title: Nrf2 is a potential prognostic marker and promotes proliferation and invasion in human hepatocellular carcinoma.
abstract: BACKGROUND
  Nuclear factor E2-related factor 2 (Nrf2 or NFE2L2) is abundantly expressed in cancer cells and relates to proliferation, invasion, and chemoresistance. Our early observations also found that expression of Nrf2 was up-regulated in kinds of cancer including human hepatocellular carcinoma (HCC) cells. But there are limited reports about the expression, significance, function of Nrf2 in HCC.
  
  
  METHODS
  First, Nrf2 expression was analyzed in HCC cell lines and tumor samples. Then, the relationship of Nrf2 with clinicopathological factors and survival were analyzed. Further, the effect of Nrf2 on cell proliferation, apoptosis, and metastasis was examined in vitro by modulating expression of Nrf2 through specific shRNA or expression plasmid. Last, the potential mechanisms were also investigated.
  
  
  RESULTS
  Nrf2 was up-regulated in HCC, and expression of Nrf2 was correlated with tumor differentiation, metastasis, and tumor size. Univariate and multivariate analyses indicated that high Nrf2 expression might be a poor prognostic factor. Further studies demonstrated that inhibition of Nrf2 expression inhibited proliferation by inducing apoptosis and repressed invasion, and up-regulation of Nrf2 expression resulted in opposite phenotypes. Moreover, there are positive correlation between Nrf2 expression and that of Bcl-xL and MMP-9.
  
  
  CONCLUSIONS
  Nrf2 is a potential prognostic marker and promotes proliferation and invasion in human hepatocellular carcinoma partly through regulating expression of Bcl-xL and MMP-9.
authors.affiliation: Department of Gastroenterology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China. zmx3115@163.com.
authors.forename: Mingxin
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Gastroenterology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China. zzwwcc2001@163.com.
authors.forename: Chao
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital, Medical School, Xi'an Jiaotong University, Xi'an, 710061, Shaanxi Province, China. zlm711@163.com.
authors.forename: Lingmin
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Gastroenterology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China. 969211665@qq.com.
authors.forename: Qi
authors.initials: Q
authors.lastname: Yang
authors.affiliation: Department of Radiotherapy, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China. annyzhou0913@163.com.
authors.forename: Suna
authors.initials: S
authors.lastname: Zhou
authors.affiliation: Department of Gastroenterology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China. wenqsss@yahoo.com.cn.
authors.forename: Qinsheng
authors.initials: Q
authors.lastname: Wen
authors.affiliation: Department of Gastroenterology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China. jingjie@fmmu.edu.cn.
authors.forename: Jingjie
authors.initials: J
authors.lastname: Wang
mesh_terms: D014408:Biomarkers, Tumor / Q000235:genetics* / Q000378:metabolism*; D006528:Carcinoma, Hepatocellular / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D045744:Cell Line, Tumor; D049109:Cell Proliferation; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D056945:Hep G2 Cells; D006801:Humans; D008113:Liver Neoplasms / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000378:metabolism; D051267:NF-E2-Related Factor 2 / Q000235:genetics* / Q000378:metabolism*; D009361:Neoplasm Invasiveness; D011379:Prognosis; D016019:Survival Analysis; D051020:bcl-X Protein / Q000378:metabolism
chemical_list: C494811:BCL2L1 protein, human; D014408:Biomarkers, Tumor; D051267:NF-E2-Related Factor 2; C495635:NFE2L2 protein, human; D051020:bcl-X Protein; C579270:MMP9 protein, human; D020780:Matrix Metalloproteinase 9