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2017 ; 23
(13
): 2318-2329
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Cullin 4A is associated with epithelial to mesenchymal transition and poor
prognosis in perihilar cholangiocarcinoma
#MMPMID28428711
Zhang TJ
; Xue D
; Zhang CD
; Zhang ZD
; Liu QR
; Wang JQ
World J Gastroenterol
2017[Apr]; 23
(13
): 2318-2329
PMID28428711
show ga
AIM: To explore the functional role of cullin 4A (CUL4A), a core subunit of E3
ubiquitin ligase, in perihilar cholangiocarcinoma (PHCC). METHODS: The expression
of CUL4A in PHCC cell lines was evaluated by Western blot and quantitative
reverse transcription-polymerase chain reaction. Immunohistochemistry (IHC) was
adopted to investigate the relationship between CUL4A expression and
clinicopathological characteristics of PHCC. Univariate analysis and multivariate
regression analysis were performed to analyze the risk factors related to overall
survival (OS) and progression-free survival (PFS) of PHCC patients. Wound
healing, Transwell and Matrigel assays were utilized to explore the function of
CUL4A in PHCC metastasis. Furthermore, expression of epithelial to mesenchymal
transition (EMT) markers was verified in cells with CUL4A knockdown or
overexpression. The relationship between CUL4A expression and E-cadherin
expression was also analyzed by IHC assay. Finally, the role of ZEB1 in
regulating CUL4A mediated PHCC was detected by IHC, Western blot, Transwell and
Matrigel assays. RESULTS: CUL4A overexpression was detected in PHCC cell lines
and clinical specimens. Clinicopathological analysis revealed a close correlation
between CUL4A overexpression and tumour differentiation, T, N and TNM stages in
PHCC. Kaplan-Meier analysis revealed that high CUL4A expression was correlated
with poor OS and PFS of PHCC patients. Univariate analysis identified the
following four parameters as risk factors related to OS rate of PHCC: T, N, TNM
stages and high CUL4A expression; as well as three related to PFS: N stage, TNM
stage and high CUL4A expression. Further multivariate logistic regression
analysis identified high CUL4A expression as the only independent prognostic
factor for PHCC. Moreover, CUL4A silencing in PHCC cell lines dramatically
inhibited metastasis and the EMT. Conversely, CUL4A overexpression promoted these
processes. Mechanistically, ZEB1 was discovered to regulate the function of CUL4A
in promoting the EMT and metastasis. CONCLUSION: CUL4A is an independent
prognostic factor for PHCC, and it can promote the EMT by regulating ZEB1
expression. CUL4A may be a potential therapeutic target for PHCC.