MicroRNA Expression, Survival, and Response to Interferon in Liver Cancer

Junfang Ji(National Institutes of Health), Jiong Shi(National Institutes of Health), Anuradha Budhu(National Institutes of Health), Zhipeng Yu(National Institutes of Health), Marshonna Forgues(National Institutes of Health), Stéphanie Roessler(National Institutes of Health), Stefan Ambs(National Institutes of Health), Yidong Chen(National Institutes of Health), Paul S. Meltzer(National Institutes of Health), Carlo M. Croce(The Ohio State University), Lun‐Xiu Qin(Zhongshan Hospital), Kwan Man(University of Hong Kong), Chung Mau Lo(University of Hong Kong), Joyce Lee(University of Hong Kong), Irene Oi‐Lin Ng(University of Hong Kong), Jia Fan(Zhongshan Hospital), Zhao-You Tang(Zhongshan Hospital), Hui‐Chuan Sun(Zhongshan Hospital), Xin Wei Wang(National Institutes of Health)
New England Journal of Medicine
October 7, 2009
Cited by 807Open Access
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Abstract

BACKGROUND: Hepatocellular carcinoma is a common and aggressive cancer that occurs mainly in men. We examined microRNA expression patterns, survival, and response to interferon alfa in both men and women with the disease. METHODS: We analyzed three independent cohorts that included a total of 455 patients with hepatocellular carcinoma who had undergone radical tumor resection between 1999 and 2003. MicroRNA-expression profiling was performed in a cohort of 241 patients with hepatocellular carcinoma to identify tumor-related microRNAs and determine their association with survival in men and women. In addition, to validate our findings, we used quantitative reverse-transcriptase-polymerase-chain-reaction assays to measure microRNAs and assess their association with survival and response to therapy with interferon alfa in 214 patients from two independent, prospective, randomized, controlled trials of adjuvant interferon therapy. RESULTS: In patients with hepatocellular carcinoma, the expression of miR-26a and miR-26b in nontumor liver tissue was higher in women than in men. Tumors had reduced levels of miR-26 expression, as compared with paired noncancerous tissues, which indicated that the level of miR-26 expression was also associated with hepatocellular carcinoma. Moreover, tumors with reduced miR-26 expression had a distinct transcriptomic pattern, and analyses of gene networks revealed that activation of signaling pathways between nuclear factor kappaB and interleukin-6 might play a role in tumor development. Patients whose tumors had low miR-26 expression had shorter overall survival but a better response to interferon therapy than did patients whose tumors had high expression of the microRNA. CONCLUSIONS: The expression patterns of microRNAs in liver tissue differ between men and women with hepatocellular carcinoma. The miR-26 expression status of such patients is associated with survival and response to adjuvant therapy with interferon alfa.


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