Hepatocellular carcinoma (HCC) is a significant cause of cancer-related mortality owing to resistance to traditional treatments and tumor recurrence after therapy, which leads to poor therapeutic outcomes. Cancer stem cells (CSC) are a small subset of tumor cells with the capability to influence self-renewal, differentiation, and tumorigenesis. A number of surface markers for liver cancer stem cell (LCSC) subpopulations (EpCAM, CD133, CD44, CD13, CD90, OV-6, CD47, and side populations) in HCC have been identified. LCSCs play critical roles in regulating HCC stemness, self-renewal, tumorigenicity, metastasis, recurrence, and therapeutic resistance via genetic mutations, epigenetic disruption, signaling pathway dysregulation, or alterations microenvironment. Accumulating studies have shown that biomarkers for LCSCs contribute to diagnosis and prognosis prediction of HCC, supporting their utility in clinical management and development of therapeutic strategies. Preclinical and clinical analyses of therapeutic approaches for HCC using small molecule inhibitors, oncolytic measles viruses, and anti-surface marker antibodies have demonstrated selective, efficient, and safe targeting of LCSC populations. The current review focuses on recent reports on the influence of LCSCs on HCC stemness, tumorigenesis, and multiple drug resistance (MDR), along with LCSC-targeted therapeutic strategies for HCC.

中文翻译：

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肝细胞癌中的癌症干细胞功能及综合治疗策略。

肝细胞癌（HCC）由于对传统疗法的耐药性和治疗后的肿瘤复发而成为与癌症相关的死亡率的重要原因，这导致不良的治疗结果。癌症干细胞（CSC）是一小部分肿瘤细胞，具有影响自我更新，分化和肿瘤发生的能力。已经确定了肝癌中肝癌干细胞（LCSC）亚群的许多表面标记（EpCAM，CD133，CD44，CD13，CD90，OV-6，CD47和侧群）。LCSC通过基因突变，表观遗传破坏，信号通路失调或微环境改变，在调节HCC干细胞，自我更新，致瘤性，转移，复发和治疗抗性中起关键作用。越来越多的研究表明，LCSC的生物标志物有助于HCC的诊断和预后预测，从而支持其在临床管理和治疗策略开发中的效用。使用小分子抑制剂，溶瘤性麻疹病毒和抗表面标志物抗体对HCC进行治疗的临床前和临床分析表明，LCSC人群具有选择性，有效和安全的靶向性。当前的评论集中在有关LCSC对HCC干细胞，肿瘤发生和多药耐药性（MDR）的影响的最新报道，以及针对LCSC的HCC治疗策略。溶瘤性麻疹病毒和抗表面标记抗体已证明对LCSC群体具有选择性，有效和安全的靶向性。当前的评论集中在有关LCSC对HCC干细胞，肿瘤发生和多药耐药性（MDR）的影响的最新报道，以及针对LCSC的HCC治疗策略。溶瘤性麻疹病毒和抗表面标记抗体已证明对LCSC群体具有选择性，有效和安全的靶向性。当前的评论集中在有关LCSC对HCC干细胞，肿瘤发生和多药耐药性（MDR）的影响的最新报道，以及针对LCSC的HCC治疗策略。