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Abstract
Hepatocellular carcinoma (HCC) is the most prevalent primary cancer and a highly aggressive liver malignancy. Liver cancer cells reprogram their metabolism to meet their needs for rapid proliferation and tumor growth. In the present study, we investigated the alterations in the expression of the genes involved in glucose metabolic pathways as well as their association with the clinical stage and survival of HCC patients. We found that the expressions of around 30% of genes involved in the glucose metabolic pathway are consistently dysregulated with a predominant down-regulation in HCC tumors. Moreover, the differentially expressed genes are associated with an advanced clinical stage and a poor prognosis. More importantly, unsupervised clustering analysis with the differentially expressed genes that were also associated with overall survival (OS) revealed a subgroup of patients with a worse prognosis including reduced OS, disease specific survival, and recurrence-free survival. This aggressive subtype had significantly increased expression of stemness-related genes and down-regulated metabolic genes, as well as increased immune infiltrates that contribute to a poor prognosis. Collectively, this integrative study indicates that expressions of the glucose metabolic genes could be used as potential prognostic markers and/or therapeutic targets, which might be helpful in developing precise treatment for patients with HCC.
Highlights
Hepatocellular carcinoma (HCC) is the most prevalent primary cancer worldwide and the third leading cause of cancer-related mortality [1,2]
To understand the alteration of glucose metabolic pathway in clinical HCC samples, genes involved in the pathways of glycolysis, pentose phosphate, Tricarboxylic Acid Cycle (TCA) cycle, gluconeogenesis, and glycogen metabolism were curated from the KEGG
179 genes involved in glucose metabolism were assessed in primary HCC patient cohorts (Table S4)
Summary
Hepatocellular carcinoma (HCC) is the most prevalent primary cancer worldwide and the third leading cause of cancer-related mortality [1,2]. It is highly malignant, recurrent, resistant to drugs, and typically diagnosed at a late stage [3,4]. Reprogramming of glucose metabolism has been recognized as a key hallmark of cancer cells. This alteration in glucose metabolism accompanied by enhanced uptake of glucose and conversion of pyruvate to lactate, known as the Warburg effect, is to satisfy the increasing requirement of macromolecular synthesis to maintain unregulated rapid cellular proliferation
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