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Background: In the past decade, the field of tumour immunotherapy has made a great progress. However, the efficacy of immune checkpoint blocking (ICB) in the treatment of hepatocellular carcinoma (HCC) remains limited. Cytotoxic lymphocyte trafficking into tumours is critical for the success of ICB. Therefore, additional strategies that increase cytotoxic lymphocyte trafficking into tumours are urgently needed to improve patient immune responses. Methods: Paired adjacent tissue and cancerous lesions with HBV‐associated HCC were subjected to RNA‐seq analysis. Bone morphogenetic protein (BMP9), which reflects vessel normalisation, was identified through Cytoscape software, clinical specimens and Gene Expression Omnibus (GEO) datasets for HCC. The functional effects and mechanism of BMP9 on the tumour vasculature were evaluated in cells and animals. An ultrasound‐targeted microbubble destruction (UTMD)‐mediated BMP9 delivery strategy was used to normalise the vasculature and evaluate therapeutic efficacy mediated by cytotoxic lymphocytes (NK cells) in combination with a PD‐L1 antibody in human cancer xenografts of immune‐deficient mice. Results: We discovered that hepatitis B virus (HBV) infection‐induced downregulation of BMP9 expression correlated with a poor prognosis and pathological vascular abnormalities in patients with HCC. BMP9 overexpression in HBV‐infected HCC cells promoted intra‐tumoural cytotoxic lymphocyte infiltration via vascular normalisation by inhibiting the Rho‐ROCK‐myosin light chain (MLC) signalling cascade, resulting in enhanced efficacy of immunotherapy. Furthermore, UTMD‐mediated BMP9 delivery restored the anti‐tumour function of cytotoxic lymphocytes (NK cells) and showed therapeutic efficacy in combination with a PD‐L1 antibody in human cancer xenografts of immune‐deficient mice. Conclusions: HBV‐induced BMP9 downregulation causes vascular abnormalities that inhibit intra‐tumoural cytotoxic lymphocyte infiltration, providing a rationale for developing and combining immunotherapy with BMP9‐based therapy to treat HBV‐associated HCC. [ABSTRACT FROM AUTHOR]

Simple Summary: Currently, there is no effective method to detect the prognosis for hepatocellular carcinoma (HCC). This study used bioinformatics techniques to determine HCC molecular subtypes and prognosis-related biomarkers. A total of 3330 intersectional differentially expressed genes (DEGs) with the same differential direction in four datasets were identified by differential expression analysis. Intersectional DEGs were involved in the cell cycle, FOXO signaling pathway, and complement and coagulation cascades. Then, two subtypes were identified using a non-negative matrix decomposition method. Subtype C2 displayed better overall survival than subtype C1. Moreover, 217 prognostic related-genes were identified using the Cox regression and Kaplan-Meier curves. The area under the curve >0.80 of prognostic relate-genes were selected to construct random survival forest and the least absolute shrinkage and selection operator model and obtained seven feature genes (SORBS2, DHRS1, SLC16A2, RCL1, IGFALS, GNA14 and FANCI). Risk score model and recurrence model were constructed based on feature genes, and FANCI was inferred as a key gene by univariate Cox model. High expression of FANCI was mainly involved in cell cycle, DNA replication and mismatch repair. Interestingly, Single Sample Gene Set Enrichment Analysis was used to quantify immune infiltration and showed that Th2 cells and T helper cells were significantly up regulated in HCC compared to controls. Furthermore, we found the presence of two mutation sites as well as methylation modifications occurred in FANCI. Overall, we identified two types of HCC and identified that FANCI will serve as a potential biomarker for HCC prognosis and be important to the diagnosis and treatment of HCC. Bioinformatics tools were used to identify prognosis-related molecular subtypes and biomarkers of hepatocellular carcinoma (HCC). Differential expression analysis of four datasets identified 3330 overlapping differentially expressed genes (DEGs) in the same direction in all four datasets. Those genes were involved in the cell cycle, FOXO signaling pathway, as well as complement and coagulation cascades. Based on non-negative matrix decomposition, two molecular subtypes of HCC with different prognoses were identified, with subtype C2 showing better overall survival than subtype C1. Cox regression and Kaplan-Meier analysis showed that 217 of the overlapping DEGs were closely associated with HCC prognosis. The subset of those genes showing an area under the curve >0.80 was used to construct random survival forest and least absolute shrinkage and selection operator models, which identified seven feature genes (SORBS2, DHRS1, SLC16A2, RCL1, IGFALS, GNA14, and FANCI) that may be involved in HCC occurrence and prognosis. Based on the feature genes, risk score and recurrence models were constructed, while a univariate Cox model identified FANCI as a key gene involved mainly in the cell cycle, DNA replication, and mismatch repair. Further analysis showed that FANCI had two mutation sites and that its gene may undergo methylation. Single-sample gene set enrichment analysis showed that Th2 and T helper cells are significantly upregulated in HCC patients compared to controls. Our results identify FANCI as a potential prognostic biomarker for HCC. [ABSTRACT FROM AUTHOR]

Background: The protein "human endogenous retrovirus H long terminal repeat-associating 2" (HHLA2), a member of the B7 family, has been linked to cancer progression and immune responses. However, its functional role in hepatocellular carcinoma (HCC) remains unknown. Methods: Bioinformatics was used to examine the potential roles of HHLA2 in HCC and the molecular pathways involved. Expression of HHLA2 and PD-L1 as well as the density of tumor-infiltrating lymphocytes (TILs) in tumoral areas were evaluated by immunohistochemistry and hematoxylin-eosin staining of 202 resected human HCC samples. Potential correlations of HHLA2 expression with pathological characteristics or prognosis of HCC patients were explored. Different types of immune microenvironment in HCC were defined based on HHLA2 expression and TIL density. Results: High HHLA2 levels in HCC correlated with more advanced clinical cancer stage (P = 0.040), multiple tumors (P = 0.044), poor tumor differentiation (P = 0.048), microvascular invasion (P = 0.011) and hepatic capsule invasion (P = 0.047). HHLA2 levels correlated significantly with density of TILs, but not with PD-L1 levels. High HHLA2 levels were associated with worse prognosis. Intermediate and high TIL densities were independent predictors of better prognosis. Tumor microenvironments with type I (HHLA2 - high TILs +) or type IV (HHLA2 - low TILs +) were associated with better prognosis. Conclusion: HHLA2 level can independently predict worse prognosis and affect the tumor microenvironment in HCC, which may help guide immunotherapy against the cancer. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) inevitably developed oxaliplatin (OXA) resistance after long‐term treatment, but the mechanism remains unclear. Here, we found that LncRNA UCA1 was upregulated in most of OXA‐resistant HCC tissues and cells (HepG2/OXA and SMMC‐7721/OXA). Follow‐up analysis and online Kaplan–Meier Plotter revealed that HCC patients with high UCA1 level had a shorter survival compared with those with low expression. Overexpression of UCA1 increased OXA IC50 in HepG2 and SMMC‐7721 cells, whereas knockdown of UCA1 decreased OXA IC50 in resistant counterparts. Moreover, dual luciferase reporter assay showed that co‐transfection of UCA1‐WT plasmid with miR‐138‐5p mimics enhanced fluorescence signals, whereas co‐transfection of UCA1‐Mut plasmid and miR‐138‐5p mimics did not induce any changes. Consistently, UCA1 levels in HepG2/OXA and SMMC‐7721/OXA cells were downregulated after transfected with miR‐138‐5p mimics. UCA1 silencing or transfection of miR‐138‐5p mmics inhibited the activation of AKT and mTOR in HepG2/OXA and SMMC‐7721/OXA cells, whereas UCA1 overexpression increased the phosphorylated AKT and mTOR levels in parental counterparts. Rapamycin or miR‐138‐5p mimics similarly suppressed the activation of AKT and mTOR, whereas UCA1 overexpression exert opposite roles. Interestingly, administration of rapamycin or miR‐138‐5p mimics apparently antagonized the effects of UCA1 on AKT and mTOR activation. Besides, depletion of UCA1 triggered more dramatic regression of HepG2 xenografts than that of HepG2/OXA xenografts with OXA treatment and impaired the p‐AKT and p‐mTOR levels in vivo. In conclusion, our findings provide the evidence that UCA1 may contribute to OXA resistance via miR‐138‐5p‐mediated AK /mTOR activation, suggesting that UCA1 is a potential therapeutic target for HCC. [ABSTRACT FROM AUTHOR]

RNA-binding motif protein 8A (RBM8A) is abnormally overexpressed in hepatocellular carcinoma (HCC) and involved in the epithelial-mesenchymal transition (EMT). The EMT plays an important role in the development of drug resistance, suggesting that RBM8A may be involved in the regulation of oxaliplatin (OXA) resistance in HCC. Here we examined the potential involvement of RBM8A and its downstream pathways in OXA resistance using in vitro and in vivo models. RBM8A overexpression induced the EMT in OXA-resistant HCC cells, altering cell proliferation, apoptosis, migration, and invasion. Moreover, whole-genome microarrays combined with bioinformatics analysis revealed that RBM8A has a wide range of transcriptional regulatory capabilities in OXA-resistant HCC, including the ability to regulate several important tumor-related signaling pathways. In particular, histone deacetylase 9 (HDAC9) emerged as an important mediator of RBM8A activity related to OXA resistance. These data suggest that RBM8A and its related regulatory pathways represent potential markers of OXA resistance and therapeutic targets in HCC. [ABSTRACT FROM AUTHOR]

Increasing evidence suggests that long non-coding RNAs (lncRNAs) serve a crucial role in predicting prognosis for hepatocellular carcinoma (HCC). However, prognostic performance may not be the same for alcohol-related HCC. The aim of the present study was to screen prognosis-associated lncRNAs and construct a risk scoring system for alcohol-related HCC. The expression profiles of lncRNAs in 113 patients with alcohol-related HCC and 224 with non-alcohol-related HCC were obtained from The Cancer Genome Atlas (TCGA) database and screened for differentially expressed lncRNAs. Cox regression analysis was performed to identify prognosis-associated lncRNAs and select the optimal lncRNA model. A risk scoring system was established to calculate the risk score for each patient. The prognostic ability of this system was tested. Functional enrichment analysis was performed for genes that were highly associated with lncRNA expression. A total of 102 differentially expressed lncRNAs were identified between alcohol-related and non-alcohol-related HCC. Four lncRNAs (AC012640.1, AC013451.2, AC062004.1 and LINC02334) were used to construct the risk assessment model to predict overall survival (OS), and five lncRNAs (ERVH48-1, LINC02043, LINC01605, AC062004.1 and AL139385) were used to predict recurrence-free survival (RFS). Patients were assigned to high- or low-risk groups according to the risk score. OS in the high-risk group was significantly shorter than that of the low-risk group. The area under the receiver operating characteristic (ROC) curve of risk scoring systems was >0.7. The risk score was an independent prognostic factor for alcohol-related HCC. Functional enrichment analysis demonstrated that lncRNA-related genes found in this system were mainly involved in chemical carcinogenesis, drug metabolism, and the cell cycle. In conclusion, this study developed and validated a prognostic scoring system for alcohol-related HCC based on lncRNAs. [ABSTRACT FROM AUTHOR]

Almost all the patients with hepatocellular carcinoma (HCC) at advanced stage experience pathological changes of chronic liver cirrhosis, which generally leads to moderate ascites. Recognition of novel biomarkers in malignant ascites could be favorable for establishing a diagnosis for the HCC patients with ascites, and even predicting prognosis, such as risk of distant metastasis. To distinguish the proteomic profiles of malignant ascites in HCC patients from those with nonmalignant liver cirrhosis, an iTRAQ pipeline was built up to analyze the differentially distributed proteins in the malignant ascites from HCC patients (n=10) and benign ascites from hepatic decompensation (HD) controls (n=9). In total, 112 differentially distributed proteins were identified, of which 69 proteins were upregulated and 43 proteins were downregulated (ratio <0.667 or >1.3, respectively) in the malignant ascites. Moreover, 19 upregulated proteins (including keratin 1 protein and rheumatoid factor RF-IP20, ratio>1.5) and 8 downregulated proteins (including carbonic anhydrase 1, ratio<0.667) were identified from malignant ascites samples. Functional categories analyses indicated that membrane proteins, ion regulation, and amino acid metabolism are implicated in the formation of HCC malignant ascites. Pathways mapping revealed that glycolysis/gluconeogenesis and complement/coagulation cascades are the mostly affected cell life activities in HCC malignant ascites, suggesting the key factors in these pathways such as Enolase-1 and fibrinogen are potential ascitic fluid based biomarkers for diagnosis and prognosis for HCC. [ABSTRACT FROM AUTHOR]

Objective: HJURP (Holliday Junction-Recognizing Protein) plays dual roles in DNA repair and in accurate chromosome segregation during mitosis. We examined whether the single nucleotide polymorphisms (SNPs) of HJURP were associated with the risk of occurrence of hepatocellular carcinoma (HCC) among chronic hepatitis B virus (HBV) carriers from well-known high-risk regions for HCC in China. Methods: Twenty-four haplotype-tagging SNPs across HJURP were selected from HapMap data using the Haploview software. We genotyped these 24 SNPs using the using Sequenom's iPLEX assay in the Fusui population, consisting of 348 patients with HCC and 359 cancer-free controls, and further investigated the significantly associated SNP using the TaqMan assay in the Haimen population, consisting of 100 cases and 103 controls. The genetic associations with the risk of HCC were analyzed by logistic regression. Results: We observed an increased occurrence of HCC consistently associated with A/C or C/C genotypes of the non-synonymous SNP rs3771333 compared with the A/A genotype in both the Fusui and Haimen populations, with a pooled odds ratio 1.82 (95% confidence interval, 1.33–2.49; P = 1.9 × 10−4). Case-only analysis further indicated that carriers of the at-risk C allele were younger than those carrying the A/A genotype (P = 0.0016). In addition, the expression levels of HJURP in C allele carriers were lower than that in A/A genotype carriers (P = 0.0078 and 0.0010, for mRNA and protein levels, respectively). Conclusion: Our findings suggest that rs3771333 in HJURP may play a role in mediating the susceptibility to HCC among Chinese. [ABSTRACT FROM AUTHOR]

Our previous studies have initially identified HJURP, which encodes a Holliday junction recognizing protein, as a hepatocellular carcinoma (HCC) susceptibility gene. In this report, we showed that the HJURP is highly expressed in HCC tissues compared to adjacent normal tissues. Overexpression of HJURP in HCC tissues is mainly due to the hypomethylation of HJURP promoter region. Clinically, high expression of HJURP is significantly associated with poor overall survival and disease-free survival of patients with HCC, as well as in multiple other types of cancer. Gain- and loss-of functional studies demonstrated that HJURP promotes HCC cell proliferation, clone formation, migration and invasion. Additionally, HJURP enhances HCC tumorigenesis via reducing G0/G1 arrest and apoptosis. Mechanistically, by gene set enrichment analysis (GSEA) analysis, HJURP was identified as a modulator involved in CENPA-mediated centromere maintenance. Our results provide evidence of HJURP as an important oncogene that promotes HCC progression, and the HJURP pathway may be a potential target for the treatment of HCC. • HJURP is overexpressed in HCC and many other types of cancer, which is mainly driven by DNA hypomethylation. • Overexpression of HJURP is significantly associated with poor outcomes of patients with HCC. • HJURP functions as an oncogene in HCC cells via promoting cell growth, migration and invasion. • Integrated genomic analysis indicates the involvement of HJURP in CENPA-mediated centromere maintenance. [ABSTRACT FROM AUTHOR]

Netrin G1 (NTNG1) is a member of the Netrin family and plays a crucial role in various human cancers. However, the molecular functions of NTNG1 in HCC and the underlying mechanisms remain unclear. HCC expression data was obtained from the GEO database and analyzed using various bioinformatics tools. The expression of NTNG1 in HCC tissues and liver cancer cells was evaluated through RT-qPCR and western blotting. Cells with stable NTNG1 overexpression and knockdown were established, and CCK-8, colony formation, and flow cytometry assays were conducted in vitro. The xenograft model was utilized to verify the tumorigenesis capacity of NTNG1 in vivo. IHC was employed to analyze the expression of NTNG1 and CD163 proteins. HCC-specific genes were screened, followed by functional enrichment and immune cell infiltration analysis. Finally, the Co-IP was used to detect the interaction between NTNG1 and N-cadherin. NTNG1 was highly expressed in HCC tissues and liver cancer cells, and associated with significantly poorer OS rates. In addition, NTNG1 overexpression in liver cancer cells significantly increased their proliferation, colony growth, invasion, migration, and EMT, while inhibiting apoptosis. Bioinformatics analyses indicated that NTNG1 was closely related to EMT and tumor infiltration. IHC staining revealed a positive correlation between NTNG1 expression and CD163 in HCC tissues. Additionally, an EMT inhibitor attenuated the expression levels of EMT-related markers and counteracted the effects of NTNG1 overexpression in liver cancer cells. This study is the first to identify NTNG1 as a potential therapeutic target in HCC, promoting tumor development and progression by regulating EMT. [ABSTRACT FROM AUTHOR]