CKS1B overexpression implicates clinical aggressiveness of hepatocellular carcinomas but not p27Kip1 Protein turnover: An independent prognosticator with potential p27Kip1-Independent oncogenic attributes?

Ching Wen Huang, Ching Yih Lin, Hsuan Ying Huang, Hui Wen Liu, Yi Ju Chen, Deng Fuh Shih, Hong Yaw Chen, Chung Chou Juan, Chen Guo Ker, Chi Ying F. Huang, Chien Feng Li, Yow Ling Shiue*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Background: Through data mining the Stanford Microarray Database, the CKS1B transcript was found to be frequently upregulated in hepatocellular carcinomas (HCCs) with low alpha-fetal protein (AFP) expression. Together with SKP2, CKS1B is known to implicate p27Kip1 protein turnover promoting cell-cycle progression. Methods: CKS1B, p27Kip1, and SKP2 were immunostained in 75 HCCs and correlated with clinicopathological features, local recurrence-free survival (LRFS), and overall survival (OS). Silencing of CKS1B and SKP2 with interference short-hairpin RNA (shRNA) was performed in SK-Hep1 and Hep-3B cell lines. Results: Immunohistochemically, increased CKS1B and SKP2, and attenuated p27Kip1 were all associated with tumor multiplicity (P < 0.05) and increasing American Joint Committee on Cancer (AJCC) stage (P < 0.05). Overexpression of CKS1B significantly correlated with advanced Okuda stages (P = 0.048) and SKP2 overexpression (P = 0.047). Neither CKS1B nor SKP2 was inversely related to p27Kip1, which was reinforced by no alteration in p27Kip1 abundance in HCC-derived cells with CKS1B or SKP2 silencing. Both CKS1B overexpression (P = 0.0011 and P = 0.0017) and p27 Kip1 attenuation (P = 0.0079 and P = 0.0085) were predictive of OS and LRFS, respectively, while SKP2 overexpression was associated with worse OS alone (P = 0.0043). Combined assessment of CKS1B and p27Kip1 was able to robustly distinguish three prognostically different groups (P < 0.0001). In multivariate comparison, CKS1B overexpression represented the strongest independent adverse prognosticator [OS, P = 0.0235, hazard ratio (HR): 4.193; LRFS, P = 0.0204, HR: 4.262], followed by p27Kip1 attenuation (OS, P = 0.0320, HR: 2.553; LRFS, P = 0.0262, HR: 2.533). Conclusions: CKS1B protein overexpression in HCCs is implicated in clinical aggressiveness but not in p27Kip1 turnover, implying presence of p27Kip1-independent oncogenic attributes. The combined assessment of CKS1B and p27Kip1 immunoexpressions effectively risk-stratifies HCCs with different prognoses, which may aid in the management of this deadly malignancy.

Original languageEnglish
Pages (from-to)907-922
Number of pages16
JournalAnnals of Surgical Oncology
Volume17
Issue number3
DOIs
StatePublished - Mar 2010

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