The function of cancer stem cells (CSCs) on inducing HCC recurrence after radiofrequency ablation (RFA) is still unclear. Here, 19 RFA-treated primary HCC patients were enrolled. We identified a dramatic increase of plasma VEGF in some patients (termed type II, n=9) after RFA, who suffered early HCC recurrence; the other patients (termed type I, n=10) had no increased plasma VEGF but had longer interval for HCC recurrence. Moreover, the expression of CSCs marker, CD133, was dramatically increased in recurrent HCC tissue of Type II in comparison with type I, suggesting induction of CD133+ CSCs may contribute to early HCC recurrence. In vitro studies demonstrated that VEGF stimulus enhanced the level of CD133+ CSCs and their self-renewal ability by inducing Nanog dependently on activation of VEGFR2. In vivo studies further demonstrated that CD133+ CSCs with VEGF stimulus formed larger tumor size in comparison with non-stimulus; and VEGF stimulus increased the tumorigenic cell frequency of primary HCC cells dependently on the presence of Nanog and VEGFR2. In recurrent HCC tissue of type II, but not type I, almost all CD133+ cells were Nanog and p-VEGFR2 positive cells, suggesting that activation VEGFR2 is critical for RFA-induced tumor stemness in HCC. Taken together, RFA-induced VEGF promotes tumor stemness and accelerates tumorigenesis in HCC dependently on Nanog and VEGFR2, which is valuable for the prediction of HCC recurrence after RFA and development of novel therapeutics.

Citation Format: Dexi Chen, Kai Liu, Meijun Hao, Yabo Ouyang, Jiasheng Zheng, Kishore Babu. Challagundla. CD133+ cancer stem cells promoted by VEGF accelerate the recurrence of hepatocellular carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 935. doi:10.1158/1538-7445.AM2017-935