This work was supported by a Canadian Institutes of Health Research Phase 1 Clinician-Scientist Award (A.G.) and an Operating Grant from the Cancer Research Society (A.G.). The authors are grateful to Dr. John Dick for his support of this project.

A schematic overview of the protocol is presented in Figure 1.
1. Processing of Human HCC Samples
Obtain primary human HCC specimens with written patient consent and with the approval of the institutional research ethics board. These protocols have been carried out at our institution with approval from the University Health Network Research Ethics Board in compliance with all institutional, national, and international guidelines for human welfare....

<ol>
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The authors declare that they have no competing financial interests.

We have described a variety of techniques to establish subcutaneous and intrahepatic human HCC xenografts in immunodeficient mice that can be applied to a wide variety of experimental questions and assays. While subcutaneous xenografts have been widely used to study various aspects of HCC biology, intrahepatic xenografts are rarely described in the literature. Furthermore, the majority of studies describing the use of xenografts have generated these from well established cell lines. Given the limitations of cancer cell l...

Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the most rapidly increasing cause of cancer death in North America. The most prevalent risk factor for HCC is liver cirrhosis, most frequently occurring due to chronic viral hepatitis, alcohol misuse, autoimmune disease, or hereditary metabolic disorders 1.
Despite the heavy disease burden imposed by HCC on populations worldwide, the pathophysiology of HCC is relatively poorly understood in comparison to other common cancers such as colorectal, breast, or prostate cancer. For example, specific molecular and cellular events driving tumorigenesis remain to be clearly defined 2. Like most other solid epithelial cancers, genomic approaches have revealed heterogeneity in the aberrations associated with HCC 3. A number of studies have revealed disordered activity of a variety of signaling pathways involved in cell proliferation, survival, differentiation, and angiogenesis 4. In addition, the role of cancer stem cells in HCC pathobiology remains to be clarified 5.
With a limited understanding of HCC pathophysiology, the armamentarium of effective therapies for HCC has also remained relatively limited. Early-stage patients with tumors confined to the liver are candidates for curative therapy using tumor ablation or surgical resection, though recurrence is common. For patients with more advanced disease, chemotherapy and radiation are of limited efficacy and are used primarily for disease control with palliative intent 6.
High quality in vivo experimental models of human HCC thus provide a valuable platform for much needed basic research into the pathophysiology of human HCC as well as for evaluation of novel therapeutic approaches. As compared with the use of cell lines or highly defined mouse models, xenografts of primary human tumors in immunodeficient mice have emerged as valuable tools for such studies since they are capable of recapitulating the human disease with high fidelity while also capturing the heterogeneity that is present within and between different patients 7,8. To this end, we have developed a variety of methods to establish human HCC xenografts in immunodeficient mice. While the majority of published studies involving HCC xenografts describe the use of well-established human HCC cell lines for this purpose, we have focused on optimizing our assays to generate xenografts from primary HCC specimens obtained immediately after surgical resection from patients.
Different xenografting techniques may be required for different research applications. For example, subcutaneous xenografts generated from tumor fragments are generated rapidly, are easily monitored, and may be more appropriate for local administration of novel therapeutics with convenient monitoring of tumor response. Intrahepatic xenografts may be more relevant for studies pertaining to the role of the hepatic microenvironment in HCC biology. Xenografts generated from tumor cell suspensions are necessary for the identification and characterization of tumor-initiating cell subsets or for experiments requiring in vitro manipulations of tumor cells prior to xenotransplantation. We have thus developed and validated the following protocols to establish subcutaneous or intrahepatic xenografts from cell suspensions or tumor fragments derived from primary human HCC specimens.

<table border="1">
	<tbody>
		<tr>
			<td>Name of Reagent/Material</td>
			<td>Company</td>
			<td>Catalog Number</td>
			<td>Comments</td>
		</tr>
		<tr>
			<td>Dulbecco's Mod. Eagle Medium/Ham's F12 50/50 Mix x1(DMEM-F12)</td>
			<td>WISENT Bioproducts</td>
			<td>319-075-CL</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Collagenase TypeIV</td>
			<td>Sigma-Aldrich</td>
			<td>C5138</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Dispase II</td>
			<td>Stemcell Technologies</td>
			<td>7923</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Matrigel Matrix</td>
			<td>Becton-Dickinson Biosciences</td>
			<td>354234</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>10 % Buffered Formalin solution</td>
			<td>Sigma-Aldrich</td>
			<td>HT501128</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>0.9 % Saline Solution (NaCl), sterile</td>
			<td>House Brand</td>
			<td>1011-L8001</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Betadine surgical scrub</td>
			<td>Purdue Pharma</td>
			<td>NPN 00158313</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>LORIS 10% PVP-I Solution</td>
			<td>LERNA Pharma Inc.</td>
			<td>109-09</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Buprenorphine (Temegesic) NR 0.3 mg/ml</td>
			<td>Reckitt Benckiser</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Isoflurane USP, 99.9 %, inhalation anesthetic</td>
			<td>Pharmaceutical Partners of Canada Inc.</td>
			<td>M60302</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Tear-Gel</td>
			<td>Novartis Pharmaceuticals</td>
			<td>&nbsp;</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Frozen section compound</td>
			<td>VWR</td>
			<td>95057-838</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Cryomold, Tissue -Tek</td>
			<td>Sakura Finetek</td>
			<td>4566</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Precision Glide Needle 18G 1 &frac12;</td>
			<td>Becton-Dickinson Biosciences</td>
			<td>305196</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Precision Glide Needle 27G &frac12;</td>
			<td>Becton-Dickinson Biosciences</td>
			<td>305109</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Insulin syringe, 3/10 cc U-100, 29G&frac12;</td>
			<td>Becton-Dickinson Biosciences</td>
			<td>309301</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Surgical blade No.10</td>
			<td>Feather Safety Razor Co.</td>
			<td>08-916-5A</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>#5-0 Soft silk surgical suture, 3/8" taper point needle</td>
			<td>Syneture</td>
			<td>VS-880</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Transpore surgical tape</td>
			<td>3M Health care</td>
			<td>1577-1</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Cotton applicator</td>
			<td>Medpro</td>
			<td>018-425</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Surgicel, oxidized regenerated cellulose</td>
			<td>Ethicon</td>
			<td>1951</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Cell strainer 100 &mu;m nylon</td>
			<td>Becton-Dickinson Biosciences</td>
			<td>352360</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Magnification lighting with mobile base</td>
			<td>Benson medical Industries Inc.</td>
			<td>model: RLM-CLT-120V</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Petridish sterile 100x20 mm</td>
			<td>Sarstedt</td>
			<td>821474</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Tissue forcep, 1x2 teeth, 4-1/2"</td>
			<td>Almedic</td>
			<td>A10-302</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Adson dressing forcep 4-3/4"</td>
			<td>Almedic</td>
			<td>A10-220</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Eye dressing forcep, serrated, straight, 4"</td>
			<td>Almedic</td>
			<td>A19-560</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Hartman Hemostatic Forceps, curved, 3-1/2"</td>
			<td>Almedic</td>
			<td>A12-142</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Iris scissor, curved, 4-1/4"</td>
			<td>Almedic</td>
			<td>A8-690</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Iris scissor, straight, 4-1/2"</td>
			<td>Almedic</td>
			<td>A8-684</td>
			<td>&nbsp;</td>
		</tr>
		<tr>
			<td>Olsen-Hegan needle driver, 5-1/2"</td>
			<td>Almedic</td>
			<td>A17-228</td>
			<td>&nbsp;</td>
		</tr>
	</tbody>
</table>

generation of subcutaneous and intrahepatic human hepatocellular carcinoma xenografts in immunodeficient mice

In vivo experimental models of hepatocellular carcinoma (HCC) that recapitulate the human disease provide a valuable platform for research into disease pathophysiology and for the preclinical evaluation of novel therapies. We present a variety of methods to generate subcutaneous or orthotopic human HCC xenografts in immunodeficient mice that could be utilized in a variety of research applications. With a focus on the use of primary tumor tissue from patients undergoing surgical resection as a starting point, we describe the preparation of cell suspensions or tumor fragments for xenografting. We describe specific techniques to xenograft these tissues i) subcutaneously; or ii) intrahepatically, either by direct implantation of tumor cells or fragments into the liver, or indirectly by injection of cells into the mouse spleen. We also describe the use of partial resection of the native mouse liver at the time of xenografting as a strategy to induce a state of active liver regeneration in the recipient mouse that may facilitate the intrahepatic engraftment of primary human tumor cells. The expected results of these techniques are illustrated. The protocols described have been validated using primary human HCC samples and xenografts, which typically perform less robustly than the well-established human HCC cell lines that are widely used and frequently cited in the literature. In comparison with cell lines, we discuss factors which may contribute to the relatively low chance of primary HCC engraftment in xenotransplantation models and comment on technical issues that may influence the kinetics of xenograft growth. We also suggest methods that should be applied to ensure that xenografts obtained accurately resemble parent HCC tissues.

Figure 3 demonstrates the typical appearance of a subcutaneous human HCC xenograft and the corresponding histopathological appearance of the tumor. The development and growth of subcutaneous xenografts can be readily monitored by daily examination of recipient mice. The time interval between xenografting and development of a tumor may vary greatly depending on the type of tissue (tumor fragment vs. cell suspension), source of tissue (primary patient sample, passaged xenograft, or cell line), and quantity...

Watch this Scientific Journal Video about Generation of Subcutaneous and Intrahepatic Human Hepatocellular Carcinoma Xenografts in Immunodeficient Mice at JoVE.com

Generation of Subcutaneous and Intrahepatic Human Hepatocellular Carcinoma Xenografts in Immunodeficient Mice

Human tumor xenografts in immunodeficient mice are valuable tools to study cancer biology. Specific protocols to generate subcutaneous and intrahepatic xenografts from human hepatocellular carcinoma cells or tumor fragments are described. Liver regeneration induced by partial hepatectomy in recipient mice is presented as a strategy to facilitate intrahepatic engraftment.

In  vivo experimental models of hepatocellular carcinoma (HCC) that recapitulate  the human disease provide a valuable platform for research into disease  ...

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35.7K Views.  University Health Network. Human tumor xenografts in immunodeficient mice are valuable tools to study cancer biology. Specific protocols to generate subcutaneous and intrahepatic xenografts from human hepatocellular carcinoma cells or tumor fragments are described. Liver regeneration induced by partial hepatectomy in recipient mice is presented as a strategy to facilitate intrahepatic engraftment.