To study the expression of CD68⁺tumor-associated macrophages (TAMs), CD133⁺ cancer stem cells (CSCs) and TGF-βin hepatocellular carcinoma (HCC) and correlation with the prognosis of patients.

89 patients with HCC, who underwent surgery at our center from Jan 2014 to Jan 2016, were enrolled in this study. The tissue samples were processed by IHC to analyze the expression of CD68⁺TAMs, CD133⁺CSCs and TGF-βby semi-quantative scoring methods. The data were further interpreted with the follow-up information of patients, and χ², Fisher or Wilcoxon rank sum test was used to analyze the relation between the expression of CD68⁺TAMs, CD133⁺CSCs and TGF-βand the follow-up information of patients. The correlation of CD68⁺TAMs, CD133⁺CSCs and TGF-βwith the survival of HCC patients was analyzed by the Spearman test.

The tumors had significantly higher levels of CD68⁺TAMs (59.55﹪) and TGF-β(70.79﹪) expression than their adjacent normal tissues (37.08﹪and 56.18﹪) respectively (Z?=-3.182, P = 0.001,Z =-2.306, P = 0.021) . No significant difference was found in the CD133⁺CSCs expression levels between the tumors (52.81﹪) and their adjacent normal tissues (57.30﹪) (Z?=?-0.558, P = 0.557). The expression levels of CD68, CD133 and TGF-βwere positively correlated with the degree of tumor differentiation and lymphatic metastases (P < 0.05). The TGF-βexpression levels were positively correlated with the Child-Pugh scores (χ²= 10.930, P?=?0.001). In the HCC tissue, positive correlations were found between the CD68 and TGF-βlevels (r = 0.579,P?< 0.05), and the CD133 and TGF-βlevels (r = 0.611,P < 0.05), respectively. Patients with negative expression of all the three molecules had the longest survival time, which was 23.4 months, and patients with positive expression of all the three molecules had the shortest survival time, which was 6.3 months as analyzed by Kaplan-Meier assay.

CD68⁺TAMs may influence CD133⁺CSCs, and further study is needed to elaborate the possible mechanism for the treatment of HCC in clinic.