Case Control Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 28, 2019; 25(48): 6902-6915
Published online Dec 28, 2019. doi: 10.3748/wjg.v25.i48.6902
Diagnostic and prognostic value of lncRNA cancer susceptibility candidate 9 in hepatocellular carcinoma
Yong-Lian Zeng, Zhen-Ya Guo, Hui-Zhao Su, Fu-Di Zhong, Ke-Qing Jiang, Guan-Dou Yuan
Yong-Lian Zeng, Zhen-Ya Guo, Hui-Zhao Su, Fu-Di Zhong, Ke-Qing Jiang, Guan-Dou Yuan, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
Author contributions: Zeng YL and Yuan GD designed the research; Guo ZY, Zhong FD, Jiang KQ and Su HZ performed the research; Zeng YL, Guo ZY and Yuan GD analyzed the data; Zeng YL and Yuan GD wrote the paper.
Institutional review board statement: This study was reviewed and approved by the First Affiliated Hospital of Guangxi Medical University Ethics Committee.
Informed consent statement: All patients in our study provided informed consent.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Guan-Dou Yuan, M.D., Ph.D., Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, No. 6, Shuangyong Road, Nanning 530021, Guangxi, China. yuan25958282@163.com
Received: September 29, 2019
Peer-review started: September 29, 2019
First decision: November 10, 2019
Revised: November 27, 2019
Accepted: December 13, 2019
Article in press: December 13, 2019
Published online: December 28, 2019
ARTICLE HIGHLIGHTS
Research background

Liver cancer, the sixth most common cancer worldwide, is the second leading cause of cancer mortality. A lncRNA is a non-coding RNA with a length exceeding 200 nucleotides. Previous studies have found that lncRNAs are involved in the development and progression of hepatocellular carcinoma (HCC), but whether they can be used as potential diagnostic and prognostic indicators is unclear.

Research motivation

LncRNA is a newly discovered non-coding RNA. Some studies have revealed that lncRNAs are differentially expressed in HCC and are expected to be measures of potential outcome. In this study, we found that lncRNA CASC9 was highly expressed in HCC patients based on the Cancer Genome Atlas (TCGA) database analysis and patients with high expression of CASC9 had a poor prognosis, which indicated that lncRNA CASC9 may be a potential diagnostic and prognostic indicator of HCC.

Research objectives

This study aimed to identify the expression of lncRNA CASC9 in HCC, its diagnostic and prognostic value and to construct ceRNA network maps to further explore its underlying mechanism.

Research methods

Data on the expression of lncRNA CASC9 in TCGA were extracted, clinical samples were collected to further determine the expression of lncRNA CASC9 in HCC, and the correlation between lncRNA CASC9 and pathological data and survival of HCC patients were analyzed. Potential microRNA and target genes of lncRNA CASC9 were analyzed using on-line prediction websites, and ceRNA maps were drawn. In addition, Kyoto Encyclopedia of Genes and Genomes and GO enrichment analysis were employed to analyze the potential mechanisms of lncRNA CASC9 in biological processes.

Research results

Analysis revealed that lncRNA CASC9 was highly expressed in the tissues and serum of HCC patients and high expression of CASC9 was related to tumor size, TNM staging, lymph node metastasis, differentiation, and AFP. Further analysis showed that lncRNA CASC9 could be used as a diagnostic indicator of the above indices. Prognostic analysis revealed that the survival rate of patients with high expression of lncRNA CASC9 decreased, and Cox regression analysis showed that lncRNA CASC9 could be used as an independent prognostic indicator in HCC patients. The bioinformatics analysis revealed that lncRNA CASC9 potentially targeted 17 miRs. A total of 89 mRNAs were found in mRNA prediction. GO enrichment and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis revealed that lncRNA CASC9 participated in 18 GO functions and 8 signal transduction pathways.

Research conclusion

LncRNA CASC9 is highly expressed in HCC patients, and may be a potential diagnostic and prognostic indicator of HCC.

Research perspectives

It is necessary to further explore the value of lncRNA CASC9 in HCC, and prospective experiments and multi-center clinical studies are required to obtain more robust conclusions. In addition, we hope to further verify the relevant mechanisms of lncRNA CASC9 in HCC by carrying out relevant basic experiments, in order to address the deficiencies in this study.