Cholangiocarcinoma primary, circulating and metastatic stem-like cells

Background and aims: Cholangiocarcinoma (CCA) is a heterogeneous adenocarcinoma arising from malignant transformation of biliary tree. Cancer Stem Cells (CSCs) are responsible for tumor initiation, recurrence and metastasis. Spread of stem-like Circulating Tumor Cells (CTCs) in the blood plays a major role in tumor recurrence, metastasis initiation and drug unresponsiveness. Thus, we hypothesized the existence of CCA stem-like relapse-initiating cells. This study aimed to explore the evolution of stemness features during CCA progression.