title: Chemokine ligand 20 enhances progression of hepatocellular carcinoma via epithelial-mesenchymal transition.
abstract: OBJECTIVE
  To identify the mechanisms of chemokine ligand 20 (CCL20)-induced hepatocellular carcinoma (HCC) metastasis and evaluate it as a prognostic marker.
  
  
  METHODS
  Expression of CCL20 was evaluated by immunohistochemistry in HCC tissues from 62 patients who underwent curative resection. The relationship between CCL20 expression and clinicopathologic features was analyzed. Univariate and multivariate analyses were performed to evaluate its predictive value for recurrence and survival of HCC patients. The expression levels of epithelial-mesenchymal transition (EMT)-and signaling pathway-related proteins were evaluated by Western blotting and immunocytochemistry. The effects of CCL20 on HCC cell proliferation and migration were analyzed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenoltetrazolium bromide (MTT) and Transwell assays.
  
  
  RESULTS
  CCL20 immunoreactivity was detected in all 62 patient specimens. CCL20 expression was associated with preoperative alpha-fetoprotein level (P = 0.043), tumor size (P = 0.000), tumor number (P = 0.008), vascular invasion (P = 0.014), and tumor differentiation (P = 0.007). Patients with high CCL20 expression had poorer recurrence-free and overall survivals compared to those with low CCL20 expression (both P < 0.001). CCL20 induced EMT-like changes in HCC cells and increased their proliferation and migration ability (P < 0.05). Western blotting and immunofluorescence staining showed that CCL20 induced an EMT-like phenotype in HCC cells, and increased expression of phosphorylated AKT, β-catenin and vimentin, and decreased E-cadherin expression (P < 0.05). The correlation analysis revealed that high CCL20 expression in HCC tissue specimens was negatively correlated with E-cadherin expression (13.33%, 4/30), and positively correlated with vimentin (90.0%, 27/30), β-catenin (96.67%, 29/30) and p-AKT (76.67%, 23/30) expression.
  
  
  CONCLUSIONS
  CCL20 expression is associated with HCC recurrence and patient survival and promotes HCC cell proliferation and migration by inducing EMT-like changes via PI3K/AKT and Wnt/β-catenin pathways.
authors.affiliation: Ke-Zhu Hou, Zhi-Qiang Fu, Hua Gong, Department of First General Surgery, Shidong Hospital, Shanghai 200438, China.
authors.forename: Ke-Zhu
authors.initials: KZ
authors.lastname: Hou
authors.affiliation: Ke-Zhu Hou, Zhi-Qiang Fu, Hua Gong, Department of First General Surgery, Shidong Hospital, Shanghai 200438, China.
authors.forename: Zhi-Qiang
authors.initials: ZQ
authors.lastname: Fu
authors.affiliation: Ke-Zhu Hou, Zhi-Qiang Fu, Hua Gong, Department of First General Surgery, Shidong Hospital, Shanghai 200438, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Gong
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000378:metabolism* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D045744:Cell Line, Tumor; D002465:Cell Movement / Q000187:drug effects; D049109:Cell Proliferation / Q000187:drug effects; D054418:Chemokine CCL20 / Q000378:metabolism* / Q000494:pharmacology; D016009:Chi-Square Distribution; D018450:Disease Progression; D058750:Epithelial-Mesenchymal Transition / Q000187:drug effects; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D010641:Phenotype; D011237:Predictive Value of Tests; D012307:Risk Factors; D015398:Signal Transduction / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: C108355:CCL20 protein, human; D054418:Chemokine CCL20
keywords: Chemokine ligand 20; Epithelial-mesenchymal transition; Hepatocellular carcinoma; Phosphoinositide kinase-3/AKT; Prognosis; Wnt/β-catenin