In this study, we demonstrate that the differential behavior, including malignancy and chemosensitivity, of cancer stem-like and non-stem cells can be simultaneously distinguished in the same tumor in real time by color-coded imaging. CD133(+) Huh-7 human hepatocellular carcinoma (HCC) cells were considered as cancer stem-like cells (CSCs), and CD133(-) Huh-7 cells were considered as non-stem cancer cells (NSCCs). CD133(+) cells were isolated by magnetic bead sorting after Huh-7 cells were genetically labeled with green fluorescent protein (GFP) or red fluorescent protein (RFP). In this scheme, CD133(+) cells were labeled with GFP and CD133(-) cells were labeled with RFP. CSCs had higher proliferative potential compared to NSCCs in vitro. The same number of GFP CSCs and the RFP NSCCs were mixed and injected subcutaneously or in the spleen of nude mice. CSCs were highly tumorigenic and metastatic as well as highly resistant to chemotherapy in vivo compared to NSCCs. The ability to specifically distinguish stem-like cancer cells in vivo in real time provides a visual target for prevention of metastasis and drug resistance.
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