatments for HCC patients.

Keywords: Hepatocellular carcinoma; Liver cancer stem cells; Pluripotency transcription factors; Stem cell signaling; Genetic regulators; Epigenetic regulators

Core Tip: Liver cancer stem cells (LCSCs) play a crucial role in the development of hepatocellular carcinoma (HCC), and their tumorigenicity and chemoresistance are major reasons as to why HCC is difficult to treat. LCSCs are regulated by a variety of factors. These factors include the network of pluripotency transcription factors, signaling pathways that regulate stem cells, genetic alterations that may be caused by mutations or viral factors, and epigenetic regulations including DNA methylation, histone methylation and microRNAs. These factors together induce the cancer stem cell properties of hepatocytes and play a critical role in the development of LCSCs and HCC.