Malignant Hepatoblast-Like Cells Sustain Stemness via IGF2-Dependent Cholesterol Accumulation in Hepatoblastoma.
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Hepatoblastoma, the most aggressive childhood liver tumor, poses significant challenges due to limited knowledge of its pathogenesis, particularly in poorly differentiated advanced tumors where the prognosis is dismal. Single-cell sequencing provides an in-depth exploration at the single-cell level and offers a deep understanding of tumor heterogeneity. Herein, single-cell transcriptomics analysis is used to identify a unique malignant-hepatoblast (HB)-like cell subpopulation as the possible origin of poorly differentiated hepatoblastoma. These cells are associated with an unfavorable clinical prognosis in hepatoblastoma patients. The malignant-HB-like cell subpopulation generated insulin-like growth factor 2 (IGF2) to sustain stem-like features by promoting abnormal cholesterol accumulation via SREBF2. IGF2 also stimulated fibroblast 2 to secrete collagen 1, intensifying tumor malignancy via the collagen 1/integrin α1 signaling pathway. This suggests that targeting malignant HB-like cells by inhibiting IGF2-induced pathways can lead to promising treatments for hepatoblastoma. Additionally, serum IGF2 levels may serve as a diagnostic biomarker for advanced hepatoblastoma. In summary, these findings provide valuable insight into the genesis and malignancy of hepatoblastoma and a foundation for more effective diagnostic tools and therapeutic strategies for this challenging disease.