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Liver cancer stem cell (LCSC) markers are a diverse group of proteins and enzymes used to identify and isolate a small subpopulation of cells within liver tumors, primarily hepatocellular carcinoma (HCC), that possess stem-like properties [1, 2]. These cells are characterized by their capacity for self-renewal, multi-lineage differentiation, and high tumorigenic potential, playing a central role in tumor initiation, progression, and metastasis [3, 8]. Common markers include cell surface antigens such as CD133, CD44, EpCAM, and CD90, as well as intracellular enzymes like aldehyde dehydrogenase (ALDH) [2, 5, 10]. LCSCs are notably resistant to conventional chemotherapy and radiotherapy, often leading to tumor recurrence and treatment failure [1, 4, 6]. Consequently, these markers serve as critical therapeutic targets; strategies include using monoclonal antibodies, small molecule inhibitors of stemness pathways (e.g., Wnt/beta-catenin, Notch), and drug-conjugated antibodies to specifically eliminate the LCSC population [5, 7, 11]. However, the clinical application of LCSC-targeted therapies faces challenges due to the expression of these markers on normal stem cells and the inherent plasticity and heterogeneity of the LCSC population [3, 9, 13]. Research continues to focus on identifying more specific markers and understanding the hierarchical organization of these cells to improve therapeutic outcomes [10, 12]. Targeting the LCSC niche and the signaling pathways that maintain stemness is also a major area of drug development [4, 8]. Ultimately, the eradication of LCSCs is considered essential for achieving long-term remission in liver cancer patients [1, 3].
Inhibition of stemness signaling pathways such as Wnt/beta-catenin, Notch, and Hedgehog; antibody-dependent cellular cytotoxicity (ADCC); direct inhibition of marker enzymatic activity; induction of differentiation; and sensitization of cancer cells to conventional chemotherapy [5, 7, 10].
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