Skip to main content
Download PDF
  • Research article
  • Open access
  • Published:

The predictive powers of plasma trefoil factor 3 or its related micro RNAs for patients with hepatocellular carcinoma

BMC Cancer volume 18, Article number: 1110 (2018) Cite this article

Abstract

Background

Earlier diagnosis is beneficial for the prognosis of hepatocellular carcinoma (HCC). Alpha fetoprotein (AFP) is the most widely used biomarker for HCC, but its sensitivity and specificity are only 60 and 90%, respectively. Therefore, it is of great clinical significance to identify early prognostic biomarkers for HCC, especially a blood-based biomarker as it offers several advantages over tissue-based biomarkers. Trefoil factor 3 (TFF3), a novel secretory protein, was over-expressed in HCC tissues, indicating it might be a blood-based biomarker for HCC. In addition, circulating microRNAs have been investigated as biomarkers for HCC, indicating that miR-7-5p and miR-203a-3p, which are reported or predicted to target TFF3, also hold promise as blood-based biomarkers for HCC.

Methods

We enrolled 43 patients who were firstly diagnosed HCC and matched 47 control subjects without HCC. The levels of TFF3, miR-7-5p and miR-203a-3p were tested in the plasma of HCC patients. Moreover, we assayed the correlation of TFF3 with its related micro RNAs, miR-7-5p and miR-203a-3p, and evaluated their predictive powers for HCC.

Results

Decrease of TFF3 was associated with increase of miR-203a-3p in the plasma of HCC patients and they displayed potent predictive powers for HCC diagnosis. However, there was no significant change of plasma miR-7-5p between HCC and control group.

Conclusion

Decrease of TFF3 correlated with increase of miR-203a-3p in the plasma of HCC patients and they could be additional biomarkers to improve sensitivity and specificity in the diagnosis of HCC.

Peer Review reports

Background

Hepatocellular carcinoma (HCC), the main primary liver cancers, is the third lead causes of cancer death [1]. Earlier diagnosis is benefit for the prognosis of HCC. Alpha fetoprotein (AFP) is the most widely used biomarker for HCC, but its sensitivity and specificity are only 60 and 90%, respectively [2]. Therefore, there is an urgent need to identify early prognostic biomarkers for HCC. In addition, blood-based biomarker offers several advantages over tissue-based biomarker as it is simpler and less invasive [3].

Trefoil factor 3 (TFF3) is a novel secretory protein and plays an important role in tumor genesis and immunity [4]. Recently, over-expression of TFF3 was found in spontaneous and carcinogen-induced HCC of mice model or tissues of HCC patients and associated with higher tumor grade [5, 6]. Consistently, microarray analysis of HCC tissues from hepatitis B virus X (HBx) transgenic mice showed that the expression level of TFF3 gene was higher than AFP, suggesting that TFF3 might be as a blood-based biomarker for HCC [7]. In addition, it had been demonstrated that some circulating cancer biomarkers such as micro RNAs were from immune cells or other blood cells but not cancer tissues [8, 9]. And, their levels in blood and cancer tissues were not always consistent [8, 10]. We found that TFF3 gene was significantly down-regulated in peripheral blood samples of HCC patients by analyzing microarray data of GDS4882 including 10 patients with HCC and 10 normal subjects, which were obtained from the Gene Expression Omnibus database. Therefore, the predictive potency of circulating TFF3 for HCC needs further study. In addition, micro RNA could be as circulating biomarker as they were altered and stable in blood. Therefore, micro RNAs that target TFF3 might be also used as the biomarkers for HCC.

In this study, we investigated the plasma levels of TFF3 and miR-7-5p and miR-203-3p, which were reported or predicted to target TFF3, respectively [7, 8]. In addition, we analyzed the correlations of TFF3 with miR-7-5p or miR-203-3p, and their predictive powers for HCC by performing ROC (Receiver Operating Characteristic) curves and Binary logistical regression analysis.

Methods

Study population

In this study, we enrolled 43 HCC patients who were firstly diagnosed by computed tomography (CT) and/or magnetic resonance imaging (MRI) observations as well AFP assay and matched 47 control subjects without cancers at Second Affiliated Hospital of Dalian Medical University, Dalian China, From March 2015 to March 2016. All HCC patients were at the early stage and their blood samples (5 ml per patient) were collected before those received any treatments via a direct venous puncture and placed into tubes containing sodium citrate. To get plasma without cell pollution, all samples were first centrifuged at 3000×g for 5 min and then the layer was carefully transferred into other tubes which were centrifuged at 5000×g for 10 min. All plasma samples were stored at − 80 ∘C until use. Written consent was obtained from all subjects, and the study protocol was approved by the ethics committee of the Second Affiliated Hospital of Dalian Medical University (20180504007).

GEO analysis of TFF3 gene expression in peripheral blood samples of HCC and prediction of miRNA targeting TFF3

Microarray data of GDS4882 including 10 patients with HCC and 10 normal subjects were obtained from the Gene Expression Omnibus database. Expression of TFF3 gene in peripheral blood samples of HCC patients was analyzed. MiRNAs targeting TFF3 was predicted using the publicly available TargetScan (http://www.targetscan.org).

Assay for plasma TFF3, miR-7-5p and miR-203a-3p

We used the enzyme-linked immunosorbent assay (ELISA) kit from Elabscience to assay the level of TFF3 in the plasma of HCC patients, following the manufacturer’s instructions. Absorbance was measured at 450 nm (primary wave length).

Total RNAs were isolated from the plasma samples which were firstly added with 50 pmol/L Caenorhabditis elegans miR-39 (cel-miR-39), an external reference, following the instruction of miRcute miRNA Isolation kit (TRANS GEN, Beijing, China). The cDNAs were then generated by poly-(A) tailing and reverse transcription using the miScript reverse transcription kit (TRANS GEN, Beijing, China). QPCR was conducted with the ViiA 7 Software v1.1 (Applied Biosystems) to quantify miRNAs as follows: 95 Â°C for 5 min, followed by 40 cycles of 95 Â°C for 15 s and 60 Â°C for 30 s. Micro RNA assay primers used were miR-7-5p forward: 5′-TGGAAGACTAGTGATTTTGTTGTT-3′, miR-203a-3p 5′-GTGAAATGTTTAGGACCACTAG-3′ and cel-miR-39 forward: 5′-TCACCGGGUGUAAATCAGCTTG-3′. Negative controls using nuclease-free water were included with every real-time PCR operation and cycle threshold (CT) values ≤6 or > 35 were removed from analysis. All samples for miRs were run in one assay and all reactions were run in triplicate. Analysis of relative gene expression levels was performed using the formula 2-ΔCT with ΔCT = CT (target gene)-CT (control) [11].

Statistical analyses

Statistical analyses were performed using SPSS 19.0. Data are presented as the mean ± SD and median for the general characteristics of the subjects. Differences among the different groups were assessed using the one-way ANOVA comparison method. Values with a p <  0.05 were considered to indicate statistical significance. The correlation of plasma TFF3 with its related micro RNAs were calculated using the Spearman correlation test. The predictive powers of plasma TFF3 with its related micro RNAs for HCC were assayed by receiver operating characteristic (ROC) and binary logistical regression analysis [11].

Results

Baseline characteristics

Fourty-three patients with HCC and matched 47 control subjects without HCC were enrolled. Their clinical characteristics and biochemical parameters are listed in Table 1. Age; sex; hypertension; smoking history; drinking history; Hepatitis B or Hepatitis C infection; were not different between HCC and control groups. The plasma level of AFP in HCC patients was significantly increased compared to control group. However, the level of AFP in 39.95% of HCC patients was less than its cut-off value (20 ng/ml) and the level of AFP in 8.51% of control subjects was higher than that.

Table. 1 Clinical characteristics and biochemical parameters of the patients
Full size table

Analysis of TFF3 gene expression in peripheral blood samples of HCC patients and screening of micro RNAs targeting TFF3

The expression of TFF3 gene was higher than AFP in microarray analysis of HCC tissues from HBx transgenic mice and protein level of TFF3 was higher in tissues of HCC patients [7]. In addition, TFF3 holds promising as a blood-based biomarker as it is a secretory protein. However, it was also reported that some circulating cancer biomarkers such as micro RNAs were not only from cancer tissues but also from the immune or other blood cells [8, 9]. And, their levels in blood and cancer tissues were not always consistent [10]. In this study, we also analyzed the expression of TFF3 gene in peripheral blood samples of HCC patients, the microarray data (GDS4882) was obtained from Gene Expression Omnibus database. The results showed that expression level of TFF3 gene in peripheral blood samples of HCC patients was 0.09 fold compared with that in control subjects (p <  0.01) (Fig. 1a).

Fig. 1
figure 1

Analysis of TFF3 gene expression in peripheral blood samples of HCC patients and Screening of micro RNAs targeting TFF3. a The expression of TFF3 gene in peripheral blood samples of HCC patients by GEO data analysis, b prediction of micro RNA that target at TFF3 by screening TargetScan database

Full size image

MiR-7-5p has been proven to directly bind the 3’UTR of TFF3 mRNA. In addition, we screened TargetScan database, and predicted that hsa-miR-203a-3p was the only microRNA that could bind to converse site located with the 3’UTR of TFF3 mRNA (nt 414–421) with a high target score (Fig. 1b).

The plasma levels of TFF3 and miR-7-5p, miR-203-3p and their correlations in HCC patients

To explore the biological relevance of TFF3 and its related micro RNAs in HCC, we tested plasma levels of TFF3 and miR-7-5p, miR-203a-3p in HCC patients. The results showed that the plasma level of TFF3 was markedly decreased in HCC patients compared with control subjects (25.83 ± 15.53 vs 60.91 ± 53.93 ng/ml, p < 0.01) (Fig. 2a). In contrast, the plasma miR-203a-3p was significantly increased in patients with HCC compared with control subjects (9.57 ± 13.52 vs 1.00 ± 1.43 fold, p < 0.01) (Fig. 2c). While, there was no significant difference in plasma miR-7-5p between HCC and control group (1.18 ± 1.13 vs 1.00 ± 0.90 fold, p < 0.01) (Fig. 2b).

Fig. 2
figure 2

The plasma levels of TFF3 and miR-7-5p, and miR-203a-3p and the correlation of TFF3 and miR-203a-3p. a The plasma level of TFF3 in HCC patients or control subjects, b T The plasma level of miR-7-5p in HCC patients or control subjects, c The plasma level of miR-203a-3p in HCC patients or control subjects, d The correlation of plasmaTFF3 and miR-203a-3p

Full size image

In addition, we analyzed correlations of TFF3 with miR-203a-3p and found that TFF3 negatively correlated with miR-203a-3p in the plasma of HCC patients (r = − 0.243, p = 0.020) (Fig. 2d).

Comparison of the predictive powers of TFF3 and miR-203a-3p for HCC

We evaluated the predictive powers of plasma TFF3 and miR-203a-3p for HCC by receiver operating characteristic (ROC) and binary logistical regression analysis. The predictive power of AFP for HCC was also tested in this study, and the AUC for AFP was 0.886 (95% CI: 0.821–0.951; p = 0.00). The miR-203a displayed similar predictive potency with AFP, the AUC for miR-203a-3p was 0.860 (95% CI: 0.784–0.936; p = 0.00) and the optimal cut-off value was 1.44 fold with sensitivity and specificity of 77.3 and 75.1%, respectively (Fig. 3). As plasma TFF3 was down-regulated in HCC patients, we used 1/TFF3 to distinguish the HCC patients and the results showed that the AUC for 1/ TFF3 was 0.763 (95% CI: 0.667–0.859; p = 0.00) and the optimal cut-off value was 35.13 ng/ml with sensitivity and specificity of 70.2 and 63.6%, respectively (Fig. 3). Moreover, we also corroborated the discriminatory value of TFF3, miR-7-5p, miR-203a-3p, and AFP by binary logistical regression analysis (Table 2). The results showed that plasma TFF3, miR-203a-3p, and AFP were significantly correlated with HCC status (p = 0.028, p = 0.012, p = 0.037, respectively).

Fig. 3
figure 3

The ROC analysis of the predictive power of TFF3 and miR-7-5p, and miR-203a-3p for HCC status

Full size image
Table 2 Binary logistical regression analysis of TFF3, miR-7-5p, miR-203a-3p, AFP, in patients with HCC
Full size table

Discussion

TFF3 plays an important role in promoting proliferation and migration in many tumor cells such as mammary, prostate carcinoma and HCC cells [12,13,14]. Over-expression of TFF3 was found in HCC tissues and positively correlated with tumor size and stage [14,15,16]. TFF3 could promote angiogenesis in mammary carcinoma or in human umbilical vein endothelial cells via up-regulation of vascular endothelial growth factor (VEGF) [17, 18]. In addition, over-expression of TFF3 facilitated the doxorubicin resistance in gastric cancer and HCC cells, which limited the efficacy of chemotherapeutic treatment of HCC [19, 20]. Moreover, microarray analysis of HCC tissues from HBx transgenic mice showed that expression levels of TFF3 gene was higher than AFP, which was widely used as biomarker for HCC, indicating that TFF3 could be as biomarker for HCC [7]. Moreover, TFF3 holds promising as blood-based biomarker as it is secretory protein. Interestingly, we found the plasma level of TFF3 was reduced in HCC patients. Consistently, expression of TFF3 gene was down-regulated in peripheral blood samples of HCC patients by analyzing microarray data of GDS4882, which were obtained from Gene Expression Omnibus database, indicating that the plasma TFF3 might be secreted from immune cells or other blood cells.

Similarly, miRNAs with a relatively low expression in cancer tissue are abundantly expressed in plasma or serum of gastric cancer patients [8]. It has been demonstrated that only a small subset of circulating miRNAs are secreted from tumor and most of them are produced by immune and other blood cells [8,9,10]. In this study, we also investigated circulating miR-203a-3p, which was predicted to target TFF3 by bioinformatics analysis and found that miR-203a-3p was up-regulated and negatively correlated with TFF3 in the plasma of HCC patients. However, miR-203 was down-regulated in HCC tissue [19]. Low level of miR-203a was also found in many other types of tumor such as breast cancer and colorectal cancer, which was also positively correlated with proliferation, migration, invasion and angiogenesis [21,22,23,24]. In addition, miR-122 was down-regulated in HCC tissues and cancer cell lines [25] but up-regulated in the serum of HCC patients [7]. Previous observations also showed that only a few differentially expressed miRNAs were common to tumors and serum [26]. Therefore, the plasma miR-203 might be from the immune cells or other blood cells but not HCC tissues.

The abilities of TFF3 and miR-203 in regulating immune response are also found, which might participate in the development of HCC. It has been demonstrated that TFF3 could activate nuclear factor kappa B (NF-κB) in intestinal epithelial cells to produce pro-inflammatory cytokines [27]. Furthermore, TFF3 also acts as a negative regulator of T-cell immunity by induction of the expression of decay accelerating factor [28]. Therefore, low level of TFF3 in plasma or peripheral blood might exert an immunosuppressive effect and favor the development of HCC. MiR-203 could inhibit the inflammatory response induced by lipopolysaccharide in macrophage [29]. In addition, miR-203 was also found to inhibit the expression of TLR4 and production of tumor necrosis factor-α and interleukin-12 in dendritic cells [30]. Moreover, miR-203 could suppress the production of inflammatory cytokines and thereby prevented mounting of a full immune response [31]. Those data indicated that high level of plasma miR-203 might also inhibit immune response against HCC. The immune-regulatory roles of TFF3 or miR-203 need further study.

In addition, miR-7-5p was reported to target TFF3 in inflammatory bowel disease [32]. MiR-7 was down-regulated in HCC tissues and the low expression of miR-7 positively correlated with tumor size [33]. It was found that miR-7 inhibited proliferation of HCC via targeting Kruppel-like factor 4 [34]. However, our data showed that there was no significant difference of plasma miR-7-5p between HCC and control group. We further evaluated the predictive powers of plasma TFF3 and miR-203a-3p for HCC and they showed a highly significant diagnostic value for HCC. Notably, TFF3 and miR-203a-3p were altered in many other tumors, indicating that they might be as additional biomarkers for HCC.

Notably, there are some limitations in this study. For example, the plasma levels of TFF3 and miR-203a-3p and their predictive potencies were tested for HCC, but they might be also changed in many other tumors. Therefore, they might only be used as additional biomarkers for HCC. In addition, the sample size was small and need larger studies from multiple centers.

Conclusion

Decrease of TFF3 correlated with increase of miR-203a-3p in the plasma HCC patients and they could be as additional biomarkers to improve sensitivity and specificity in the diagnosis of HCC.

Abbreviations

AFP:

Alpha-fetoprotein

HBx:

Hepatitis B virus X

HCC:

Hepatocellular carcinoma

miRNA:

Micro RNA

ROC:

Receiver operating characteristic

TFF3:

Trefoil factor 3

References

  1. Bruix J, Sherman M. Management of hepatocellular carcinoma: an update. Hepatology. 2011;53(3):1020–2.

    Article  Google Scholar 

  2. Ji J, Wang H, Li Y, et al. Diagnostic evaluation of des-gamma-carboxy prothrombin versus α-fetoprotein for hepatitis B virus-related hepatocellular carcinoma in China: a large-scale, multicentre study. PLoS One. 2016;11(4):e0153227.

    Article  Google Scholar 

  3. Ganepola GAP, Nizin J, Rutledge JR, et al. Use of blood-based biomarkers for early diagnosis and surveillance of colorectal cancer. World J Gastrointest Oncol. 2014;6(4):83–97.

    Article  Google Scholar 

  4. Baus-Loncar M, Giraud AS. Trefoil factors. Cell Mol Life Sci CMLS. 2005;62(24):2921–31.

    Article  CAS  Google Scholar 

  5. Chen X, Yamamoto M, Fujii K, et al. Differential reactivation of fetal/neonatal genes in mouse liver tumors induced in cirrhotic and noncirrhotic conditions. Cancer Sci. 2015;23:12700.

    Google Scholar 

  6. Franke TF. PI3K/Akt: getting it right matters. Oncogene. 2008;27:6473–88.

    Article  CAS  Google Scholar 

  7. Sun Q, Zhang Y, Liu F, Zhao X, Yang X. Identification of candidate biomarkers for hepatocellular carcinoma through pre-cancerous expression analysis in an HBx transgenic mouse. Cancer Biol Ther. 2007;6:1532–8.

    Article  CAS  Google Scholar 

  8. Sierzega M, Kaczor M, Kolodziejczyk P, et al. Evaluation of serum microRNA biomarkers for gastric cancer based on blood and tissue pools profiling: the importance of miR-21 and miR-331. Br J Cancer. 2017;117(2):266–73.

    Article  CAS  Google Scholar 

  9. Wulfken LM, Moritz R, Ohlmann C, et al. MicroRNAs in renal cell carcinoma: diagnostic implications of serum miR-1233 levels. PLoS One. 2011;6(9):e25787.

    Article  CAS  Google Scholar 

  10. Pritchard CC, Kroh E, Wood B, et al. Blood cell origin of circulating microRNAs: a cautionary note for cancer biomarker studies. Cancer Prev Res. 2011;5:492–7.

    Article  Google Scholar 

  11. Fei Y, Hou J, Xuan W, et al. The relationship of plasma miR-503 and coronary collateral circulation in patients with coronary artery disease. Life Sci. 2018;207:145–51.

    Article  CAS  Google Scholar 

  12. Kannan N, Kang J, Kong X, et al. Trefoil factor 3 is oncogenic and mediates anti-estrogen resistance in human mammary carcinoma. Neoplasia. 2010;12:1041–53.

    Article  CAS  Google Scholar 

  13. Garraway IP, Seligson D, Said J, Horvath S, Reiter RE. Trefoil factor 3 is overexpressed in human prostate cancer. Prostate. 2004;61:209–14.

    Article  CAS  Google Scholar 

  14. Khoury T, Chadha K, Javle M, et al. Expression of intestinal trefoil factor (TFF-3) in hepatocellular carcinoma. Int J Gastrointest Cancer. 2005;35:171–7.

    Article  CAS  Google Scholar 

  15. Shukla A, Gupta P, Singh R, et al. Glycolytic inhibitor 2-deoxy-d-glucose activates migration and invasion in glioblastoma cells through modulation of the miR-7-5p/TFF3 signaling pathway. Biochem Biophys Res Commun. 2018;499(4):829–35.

    Article  CAS  Google Scholar 

  16. Shang YL, Qian YB. Clinical significance of expression of trefoil factor 3 in hepatocellular carcinoma. World Chinese J Digestol. 2014;22(8):1141-1145.

    Article  CAS  Google Scholar 

  17. Lau WH, Pandey V, Kong X, et al. Trefoil factor-3 (TFF3) stimulates de novo angiogenesis in mammary carcinoma both directly and indirectly via IL-8/CXCR2. PLoS One. 2015;10(11):e0141947.

    Article  Google Scholar 

  18. Guleng B, Han J, Yang JQ, et al. TFF3 mediated induction of VEGF via hypoxia in human gastric cancer SGC-7901 cells. Mol Biol Rep. 2012;39(4):4127–34.

    Article  CAS  Google Scholar 

  19. Chan MW, Chan VY, Leung WK, et al. Anti-sense trefoil factor family-3 (intestinal trefoil factor) inhibits cell growth and induces chemosensitivity to adriamycin in human gastric cancer cells. Life Sci. 2005;76:2581–92.

    Article  CAS  Google Scholar 

  20. You ML, Chen YJ, Chong QY, et al. Trefoil factor 3 mediation of oncogenicity and chemoresistance in hepatocellular carcinoma is AKT-BCL-2 dependent. Oncotarget. 2017;8(24):39323–44.

    Article  Google Scholar 

  21. Zhao S, Han J, Zheng L, et al. Microrna-203 regulates growth and metastasis of breast cancer. Cell Physiol Biochem. 2015;37(1):35–42.

    Article  Google Scholar 

  22. Deng B, Wang B, Fang J, et al. MiRNA-203 suppresses cell proliferation, migration and invasion in colorectal cancer via targeting of EIF5A2. Sci Rep. 2016;6:28301.

    Article  CAS  Google Scholar 

  23. Lohcharoenkal W, Harada M, Lovén J, et al. MicroRNA-203 inversely correlates with differentiation grade, targets c-MYC, and functions as a tumor suppressor in cSCC. J Investig Dermatol. 2016;136(12):2485–94.

    Article  CAS  Google Scholar 

  24. Zhu X, Er K, Mao C, et al. miR-203 suppresses tumor growth and angiogenesis by targeting VEGFA in cervical cancer. Cell Physiol Biochem. 2013;32(1):64–73.

    Article  CAS  Google Scholar 

  25. Xu J, Zhu X, Wu L, et al. MicroRNA-122 suppresses cell proliferation and induces cell apoptosis in hepatocellular carcinoma by directly targeting Wnt/β-catenin pathway. Liver Int. 2012;32:752–60.

    Article  CAS  Google Scholar 

  26. Zhu J, Zheng Z, Wang J, et al. Different miRNA expression profiles between human breast cancer tumors and serum. Front Genet. 2014;5:149.

    Article  Google Scholar 

  27. Zhu YQ, Tan XD. TFF3 modulates NF-κB and a novel negative regulatory molecule of NF-κB in intestinal epithelial cells via a mechanism distinct from TNF-α. Am J Phys Cell Phys. 2005;289(5):C1085–93.

    Article  CAS  Google Scholar 

  28. Loos M, De Creus A, Thim L, Remaut E, Rottiers P. Murine trefoil factor 3 does not directly modulate LPS-mediated dendritic cell function. Scand J Immunol. 2007;66(1):35–42.

    Article  CAS  Google Scholar 

  29. Wei J, Huang X, Zhang Z, et al. MyD88 as a target of microRNA-203 in regulation of lipopolysaccharide or Bacille Calmette-Guerin induced inflammatory response of macrophage RAW264. 7 cells. Mol Immunol. 2013;55(3):303–9.

    Article  CAS  Google Scholar 

  30. Zhou M, Chen J, Zhou L, et al. Pancreatic cancer derived exosomes regulate the expression of TLR4 in dendritic cells via miR-203. Cell Immunol. 2014;292(1–2):65–9.

    Article  CAS  Google Scholar 

  31. Xu T, Chu Q, Cui J, Zhao X. The inducible microRNA-203 in fish represses the inflammatory responses to gram-negative bacteria by targeting IL-1 receptor-associated kinase 4. J Biol Chem. 2018;293(4):1386–96.

    Article  CAS  Google Scholar 

  32. Guo J, Sun M, Teng X, et al. MicroRNA-7-5p regulates the expression of TFF3 in inflammatory bowel disease. Mol Med Rep. 2017;16(2):1200–6.

    Article  CAS  Google Scholar 

  33. Tarek M, Louka ML, Khairy E, et al. Role of microRNA-7 and selenoprotein P in hepatocellular carcinoma. Tumor Biol. 2017;39(5):1010428317698372.

    Article  Google Scholar 

  34. Wu W, Liu S, Liang Y, et al. MiR-7 inhibits progression of hepatocarcinoma by targeting KLF-4 and promises a novel diagnostic biomarker. Cancer Cell Int. 2017;17(1):31.

    Article  Google Scholar 

Download references

Acknowledgements

We thank Zhoufu Li for providing some reagents (TRANS GEN).

Funding

No funding was obtained for this study.

Availability of data and materials

Data is available upon request.

Author information

Authors and Affiliations

  1. Department of Endoscopy, Jilin Cancer Hospital, Changchun, 130012, China

    Chenghua Zhang

  2. Department of Geriatrics 1, Affiliated Hospital of Changchuan University of Traditional Chinese Medicine, Changchun, 130012, China

    Ran Xia & Bo Zhang

  3. Department of Hepatopancreaticobiliary Surgery, Second Affiliated Hospital of Dalian Medical University, 467 Zhongshan Road, Dalian, 116044, China

    Haibo Wang

Authors
  1. Chenghua Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ran Xia
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bo Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Haibo Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

HW and CZ contributed to the study design, the blood sample collection and drafting the manuscript. CZ, RX and BZ were involved in GEO database analysis, micro RNA prediction, statistical analysis and interpretation of data. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Haibo Wang.

Ethics declarations

Ethics approval and consent to participate

Written consent was obtained from all subjects and individual patient data was not available. This study protocol was approved by the ethics committee of the Second Affiliated Hospital of Dalian Medical University (20180504007).

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, C., Xia, R., Zhang, B. et al. The predictive powers of plasma trefoil factor 3 or its related micro RNAs for patients with hepatocellular carcinoma. BMC Cancer 18, 1110 (2018). https://doi.org/10.1186/s12885-018-5017-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s12885-018-5017-y

Keywords

BMC Cancer

ISSN: 1471-2407

Contact us