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2016 ; 22
(7
): 1800-12
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Severe Hepatitis Promotes Hepatocellular Carcinoma Recurrence via NF-?B
Pathway-Mediated Epithelial-Mesenchymal Transition after Resection
#MMPMID26655845
Wu TJ
; Chang SS
; Li CW
; Hsu YH
; Chen TC
; Lee WC
; Yeh CT
; Hung MC
Clin Cancer Res
2016[Apr]; 22
(7
): 1800-12
PMID26655845
show ga
PURPOSE: Surgical resection is considered as a curative treatment modality for
hepatocellular carcinoma; however, the incidence of postoperative tumor
recurrence is high, leading to worse patient survival. Persistent hepatitis
(inflammation) is one of the risk factors of tumor recurrence after surgical
resection. The aim of this study is to investigate the underlying mechanisms
linking liver inflammation to hepatocellular carcinoma progression. EXPERIMENTAL
DESIGN: In this study, we used a cytokine array to identify important cytokines
whose levels are increased in liver microenvironment with severe hepatitis. We
evaluated the morphologic changes, migration and invasion ability, and signal
transduction in hepatocellular carcinoma cells with or without inflammatory
cytokine in vitro Finally, we analyzed the NF-?B signal pathway in tumor
specimens from 232 patients with hepatocellular carcinoma by immunohistochemical
staining. RESULTS: The proinflammatory cytokine TNF? was increased in the
peritumoral microenvironment and contributed to tumor recurrence and metastasis.
Specifically, TNF? promoted hepatocellular carcinoma cancer cell migration,
invasion, and epithelial-mesenchymal transition (EMT) by upregulating the
transcriptional regulator, Snail. We identified Snail as a direct target gene
downstream of the TNF?-mediated canonical NF-?B activation. In addition, tumor
recurrence-free survival of hepatocellular carcinoma patients correlated
negatively with high p65 and Snail expression and positively with high E-cadherin
expression. CONCLUSIONS: Our results establish a signaling axis that explains how
inflammatory tumor microenvironment promotes hepatocellular carcinoma recurrence
and metastasis. These findings suggest that controlling liver inflammation and/or
targeting NF-?B-mediated Snail expression may be a potential therapeutic strategy
to prevent hepatocellular carcinoma recurrence after hepatectomy.