Increased MiR-221 expression in hepatocellular carcinoma tissues and its role in enhancing cell growth and inhibiting apoptosis in vitro
© Rong et al.; licensee BioMed Central Ltd. 2013
Received: 11 July 2012
Accepted: 11 January 2013
Published: 16 January 2013
MiR-221 is over-expressed in human hepatocellular carcinoma (HCC), but its clinical significance and function in HCC remains uncertain. The aim of the study was to investigate the relationship between miR-221 overexpression and clinicopathological parameters in HCC formalin-fixed paraffin-embedded (FFPE) tissues, and the effect of miR-221 inhibitor and mimic on different HCC cell lines in vitro.
MiR-221 expression was detected using real time RT-qPCR in FFPE HCC and the adjacent noncancerous liver tissues. The relationship between miR-221 level and clinicopathological features was also analyzed. Furthermore, miR-221 inhibitor and mimic were transfected into HCC cell lines HepB3, HepG2 and SNU449. The effects of miR-221 on cell growth, cell cycle, caspase activity and apoptosis were also investigated by spectrophotometry, fluorimetry, fluorescence microscopy and flow cytometry, respectively.
The relative expression of miR-221 in clinical TNM stages III and IV was significantly higher than that in the stages I and II. The miR-221 level was also upregulated in the metastatic group compared to the nonmetastatic group. Furthermore, miR-221 over-expression was related to the status of tumor capsular infiltration in HCC clinical samples. Functionally, cell growth was inhibited, cell cycle was arrested in G1/S-phase and apoptosis was increased by miR-221 inhibitor in vitro. Likewise, miR-221 mimic accelerated the cell growth.
Expression of miR-221 in FFPE tissues could provide predictive significance for prognosis of HCC patients. Moreover, miR-221 inhibitor could be useful to suppress proliferation and induce apoptosis in HCC cells. Thus miR-221 might be a critical targeted therapy strategy for HCC.
KeywordsMiR-221 Hepatocellular carcinoma (HCC) Cell growth Cell cycle Apoptosis Caspase
Primary liver cancer includes hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), and hepatic angiosarcoma. As the third leading cause of death from cancer (an estimated 549,000 deaths per year), HCC accounts for 85–90% of all primary liver cancers and ranks as the fifth most prevalent malignancy all over the world [1–4]. The development and progression of HCC is typical of a multistage process. It has been well documented that infection with hepatitis B and C virus (HBV and HCV) is the major etiological factor for the development of HCC [1–3, 5, 6]. The progression is considered to involve the deregulation of genes that are critical to cellular processes such as cell cycle control, apoptosis, cell migration and invasion. Many reports have highlighted on investigating genes and proteins underlying the development and progression of HCC, however, their sensitivity and specificity are limited [7–14]. Therefore, the identification of new biomarkers is urgently needed in order to understand the events causing hepatocarcinogenesis, also to relate various phenotypes in clinical features and prognosis and, more importantly, to predict response possibilities to therapeutic approaches.
The current therapies for HCC remain also challenging. At the earliest stages, HCC is treatable by resection or transplantation. Percutaneous ablation is an option in patients who are afflicted with early HCC and not suitable for resection or transplantation [15, 16]. Transarterial chemoembolization has been effectively utilized in patients with HCC of intermediate stage . Patients with advanced disease or whose cancer recurs following regional therapy have a dismal prognosis. New molecular therapies for HCC include epidermal growth factor receptor (EGFR) inhibitors, for instance, erlotinib  and antiangiogenic compounds, such as bevacizumab [19, 20] and sunitinib . In a phase III trial, patients with advanced HCC treated with the molecular targeted agent sorafenib, reported an increase in survival of approximately 3 months [22–25]. Nevertheless, new agents must be developed to treat advanced HCC.
In recent years, microRNAs (miRNAs) have received great attention in cancer research. These small, non-coding RNAs can inhibit target gene expression by binding to the 3’-untranslated region (3’-UTR) of target mRNA, resulting in either mRNA degradation or inhibition of translation to protein. MiRNAs play essential roles in many normal biological processes involving cell proliferation, differentiation, apoptosis, and stress resistance [26, 27]. Studies have also shown that aberrant miRNA expression is correlated with the development and progression of cancer, thus miRNAs could be used as biomarkers for diagnosis and prognosis of cancer. On the other hand, the miRNAs can have oncogenic or tumor suppressor activities, so miRNAs are emerging as targets for cancer molecular therapy .
Extensive profiling studies over the past several years have shown that various miRNAs are differentially expressed in HCC and other types of cancers [29–41]. Nevertheless, there is still a lot remaining to be understood in the involvement of miRNAs in hepatocarcinogenesis and progression of HCC. Among all the HCC-related miRNAs, miR-221 was reported to be increasingly expressed in HCC, compared with nondiseased and adjacent benign liver tissues [37, 40, 42–47]. However, the relationship between the miR-221 expression and clinicopathological parameters in HCC was not fully understood.
In the present study, we investigated the expression of miRNA-221 in HCC and their matched adjacent noncancerous liver tissues in formalin-fixed paraffin-embedded (FFPE) surgically resected samples. Furthermore, we analyzed the correlation between miR-221 level and different clinicopathological parameters of HCC. We also performed in vitro experiments to study the effect of miR-221 on the cell growth, cell cycle, caspase-3/7 activity and apoptosis in HCC cell lines Hep3B, HepG2 and SNU449.
MiR-221 expression in HCC FFPE tissues and its clinical significance
Correlation between the expression of miR-221 and clinicopathological parameters in HCC
miR-221 relavant expression
Adjacent noncancerous liver
F= 1.487 *
Clinical TNM stage
Portal vein tumor embolus
Tumor capsular infiltration
no capsular or capsular infiltration
no capsular infiltration
MiR-221 inhibitor inhibits and miR-221 mimic enhanced cell growth in HCC cells
MiR-221 inhibitor induces cell apoptosis in HCC cells
MiR-221 has been reported to be overexpressed in human HCC tissues, compared with normal liver tissues or adjacent benign liver tissues [37, 40, 42–48]. Four groups studied the miR-221 expression with fresh frozen samples using miRNA array, Northern blot or RT-qPCR assays [44, 45, 47, 48]. FFPE tissues were used by only two groups to study the miR-221 expression in HCC. Fu et al. used in situ hybridization (ISH) and real time RT-qPCR to detect the miR-221 level. Most recently, Karakatsanis et al.  also investigated the miR-221 expression with real time RT-qPCR in HCC FFPE tissues. In the current study, the result from real time RT-qPCR in 76 cases of HCC samples confirmed the previous reports, which showed that HCC had higher miR-221 level than other liver tissues. The overexpression of miR-221 in HCC indicates that miR-221 plays a critical role in the hepatocarcinogenesis, as an oncogenic miRNA.
Concerning the relationship between miR-221 expression and clinicopathological parameters, several groups reported that miR-221 level is related to the tumor TNM stages [42, 43, 45]. In the present study, miR-221 expression in stage III and IV was found to be significantly higher than that in stage I and II, which was in line with previous reports [42, 43, 45]. In vivo data also supported that miR-221 can promote tumor progression . Meanwhile, consistent with Fu et al. , miR-221 expression was significantly upregulated in metastatic group compared to that in the nonmetastatic group. Additionally, miR-221 expression was correlated with the status of tumor capsular infiltration. In the group of tumor capsular infiltration with cancer cells or tumor with no capsular, miR-221 was significantly higher than that in the group of tumor without capsular infiltration. Generally, the status of tumor capsular infiltration reflects tumor invasion and metastasis. Thus, the result in current study reveals an obvious relation between miR-221 and the infiltration of tumor cells, migration, invasion and metastasis of HCC. The recurrence occurred quicker in the patients with high expression of miR-221 than those with low expression of miR-221. The difference was not significant, however there was a trend that high expression of miR-221 might lead to HCC recurrence. Hence it may be valuable to examine miR-221 expression for the clinical prediction of metastasis of HCC. The mechanisms of miR-221 promoting metastasis could be related to different targets. Garofalo et al.  showed that miR-221, by targeting PTEN and TIMP3 tumor suppressors, induced TRAIL resistance and enhance cellular migration through the activation of the AKT pathway and metallopeptidases. Besides the relationship between miR-221 and clinical stages, metastasis and capsular infiltration, Gramantieri et al.  reported that higher miR-221 levels were observed in multifocal HCCs versus unifocal tumors; miR-221 was also found to be corrected with tumor size and cirrhosis . Different from these reports, miR-221 expression in the current study was not correlated with the number of tumor nodes, tumor diameter or cirrhosis. The number of samples involved and different methods to detect miR-221 could partially explain the discrepancies. Additionally, miR-221 level was neither related to other clinical features, such as: age, gender, differentiation, AFP level or portal vein tumor embolus.
Recently, some miRNAs were also identified in serum and plasma in a remarkably stable form that is protected from endogenous RNase activity [49, 50]. Li et al.  investigated the serum miR-221 expression in HCC. Similarly to HCC tissues, miR-221 was found to be differentially overexpressed in HCC serum samples, and high level of miR-221 expression was correlated with tumor size, cirrhosis and tumor stage. In addition, Kaplan–Meier survival analysis showed that the overall survival rate of the high miR-221 expression group (27.6%) was significantly lower than that of the low miR-221 expression group. Thus serum miR-221 could act as a noninvasive prognostic biomarker for HCC.
MiR-221 was also studied functionally in vitro and in vivo. Pineau et al.  investigated the role of miR-221 in vitro. After transfection of miR-221 precursor, they observed that most HCC cell lines, including HepG2 used also in our study, formed larger colonies than controls. When miR-221 antagomiR was transfected into HLE and Malhavu cells, the cell growth was drastically inhibited. Whereas, the same treatment led to no change in cell proliferation in PLC/PRF5 and Huh6 cell lines. In the current study, we transfected miR-221 inhibitor and mimic by combiMAGnetofection into different HCC cell lines (HepB3, HepG2 and SNU449). The cell growth was monitored by three independent assays: CellTiter96 AQueous One Solution Cell Proliferation Assay, CellTiter-Blue Cell Viability Assay and Hoechst 33342/PI double fluorescent chromatin staining. The results of the three methods were in agreement with each other and enhanced the observation of Pineau et al. . With miR-221 inhibitor, the cell growth was inhibited in all the HCC cell lines tested. By contract, with miR-221 mimic, the cell growth was moderately accelerated in HepB3 and HepG2 cells. However, the effect of miR-221 mimic to enhance the cell growth in SNU449 cells was mild and without significantly difference when compared to the negative controls. Cell cycle was also detected by flow cytometry. When HepB3 cells were transfected with miR-221 mimic post 96 hrs, a 1.8 fold increase in the S-phase cell population was observed, which explained the character of miR-221 accelerating HCC cell growth. Yuan et al.  reported that miR-221 enhances proliferation of in vitro cultivated primary hepatocytes and adeno-associated virus mediated overexpression of miR-221 in the mouse liver also accelerates hepatocyte proliferation in vivo. Furthermore, miR-221 overexpression leads to rapid S-phase entry of hepatocytes during liver regeneration. These findings help explain the mechanism of the relationship between miR-221 and HCC cell proliferation. Fornari et al. reported that cyclin-dependent kinase inhibitor (CDKN) 1C/p57 and CDKN1B/p27 are target genes of miR-221, and Yuan et al.  reported that Aryl hydrocarbon nuclear translocator (Arnt) mRNA can be a novel target of miR-221. Thus, overexpression of miR-221 can promote cell cycle progression, by affecting both CDKN1C/p57, CDKN1B/p27 and Arnt proteins.
There were contradictory reports on the relationship between miR-221 and apoptosis in HCC. Dai et al.  reported in HCC cells, endoplasmic reticulum (ER) stress-induced apoptosis is enhanced by miR-221 mimic and attenuated by miR-221 inhibitor. MiR-221 promoted-apoptosis under ER stress is associated with p27(Kip1)- and MEK/ERK-mediated cell cycle regulation. Thus, they concluded that suppression of miR-221 plays a crucial role in the protection against apoptosis induced by ER stress in HCC cells. On the contrary, Gramantieri et al. [37, 45] found that the apoptosis of HCC cell line SNU449 was induced with knock-down of miR-221. Meanwhile, with a luciferase reporter assay, Bmf,a proapoptotic BH3-only protein , and DNA damage-inducible transcript 4 (DDIT4) , a modulator of the mTOR pathway, were confirmed to be targets of miR-221. Moreover, the analysis of HCC tissues revealed an inverse correlation between miR-221 and activated caspase-3, as a marker of apoptosis . This explains that miR-221 can inhibit apoptosis by targeting Bmf and or/DDIT4. Furthermore, miR-221 has been identified as a potent posttranscriptional regulator of FAS-induced apoptosis  and necrosis factor related apoptosis-inducing ligand related apoptosis . In the current study, Hoechst 33342/PI double fluerenscent staining observed by microscope and APC Annexin V/7-AAD staining by flow cytometry were performed to test the effect of miR-221 on apoptosis in HCC cells. The result of Gramantieri et al.  could be repeated in the present study. More than that, we also found that the apoptosis of HCC cell lines HepB3 and HepG2 was significantly increased with miR-221 inhibitor. However, miR-221 mimic did not succeed in reducing the apoptosis even with the concentration of miR-221 increasing to 300 nmol/L, suggesting that a saturation threshold was reached in these cell lines by a single miRNA mimic. To verify the data of apoptosis, we further detected the caspase-3/7 activity. The result of caspase-3/7 activity was in line with apoptosis. Hence, miR-221 could inhibit the apoptosis of HCC cells.
In vivo test has also been reported using the anti-miR-221 oligonucleotides as a potential therapeutic for HCC in mice . Park et al.  showed that anti-miR-221 oligonucleotides could accumulate in the HCC tumors, reduce endogenous miR-221 oligonucleotides, modulate miR-221-related protein levels, and enhance the survival of tumor-bearing mice.
Together with previous reports, the current observations strongly confirm that miR-221 is an oncogenic miRNA that plays a vital role in the initiation and progression of human HCC, by affecting multiple pro-oncogenic pathways. MiR-221 expression in HCC FFPE or sera samples could be a prognostic biomarker for HCC. On the other hand, cell growth inhibition and apoptosis induction by miR-221 inhibitor appears of great relevance due to its possible therapeutic role. The use of synthetic inhibitor of miR-221 might thus be a promising approach to HCC therapies in the future.
This retrospective study included 76 cases of HCCs and their corresponding paraneoplastic liver FFPE tissues. The ages of HCC patients ranged from 29 to 81 years old, with a mean of 52 years. A TNM classification (American Joint Committee on Cancer (AJCC)/International Union Against Cancer (UICC) staging system) was used to stratify HCC patients’ clinical stages . This classification considers tumor size and number, vascular invasion, bilobar involvement and extra-hepatic metastasis. Clinicopathological information was obtained from medical records and summarized in Table 1. The corresponding paraneoplastic tissues were taken at least 2 cm from the cancerous node. All cases were initial hepatectomies and randomly chosen from the hepatectomies performed over a 1–2 year span in the First Affiliated Hospital, Guangxi Medical University, P.R. China between March 2010 and March 2011. Forty-eight patients were followed up till 6th, July, 2012. Time-to-recurrence was the time from randomization (operation date) to the time of radiological recurrence . Study design was revised and approved by Guangxi Medical University Ethical Committee. Written informed consent to use the samples for research was obtained from the patients and clinicians. All samples were independently reviewed and diagnosed by two pathologists.
The human HCC-derived cell lines HepB3 (ATCC HB-8064), HepG2 (ATCC HB-8065) and SNU449 (ATCC CRL-2234) were purchased from the American Type Culture Collection (ATCC, Rockville, MD,USA). HepB3 and HepG2 cell lines were cultured in Dulbecco’s modified essential medium (DMEM, Invitrogen Corp., Grand Island, NY, USA), whereas SNU449 was cultured with RPMI 1640. Both media were supplemented with 10% heat-inactivated fetal bovine serum (Invitrogen Corp., Grand Island, NY, USA), 2 mM glutamine, gentamicin, but without antibiotics, at 37°C in a humidified incubator with 5% CO2. All in vitro experiments were performed in triplicate.
For clinical FFPE tissues, blocks were sectioned at a thickness of 10μm (3 sections for total RNA isolation). The tissues were dewaxed by xylene and ethanol. The total RNA was isolated from tumor sections using the miRNeasy FFPE Kit (QIAGEN, KJ Venlo, Netherlands) according to the manufacturer’s instructions with modifications by changing the incubation time after mixing with proteinase K to 36h at 55°C, meanwhile, adding proteinase K every 12 hrs to maintain its concentration. Depending on the size of the tumor sample, the RNA concentration ranged from 20ng/μl to 2μg/μl detected by Nanodrop 2000 (Wilmington, DE 19810 USA). Previously, we found the combination of RUN6B and let-7a was the most stable internal reference for HCC in vitro experiments by NormFinder and geNorm software, whereas the combination of RUN6B and RUN48 was the best housekeeping gene for HCC FFPE work (data not shown). Thus, different internal references were used in the current study. The primers for miR-221, RNU6B, RNU48 and let-7a were included in TaqMan® MicroRNA Assays (4427975–000468, Applied Biosystems, Life Technologies Grand Island, NY 14072 USA). The reverse primers were also used in the reverse transcription step with TaqMan® MicroRNA Reverse Transcription Kit (4366596, Applied Biosystems, Life Technologies Grand Island, NY 14072 USA) in a total volume of 10 μl. For in vitro experiments, the total Cellular RNA isolation was performed on the ABI PRISM 6100 prepstation using the AbsoluteRNA Solution (Applied Biosystems, Life Technologies Grand Island, NY 14072 USA) to remove contaminating DNA and PCR inhibitory substances. Real-time qPCR for miRNA was performed with Applied Biosystems PCR7900 [59–61]. The miR-221 abundance in each sample was normalized to its references. The miR-221 expression in FFPE experiment was calculated with the formula 2-Δcq, and the change ratio of miR-221 in the in vitro experiments was: (1-1/2ΔΔCq) × 100% .
Re-expression and inhibition of miR-221 in HCC cells
HCC cells were seeded in a 24-well plate (2.5 × 104 cells per well) or a 96-well plate (2.5 × 103 cells per well) and incubated at 37°C for 24 hrs. The cells were then transfected with miR-221 inhibitor, miRNA inhibitor negative control, miR-221 mimic and miRNA mimic negative control (Ambion, Life Technologies Grand Island, NY 14072 USA) at a final concentration of 200 nmol/L using combiMAGnetofection (OZ BIOSCIENCES , Marseille cedex 9 France ) in accordance with manufacturer's procedure. The cells were transfected with the miRNA mimic or miRNA inhibitor daily up to 96 hrs. After transfection, intermediate samples at 24, 48 and 72 hrs were collected and analyzed by different assays.
Western blot analysis
After transfection with miR-221 inhibitor, miR-221 mimic and different controls, the cells were washed with PBS and lysed in a buffer containing Tris/HCL (ph 7.6) 20mM, NaCl 150mM (ph 6.85), EDTA 1mM (ph 8), TRITON-X 1%, Na-pyrophosphate 2.5mM, Sodium orthovanadate (Na3VO4) 1mM, Leupeptin 1μg/ml, protease inhibitor cocktails 1% and phosphotase inhibitor cocktails 1% (Sigma-Aldrich N.V. St. Louis, USA). The lysates were centrifuged at 12,000 × g for 10 min at 4°C and boiled for 5 min. The protein concentration of the lysate was detected by the Bio-Rad Bradford protein assay and 25μg of denatured protein was subjected to SDS-PAGE (10% SDS-acrylamide gel) with a loading buffer containing 80mM Tris–HCl (ph 6.8), 5% SDS,10% glycerol, 5mM EDTA (ph 8), 5% 2-Mercapto Ethanol, 0.2% Bromophenolblue and 1mM phenylmethylsulfonyl fluoride The separated proteins were transferred to PVDF membranes (BioRad) for 2 hrs at 100 mA. The membrane was incubated with a p27 Kip1 (SX53G8.5) Mouse Monoclonal Antibody (#3698), p57 Kip2 Rabbit Polyclonal Antibody (#2557, 1:1000 dilution, Cell Signaling Technology, Inc.3 Trask Lane, Danvers, MA 01923) or a β-actin antibody (A1978 AC-15 1:2000 dilution, Sigma-Aldrich N.V. St. Louis, USA). Primary antibodies were detected with an HRP-conjugated secondary antibody (1:4000 dilution, ECL Anti-mouse or Anti-rabbit IgG Peroxidse linked Na 931, Sigma-Aldrich N.V. St. Louis, USA) and finally the membranes were subjected to chemiluminescence detection assay. Experiments were repeated in triplicate.
Cell viability was assessed using a fluorimetric detection of resorufin (CellTiter-Blue Cell Viability Assay, G8080, Promega, Madison, USA). The protocol was as follows: miR-221 inhibitor, miR-221 mimic and their negative controls were transfected to 96 well plates and incubated at 37°C for up to 96 hrs. The procedure was according to the manufacturer. Fluorimetry (ex: 560 nm / em: 590 nm) was using an FL600 fluorescence plate reader (Bio-Tek, Virginia, USA). Fluorescence data are(or were) expressed as the fluorescence of treated sample / mock control ×100.
To further confirm the data from the above cell viability assay, cell proliferation was detected by a colorimetric tetrazolium (MTS) assay (CellTiter96 AQueous One Solution Cell Proliferation Assay G3580, Promega, Madison, USA). The treatments and controls were as mentioned above. After transfections, addition of 20 μl of MTS reagent to each well, the plates were incubated for 2 hrs at 37°C in a humidified 5% CO2 atmosphere, and the absorbance at 490 nm was recorded using a 96-well microplate reader (Scientific Multiskan MK3, Thermo Finland). The results were the mean of six wells and expressed as the ratio of the absorbance of different transfections / absorbance of mock control × 100.
Fluorescent microscopy evaluation of cell apoptosis and morphology
Besides the CellTiter-Blue cell viability assay and MTS assay, cell growth was also monitored with Hoechst 33342 (Sigma-Aldrich N.V. St. Louis, USA) and propidium iodide (PI, Sigma-Aldrich N.V. St. Louis, USA) double fluorescent chromatin staining. With this assay, the effects of miR-221 inhibitor and mimic on apoptosis and nuclear morphology in the HCC cells could also be assessed. In brief, after different transfections, cells were washed with ice-cold PBS and stained 15min with Hoechst 33342 (1 mg/ml) and PI (1 mg/ml), and observed under an advanced fluorescence microscope (ZEISS Axiovert 25, Munich, Germany). Apoptosis and nuclear morphology were identified by condensation of nuclear chromatin and its fragmentation. This system determines the absolute number of viable cells (Hoechst 33342 positive/PI negative), early apoptotic cells (Hoechst 33342 positive/PI negative with blue fragmentations in the cells), late apoptotic cells (Hoechst 33342 positive/PI positive, with red fragmentations in the cells), necrotic cells (PI positive) and debris signals. Viable, apoptotic and necrotic cells were counted in 10 different fields under the 200× vision in each well in three independent experiments by two persons and the average result was compared to the mock control. Apoptotic cell numbers from different treatments were compared by being normalized to their viable cell numbers .
Flow cytometry analysis of cell cycle
HepB3 cells (1×105) were selected to test the effect of miR-221 on cell cycle. Cells were plated into 6-well culture plates and treated with miR-221 inhibitor, mimic and their negative controls for 96h. Cells were collected with trypsin, then washed once with 4°C PBS, and fixed in cold 75% ethanol at 4°C. Cells were then washed once again with 4°C PBS and re-suspended with PBS, then stained with 50 mg/ml PI and 100 mg/ml RNase A solution (Genview, Carlsbad, CA) for 20 min at 37°C in dark. Stained cells were subjected to analysis immediately by flow cytometry. The proportion of cells in each phase of the cell cycle was determined by a BDFACScan for Quantitative Cell Analysis.
Caspase-3/7 activity detection
Caspase-3/7 activity was measured using a synthetic rhodamine labeled caspase-3/7 substrate (Apo-ONE® Homogeneous Caspase-3/7 Assay, G7790, Promega, Madison, USA) performed immediately after the detection of cell viability (described above) on the same wells, according to the instructions of the manufacturer. After incubation at room temperature for 60min, the fluorescence of each well was measured (ex: 499 nm / em: 512 nm), using a FL600 fluorescence plate reader. Caspase-3/7 activity is expressed as fluorescence of treated sample / mock control×100.
Flow cytometry analysis of apoptosis
HepB3 cells (1×105) were also selected further to confirm the effect of miR-221 on apoptosis, using 7-Amino-Actinomycin (7-AAD)/APC Annexin V (BD Pharmingen™, South San Francisco, CA, USA) with flow cytometry. Cells were prepared as above and the procedure was according to the manufacturer. This assay allows to identify early apoptotic cells (7-AAD negative, APC Annexin V positive) and late apoptosis or already dead (both APC Annexin V and 7-AAD positive).
SPSS19.0 (Munich, Germany) was used for statistical analysis. Results were representative of three independent experiments unless stated otherwise. Values were presented as the mean ± standard deviation (SD). One-way Analysis of Variance (ANOVA) test and Student’s paired t-test were used to analyze significance between groups. The Least Significant Difference (LSD) method of multiple comparisons with parental and control group was applied when the probability for ANOVA was statistically significant. Statistical significance was determined at a P<0.05 level.
- HBV and HCV:
Hepatitis B and C virus
Epidermal growth factor receptor
Cyclin-dependent kinase inhibitor
Dulbecco’s modified essential medium.
The study was supported by the Fund of Guangxi Natural Scientific Research (No. 2010GXNSFB013059).
- Kudo M: Hepatocellular carcinoma in 2011 and beyond: from the pathogenesis to molecular targeted therapy. Oncology. 2011, 81 (Suppl 1): 1-10.View ArticlePubMedGoogle Scholar
- Meguro M, Mizuguchi T, Kawamoto M, Hirata K: The molecular pathogenesis and clinical implications of hepatocellular carcinoma. Int J Hepatol. 2011, 2011: 818672-View ArticlePubMedPubMed CentralGoogle Scholar
- Yamazaki K, Masugi Y, Sakamoto M: Molecular pathogenesis of hepatocellular carcinoma: altering transforming growth factor-beta signaling in hepatocarcinogenesis. Dig Dis. 2011, 29: 284-288. 10.1159/000327560.View ArticlePubMedGoogle Scholar
- Parkin DM, Bray F, Ferlay J, Pisani P: Estimating the world cancer burden: Globocan 2000. Int J Cancer. 2001, 94: 153-156. 10.1002/ijc.1440.View ArticlePubMedGoogle Scholar
- Zemel R, Issachar A, Tur-Kaspa R: The role of oncogenic viruses in the pathogenesis of hepatocellular carcinoma. Clin Liver Dis. 2011, 15: 261-279. 10.1016/j.cld.2011.03.001. vii-xView ArticlePubMedGoogle Scholar
- Vertemati M, Moscheni C, Petrella D, Lamperti L, Cossa M, Gambacorta M, Goffredi M, Vizzotto L: Morphometric analysis of hepatocellular nodular lesions in HCV cirrhosis. Pathol Res Pract. 2012, 208: 240-244. 10.1016/j.prp.2012.02.007.View ArticlePubMedGoogle Scholar
- Hu Z, Zhao W: Novel insights into the molecular mechanisms of alpha-fetoprotein expression and malignant phenotypes of hepatocellular carcinoma. Cell Mol Immunol. 2012, 9: 7-8. 10.1038/cmi.2011.30.View ArticlePubMedGoogle Scholar
- Merle P, Trepo C: Molecular mechanisms underlying hepatocellular carcinoma. Viruses. 2009, 1: 852-872. 10.3390/v1030852.View ArticlePubMedPubMed CentralGoogle Scholar
- Aravalli RN, Steer CJ, Cressman EN: Molecular mechanisms of hepatocellular carcinoma. Hepatology. 2008, 48: 2047-2063. 10.1002/hep.22580.View ArticlePubMedGoogle Scholar
- Katzenellenbogen M, Mizrahi L, Pappo O, Klopstock N, Olam D, Barash H, Domany E, Galun E, Goldenberg D: Molecular mechanisms of the chemopreventive effect on hepatocellular carcinoma development in Mdr2 knockout mice. Mol Cancer Ther. 2007, 6: 1283-1291. 10.1158/1535-7163.MCT-06-0420.View ArticlePubMedGoogle Scholar
- Zinkin NT, Grall F, Bhaskar K, Otu HH, Spentzos D, Kalmowitz B, Wells M, Guerrero M, Asara JM, Libermann TA, Afdhal NH: Serum proteomics and biomarkers in hepatocellular carcinoma and chronic liver disease. Clin Cancer Res. 2008, 14: 470-477. 10.1158/1078-0432.CCR-07-0586.View ArticlePubMedGoogle Scholar
- Hu L, Chen G, Yu H, Qiu X: Clinicopathological significance of RASSF1A reduced expression and hypermethylation in hepatocellular carcinoma. Hepatol Int. 2010, 4: 423-432. 10.1007/s12072-010-9164-8.View ArticlePubMedPubMed CentralGoogle Scholar
- Chen G, Luo D: Expression of decoy receptor 3 in liver tissue microarrays. Natl Med J India. 2008, 21: 275-278.PubMedGoogle Scholar
- Chen G, Dang YW, Luo DZ, Feng ZB, Tang XL: Expression of heparanase in hepatocellular carcinoma has prognostic significance: a tissue microarray study. Oncol Res. 2008, 17: 183-189. 10.3727/096504008785114138.View ArticlePubMedGoogle Scholar
- Giorgio A: Percutaneous radiofrequency ablation of hepatocellular carcinoma on cirrhosis: state of the art and future perspectives. Recent Pat Anticancer Drug Discov. 2010, 5: 69-76.View ArticlePubMedGoogle Scholar
- Lencioni R, Cioni D, Crocetti L, Bartolozzi C: Percutaneous ablation of hepatocellular carcinoma: state-of-the-art. Liver Transpl. 2004, 10: S91-97. 10.1002/lt.20043.View ArticlePubMedGoogle Scholar
- Raoul JL, Sangro B, Forner A, Mazzaferro V, Piscaglia F, Bolondi L, Lencioni R: Evolving strategies for the management of intermediate-stage hepatocellular carcinoma: available evidence and expert opinion on the use of transarterial chemoembolization. Cancer Treat Rev. 2011, 37: 212-220. 10.1016/j.ctrv.2010.07.006.View ArticlePubMedGoogle Scholar
- Philip PA, Mahoney MR, Allmer C, Thomas J, Pitot HC, Kim G, Donehower RC, Fitch T, Picus J, Erlichman C: Phase II study of Erlotinib (OSI-774) in patients with advanced hepatocellular cancer. J Clin Oncol. 2005, 23: 6657-6663. 10.1200/JCO.2005.14.696.View ArticlePubMedGoogle Scholar
- Thomas MB, Morris JS, Chadha R, Iwasaki M, Kaur H, Lin E, Kaseb A, Glover K, Davila M, Abbruzzese J: Phase II trial of the combination of bevacizumab and erlotinib in patients who have advanced hepatocellular carcinoma. J Clin Oncol. 2009, 27: 843-850. 10.1200/JCO.2008.18.3301.View ArticlePubMedGoogle Scholar
- Zhu AX, Blaszkowsky LS, Ryan DP, Clark JW, Muzikansky A, Horgan K, Sheehan S, Hale KE, Enzinger PC, Bhargava P, Stuart K: Phase II study of gemcitabine and oxaliplatin in combination with bevacizumab in patients with advanced hepatocellular carcinoma. J Clin Oncol. 2006, 24: 1898-1903. 10.1200/JCO.2005.04.9130.View ArticlePubMedGoogle Scholar
- Faivre S, Raymond E, Boucher E, Douillard J, Lim HY, Kim JS, Zappa M, Lanzalone S, Lin X, Deprimo S, et al: Safety and efficacy of sunitinib in patients with advanced hepatocellular carcinoma: an open-label, multicentre, phase II study. Lancet Oncol. 2009, 10: 794-800. 10.1016/S1470-2045(09)70171-8.View ArticlePubMedGoogle Scholar
- Palmer DH: Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008, 359: 2498-author reply 2498–2499PubMedGoogle Scholar
- Copur MS: Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008, 359: 2498-author reply 2498–2499PubMedGoogle Scholar
- Spinzi G, Paggi S: Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008, 359: 2497-2498. author reply 2498–2499View ArticlePubMedGoogle Scholar
- Llovet JM, Ricci S, Mazzaferro V, Hilgard P, Gane E, Blanc JF, de Oliveira AC, Santoro A, Raoul JL, Forner A, et al: Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008, 359: 378-390. 10.1056/NEJMoa0708857.View ArticlePubMedGoogle Scholar
- Winter J, Diederichs S: MicroRNA biogenesis and cancer. Methods Mol Biol. 2011, 676: 3-22. 10.1007/978-1-60761-863-8_1.View ArticlePubMedGoogle Scholar
- Gibb EA, Brown CJ, Lam WL: The functional role of long non-coding RNA in human carcinomas. Mol Cancer. 2011, 10: 38-10.1186/1476-4598-10-38.View ArticlePubMedPubMed CentralGoogle Scholar
- Hummel R, Hussey DJ, Haier J: MicroRNAs: predictors and modifiers of chemo- and radiotherapy in different tumour types. Eur J Cancer. 2010, 46: 298-311. 10.1016/j.ejca.2009.10.027.View ArticlePubMedGoogle Scholar
- Augello C, Vaira V, Caruso L, Destro A, Maggioni M, Park YN, Montorsi M, Santambrogio R, Roncalli M, Bosari S: MicroRNA profiling of hepatocarcinogenesis identifies C19MC cluster as a novel prognostic biomarker in hepatocellular carcinoma. Liver Int. 2012, 32: 772-782. 10.1111/j.1478-3231.2012.02795.x.View ArticlePubMedGoogle Scholar
- Negrini M, Gramantieri L, Sabbioni S, Croce CM: microRNA involvement in hepatocellular carcinoma. Anticancer Agents Med Chem. 2011, 11: 500-521. 10.2174/187152011796011037.View ArticlePubMedGoogle Scholar
- Sato F, Hatano E, Kitamura K, Myomoto A, Fujiwara T, Takizawa S, Tsuchiya S, Tsujimoto G, Uemoto S, Shimizu K: MicroRNA profile predicts recurrence after resection in patients with hepatocellular carcinoma within the Milan Criteria. PLoS One. 2011, 6: e16435-10.1371/journal.pone.0016435.View ArticlePubMedPubMed CentralGoogle Scholar
- Diao S, Zhang JF, Wang H, He ML, Lin MC, Chen Y, Kung HF: Proteomic identification of microRNA-122a target proteins in hepatocellular carcinoma. Proteomics. 2010, 10: 3723-3731. 10.1002/pmic.201000050.View ArticlePubMedGoogle Scholar
- Burchard J, Zhang C, Liu AM, Poon RT, Lee NP, Wong KF, Sham PC, Lam BY, Ferguson MD, Tokiwa G, et al: microRNA-122 as a regulator of mitochondrial metabolic gene network in hepatocellular carcinoma. Mol Syst Biol. 2010, 6: 402-View ArticlePubMedPubMed CentralGoogle Scholar
- Huang XH, Wang Q, Chen JS, Fu XH, Chen XL, Chen LZ, Li W, Bi J, Zhang LJ, Fu Q, et al: Bead-based microarray analysis of microRNA expression in hepatocellular carcinoma: miR-338 is downregulated. Hepatol Res. 2009, 39: 786-794. 10.1111/j.1872-034X.2009.00502.x.View ArticlePubMedGoogle Scholar
- Ura S, Honda M, Yamashita T, Ueda T, Takatori H, Nishino R, Sunakozaka H, Sakai Y, Horimoto K, Kaneko S: Differential microRNA expression between hepatitis B and hepatitis C leading disease progression to hepatocellular carcinoma. Hepatology. 2009, 49: 1098-1112. 10.1002/hep.22749.View ArticlePubMedGoogle Scholar
- Li S, Fu H, Wang Y, Tie Y, Xing R, Zhu J, Sun Z, Wei L, Zheng X: MicroRNA-101 regulates expression of the v-fos FBJ murine osteosarcoma viral oncogene homolog (FOS) oncogene in human hepatocellular carcinoma. Hepatology. 2009, 49: 1194-1202. 10.1002/hep.22757.View ArticlePubMedGoogle Scholar
- Gramantieri L, Fornari F, Callegari E, Sabbioni S, Lanza G, Croce CM, Bolondi L, Negrini M: MicroRNA involvement in hepatocellular carcinoma. J Cell Mol Med. 2008, 12: 2189-2204. 10.1111/j.1582-4934.2008.00533.x.View ArticlePubMedPubMed CentralGoogle Scholar
- Wang Y, Lee AT, Ma JZ, Wang J, Ren J, Yang Y, Tantoso E, Li KB, Ooi LL, Tan P, Lee CG: Profiling microRNA expression in hepatocellular carcinoma reveals microRNA-224 up-regulation and apoptosis inhibitor-5 as a microRNA-224-specific target. J Biol Chem. 2008, 283: 13205-13215. 10.1074/jbc.M707629200.View ArticlePubMedGoogle Scholar
- Varnholt H, Drebber U, Schulze F, Wedemeyer I, Schirmacher P, Dienes HP, Odenthal M: MicroRNA gene expression profile of hepatitis C virus-associated hepatocellular carcinoma. Hepatology. 2008, 47: 1223-1232.View ArticlePubMedGoogle Scholar
- Gramantieri L, Ferracin M, Fornari F, Veronese A, Sabbioni S, Liu CG, Calin GA, Giovannini C, Ferrazzi E, Grazi GL, et al: Cyclin G1 is a target of miR-122a, a microRNA frequently down-regulated in human hepatocellular carcinoma. Cancer Res. 2007, 67: 6092-6099. 10.1158/0008-5472.CAN-06-4607.View ArticlePubMedGoogle Scholar
- Murakami Y, Yasuda T, Saigo K, Urashima T, Toyoda H, Okanoue T, Shimotohno K: Comprehensive analysis of microRNA expression patterns in hepatocellular carcinoma and non-tumorous tissues. Oncogene. 2006, 25: 2537-2545. 10.1038/sj.onc.1209283.View ArticlePubMedGoogle Scholar
- Karakatsanis A, Papaconstantinou I, Gazouli M, Lyberopoulou A, Polymeneas G, Voros D: Expression of microRNAs, miR-21, miR-31, miR-122, miR-145, miR-146a, miR-200c, miR-221, miR-222, and miR-223 in patients with hepatocellular carcinoma or intrahepatic cholangiocarcinoma and its prognostic significance. Mol Carcinog. 2011, 10.1002/mc.21864.Google Scholar
- Fu X, Wang Q, Chen J, Huang X, Chen X, Cao L, Tan H, Li W, Zhang L, Bi J, et al: Clinical significance of miR-221 and its inverse correlation with p27Kip(1) in hepatocellular carcinoma. Mol Biol Rep. 2011, 38: 3029-3035. 10.1007/s11033-010-9969-5.View ArticlePubMedGoogle Scholar
- Pineau P, Volinia S, McJunkin K, Marchio A, Battiston C, Terris B, Mazzaferro V, Lowe SW, Croce CM, Dejean A: miR-221 overexpression contributes to liver tumorigenesis. Proc Natl Acad Sci U S A. 2010, 107: 264-269. 10.1073/pnas.0907904107.View ArticlePubMedGoogle Scholar
- Gramantieri L, Fornari F, Ferracin M, Veronese A, Sabbioni S, Calin GA, Grazi GL, Croce CM, Bolondi L, Negrini M: MicroRNA-221 targets Bmf in hepatocellular carcinoma and correlates with tumor multifocality. Clin Cancer Res. 2009, 15: 5073-5081. 10.1158/1078-0432.CCR-09-0092.View ArticlePubMedPubMed CentralGoogle Scholar
- Wong QW, Lung RW, Law PT, Lai PB, Chan KY, To KF, Wong N: MicroRNA-223 is commonly repressed in hepatocellular carcinoma and potentiates expression of Stathmin1. Gastroenterology. 2008, 135: 257-269. 10.1053/j.gastro.2008.04.003.View ArticlePubMedGoogle Scholar
- Fornari F, Gramantieri L, Ferracin M, Veronese A, Sabbioni S, Calin GA, Grazi GL, Giovannini C, Croce CM, Bolondi L, Negrini M: MiR-221 controls CDKN1C/p57 and CDKN1B/p27 expression in human hepatocellular carcinoma. Oncogene. 2008, 27: 5651-5661. 10.1038/onc.2008.178.View ArticlePubMedGoogle Scholar
- Garofalo M, Di Leva G, Romano G, Nuovo G, Suh SS, Ngankeu A, Taccioli C, Pichiorri F, Alder H, Secchiero P, et al: miR-221&222 regulate TRAIL resistance and enhance tumorigenicity through PTEN and TIMP3 downregulation. Cancer Cell. 2009, 16: 498-509. 10.1016/j.ccr.2009.10.014.View ArticlePubMedPubMed CentralGoogle Scholar
- Chen X, Ba Y, Ma L, Cai X, Yin Y, Wang K, Guo J, Zhang Y, Chen J, Guo X, et al: Characterization of microRNAs in serum: a novel class of biomarkers for diagnosis of cancer and other diseases. Cell Res. 2008, 18: 997-1006. 10.1038/cr.2008.282.View ArticlePubMedGoogle Scholar
- Brase JC, Wuttig D, Kuner R, Sultmann H: Serum microRNAs as non-invasive biomarkers for cancer. Mol Cancer. 2010, 9: 306-10.1186/1476-4598-9-306.View ArticlePubMedPubMed CentralGoogle Scholar
- Li J, Wang Y, Yu W, Chen J, Luo J: Expression of serum miR-221 in human hepatocellular carcinoma and its prognostic significance. Biochem Biophys Res Commun. 2011, 406: 70-73. 10.1016/j.bbrc.2011.01.111.View ArticlePubMedGoogle Scholar
- Yuan Q, Loya K, Rani B, Mobus S, Balakrishnan A, Lamle J, Cathomen T, Vogel A, Manns MP, Ott M, et al: MicroRNA-221 overexpression accelerates hepatocyte proliferation during liver regeneration. Hepatology. 2013, 57: 299-310. 10.1002/hep.25984.View ArticlePubMedGoogle Scholar
- Dai R, Li J, Liu Y, Yan D, Chen S, Duan C, Liu X, He T, Li H: miR-221/222 suppression protects against endoplasmic reticulum stress-induced apoptosis via p27(Kip1)- and MEK/ERK-mediated cell cycle regulation. Biol Chem. 2010, 391: 791-801.View ArticlePubMedGoogle Scholar
- Sharma AD, Narain N, Handel EM, Iken M, Singhal N, Cathomen T, Manns MP, Scholer HR, Ott M, Cantz T: MicroRNA-221 regulates FAS-induced fulminant liver failure. Hepatology. 2011, 53: 1651-1661. 10.1002/hep.24243.View ArticlePubMedGoogle Scholar
- Lu Q, Lu C, Zhou GP, Zhang W, Xiao H, Wang XR: MicroRNA-221 silencing predisposed human bladder cancer cells to undergo apoptosis induced by TRAIL. Urol Oncol. 2010, 28: 635-641. 10.1016/j.urolonc.2009.06.005.View ArticlePubMedGoogle Scholar
- Park JK, Kogure T, Nuovo GJ, Jiang J, He L, Kim JH, Phelps MA, Papenfuss TL, Croce CM, Patel T, Schmittgen TD: miR-221 silencing blocks hepatocellular carcinoma and promotes survival. Cancer Res. 2011, 71: 7608-7616. 10.1158/0008-5472.CAN-11-1144.View ArticlePubMedPubMed CentralGoogle Scholar
- Sobin LH, Compton CC: TNM seventh edition: what's new, what's changed: communication from the International Union Against Cancer and the American Joint Committee on Cancer. Cancer. 2010, 116: 5336-5339. 10.1002/cncr.25537.View ArticlePubMedGoogle Scholar
- Llovet JM, Di Bisceglie AM, Bruix J, Kramer BS, Lencioni R, Zhu AX, Sherman M, Schwartz M, Lotze M, Talwalkar J, Gores GJ: Design and endpoints of clinical trials in hepatocellular carcinoma. J Natl Cancer Inst. 2008, 100: 698-711. 10.1093/jnci/djn134.View ArticlePubMedGoogle Scholar
- Chen G, Kronenberger P, Umelo IA, Teugels E, De Grève J: Quantification of epidermal growth factor receptor T790M mutant transcripts in lung cancer cells by real-time reverse transcriptase-quantitative polymerase chain reaction. Anal Biochem. 2010, 398: 266-268. 10.1016/j.ab.2009.11.034.View ArticlePubMedGoogle Scholar
- Chen G, Kronenberger P, Teugels E, De Grève J: Influence of RT-qPCR primer position on EGFR interference efficacy in lung cancer cells. Biol Proced Online. 2011, 13: 1-10.1186/1480-9222-13-1.View ArticleGoogle Scholar
- Chen G, Kronenberger P, Teugels E, Adaku Umelo I, De Greve J: Targeting the epidermal growth factor receptor in non-small cell lung cancer cells: the effect of combining RNA interference with tyrosine kinase inhibitors or cetuximab. BMC Med. 2012, 10: 28-10.1186/1741-7015-10-28.View ArticlePubMedPubMed CentralGoogle Scholar
- Livak KJ, Schmittgen TD: Analysis of relative gene expression data using real-time quantitative PCR and the 2(−Delta Delta C(T)) Method. Methods. 2001, 25: 402-408. 10.1006/meth.2001.1262.View ArticlePubMedGoogle Scholar
- The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2407/13/21/prepub
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