Hepatocellular expression of epithelial–mesenchymal transition markers in a sample of hepatitis C virus-infected Egyptian patients

This study aimed to detect markers of epithelial–mesenchymal transition (EMT) in chronic hepatitis C in a sample of Egyptian patients and to assess the role of EMT in the progression of hepatic fibrosis and in carcinogenesis. Ninety-seven Egyptian patients infected with hepatitis C virus (HCV) and 15 normal controls were incorporated in this study. According to the histopathological examination of their liver biopsies, patients were classified into distinct stages of liver fibrosis (F1, F2, and F3), cirrhosis (F4), and hepatocellular carcinoma (HCC). The expression of EMT markers (β catenin, α-smooth muscle actin, and fibroblast specific protein-1) and of glial fibrillary acidic protein in hepatocytes was evaluated immunohistochemically. Our results showed increasing hepatocellular expression of mesenchymal markers (α-smooth muscle actin, fibroblast specific protein-1, and β-catenin) with the progression of liver fibrosis. Additionally, there was a shift from cytoplasmic to nuclear expression of β-catenin in hepatocytes, which is indicative of mesenchymal transition. In conclusion, we assume that hepatocytes show a phenotypic transition to fibroblasts. The increased positivity of the fibroblastic markers in cirrhosis and HCC signifies that EMT of hepatocytes participates in the progression of fibrosis and development of HCC.