改写Cancer stem cells CSCs are a small branch of undifferentiated cells that possess unlimited self-renewal ability 1 CSCs are closely correlated with the worse prognosis of tumor patients due to their

Cancer stem cells (CSCs) are a subset of undifferentiated cells with the ability to self-renew indefinitely [1]. CSCs are strongly associated with poor prognosis in cancer patients, as they play a critical role in tumor development, metastasis, and resistance to treatment [2]. In hepatocellular carcinoma (HCC), CSCs have been shown to drive tumor progression through genomic, epigenomic, transcriptomic, and proteomic alterations [3]. The presence of CSCs is also linked to the high rates of metastasis and treatment resistance in HCC. The mRNA expression-based stemness index (mRNAsi) is a novel quantitative tool that measures the degree of similarity between cancer cells and CSCs. Higher mRNAsi scores indicate greater biological activity in CSCs and more aggressive tumor dedifferentiation, as reflected in histopathological grades [4]. Previous studies have demonstrated that mRNAsi is a powerful predictor of tumor recurrence and resistance to treatment [5]. However, the underlying mechanisms and clinical significance of mRNAsi in HCC remain largely unknown. Therefore, further investigation into CSCs and immune status is critical for improving survival outcomes and treatment efficacy in HCC.