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<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">OR</journal-id>
<journal-title-group>
<journal-title>Oncology Reports</journal-title>
</journal-title-group>
<issn pub-type="ppub">1021-335X</issn>
<issn pub-type="epub">1791-2431</issn>
<publisher>
<publisher-name>D.A. Spandidos</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3892/or.2017.5946</article-id>
<article-id pub-id-type="publisher-id">or-38-05-2607</article-id>
<article-categories>
<subj-group>
<subject>Articles</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Screening and identification of key biomarkers in hepatocellular carcinoma: Evidence from bioinformatic analysis</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author"><name><surname>Li</surname><given-names>Lin</given-names></name>
<xref rid="af1-or-38-05-2607" ref-type="aff">1</xref>
<xref rid="fn1-or-38-05-2607" ref-type="author-notes">&#x002A;</xref></contrib>
<contrib contrib-type="author"><name><surname>Lei</surname><given-names>Qingsong</given-names></name>
<xref rid="af1-or-38-05-2607" ref-type="aff">1</xref>
<xref rid="fn1-or-38-05-2607" ref-type="author-notes">&#x002A;</xref></contrib>
<contrib contrib-type="author"><name><surname>Zhang</surname><given-names>Shujun</given-names></name>
<xref rid="af1-or-38-05-2607" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author"><name><surname>Kong</surname><given-names>Lingna</given-names></name>
<xref rid="af2-or-38-05-2607" ref-type="aff">2</xref></contrib>
<contrib contrib-type="author"><name><surname>Qin</surname><given-names>Bo</given-names></name>
<xref rid="af1-or-38-05-2607" ref-type="aff">1</xref>
<xref rid="c1-or-38-05-2607" ref-type="corresp"/></contrib>
</contrib-group>
<aff id="af1-or-38-05-2607"><label>1</label>Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing 400016, P.R. China</aff>
<aff id="af2-or-38-05-2607"><label>2</label>The Nursing College of Chongqing Medical University, Yuzhong, Chongqing 400016, P.R. China</aff>
<author-notes>
<corresp id="c1-or-38-05-2607"><italic>Correspondence to</italic>: Dr Bo Qin, Department of Infectious Diseases, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong, Chongqing 400016, P.R. China, E-mail: <email>cqqinbo@126.com</email></corresp>
<fn id="fn1-or-38-05-2607"><label>&#x002A;</label><p>Contributed equally</p></fn>
</author-notes>
<pub-date pub-type="ppub"><month>11</month><year>2017</year></pub-date>
<pub-date pub-type="epub"><day>07</day><month>09</month><year>2017</year></pub-date>
<volume>38</volume>
<issue>5</issue>
<fpage>2607</fpage>
<lpage>2618</lpage>
<history>
<date date-type="received"><day>14</day><month>02</month><year>2017</year></date>
<date date-type="accepted"><day>18</day><month>05</month><year>2017</year></date>
</history>
<permissions>
<copyright-statement>Copyright: &#x00A9; Li et al.</copyright-statement>
<copyright-year>2017</copyright-year>
<license license-type="open-access">
<license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by-nc-nd/4.0/">Creative Commons Attribution-NonCommercial-NoDerivs License</ext-link>, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.</license-p></license>
</permissions>
<abstract>
<p>Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. Intense efforts have been made to elucidate the pathogeny, but the molecular mechanisms of HCC are still not well understood. To identify the candidate genes in the carcinogenesis and progression of HCC, microarray datasets GSE19665, GSE33006 and GSE41804 were downloaded from Gene Expression Omnibus (GEO) database. The differentially expressed genes (DEGs) were identified, and function enrichment analyses were performed. The protein-protein interaction network (PPI) was constructed and the module analysis was performed using STRING and Cytoscape. A total of 273 DEGs were identified, consisting of 189 downregulated genes and 84 upregulated genes. The enriched functions and pathways of the DEGs include protein activation cascade, complement activation, carbohydrate binding, complement and coagulation cascades, mitotic cell cycle and oocyte meiosis. Sixteen hub genes were identified and biological process analysis revealed that these genes were mainly enriched in cell division, cell cycle and nuclear division. Survival analysis showed that BUB1, CDC20, KIF20A, RACGAP1 and CEP55 may be involved in the carcinogenesis, invasion or recurrence of HCC. In conclusion, DEGs and hub genes identified in the present study help us understand the molecular mechanisms underlying the carcinogenesis and progression of HCC, and provide candidate targets for diagnosis and treatment of HCC.</p>
</abstract>
<kwd-group>
<kwd>hepatocellular carcinoma</kwd>
<kwd>differentially expressed genes</kwd>
<kwd>microarray</kwd>
<kwd>protein-protein interaction</kwd>
<kwd>Kaplan-Meier curve</kwd>
</kwd-group>
</article-meta>
</front>
<body>
<sec sec-type="intro">
<title>Introduction</title>
<p>Hepatocellular carcinoma (HCC), mainly induced by chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection, hepatic cirrhosis or alcoholic liver diseases, is one of the most common malignancies with a rise in new cases worldwide each year. HCC has a higher rate in developing countries partly East Asia as compared to developed countries (<xref rid="b1-or-38-05-2607" ref-type="bibr">1</xref>). Accumulating evidence has demonstrated that abnormal expression and mutation of genes are involved in the carcinogenesis and progression of HCC, including cyclin D1 (CCND1), epidermal growth factor receptor (EGFR), c-myc and Ras, as well as mutations of tumor-suppressor genes. It was found that the G870A polymorphism in exon 4 of the CCND1 gene may increase the risk of HBV-related HCC in the Chinese population (<xref rid="b2-or-38-05-2607" ref-type="bibr">2</xref>). The chronic stimulation of EGFR plays a key role in the neoplastic conversion and development of HCC (<xref rid="b3-or-38-05-2607" ref-type="bibr">3</xref>). A progressive increase in c-myc mRNA and protein was noted during the different steps of malignancy of HCC (<xref rid="b4-or-38-05-2607" ref-type="bibr">4</xref>). Aberrant activation of different levels of the Ras pathway could play important roles in HCC. In addition, overexpression of H-ras, DNA copy number gains of B-Raf and hypermethylation of Ras binding proteins were found to be involved in the poor prognosis of HCC patients (<xref rid="b5-or-38-05-2607" ref-type="bibr">5</xref>). However, due to the lack of effective diagnostic methods at the early stage of the disease, the mortality rate of HCC remains high. Therefore, it is crucial to understand the precise molecular mechanisms involved in the carcinogenesis, proliferation and recurrence of HCC and thus develop effective diagnostic and therapeutic strategies.</p>
<p>During the last decades, microarray technology and bioinformatic analysis have been widely used to screen genetic alterations at the genome level, which have helped us identify the differentially expressed genes (DEGs) and functional pathways involved in the carcinogenesis and progression of HCC. However, false-positive rates in independent microarray analysis make it difficult to obtain reliable results. Thus, in the present study, 3 mRNA microarray datasets from Gene Expression Omnibus (GEO) were downloaded and analyzed to obtain DEGs between liver cancer tissues and non-cancerous tissues. Subsequently, Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis and protein-protein interaction (PPI) network analyses were performed to help us understand the molecular mechanisms underlying carcinogenesis and progression. In conclusion, a total of 273 DEGs and 16 hub genes were identified, which may be candidate biomarkers for HCC.</p>
</sec>
<sec sec-type="materials|methods">
<title>Materials and methods</title>
<sec>
<title/>
<sec>
<title>Microarray data</title>
<p>GEO (<uri xlink:href="http://www.ncbi.nlm.nih.gov/geo">http://www.ncbi.nlm.nih.gov/geo</uri>) (<xref rid="b6-or-38-05-2607" ref-type="bibr">6</xref>) is a public functional genomics data repository of high throughout gene expression data, chips and microarrays. Three gene expression datasets [GSE36668 (<xref rid="b7-or-38-05-2607" ref-type="bibr">7</xref>), GSE18520 (<xref rid="b8-or-38-05-2607" ref-type="bibr">8</xref>) and GSE14407 (<xref rid="b9-or-38-05-2607" ref-type="bibr">9</xref>)] were downloaded from GEO (Affymetrix GPL570 platform, Affymetrix Human Genome U133 Plus 2.0 Array). The probes were converted into the corresponding gene symbol according to the annotation information in the platform. The GSE19665 dataset contained 10 HCC tissue samples and 10 non-cancerous samples. GSE33006 contained 3 HCC samples and 3 non-cancerous samples. GSE41804 contained 20 HCC samples and 20 non-cancerous samples.</p>
</sec>
<sec>
<title>Identification of DEGs</title>
<p>The DEGs between HCC and non-cancerous samples were screened using GEO2R (<uri xlink:href="http://www.ncbi.nlm.nih.gov/geo/geo2r">http://www.ncbi.nlm.nih.gov/geo/geo2r</uri>). GEO2R is an interactive web tool that allows users to compare two or more datasets in a GEO series in order to identify DEGs across experimental conditions. The adjusted P-values (adj. P) and Benjamini and Hochberg false discovery rate were applied to provide a balance between discovery of statistically significant genes and limitations of false-positives. Probe sets without corresponding gene symbols or genes with more than one probe set were removed or averaged, respectively. logFC (fold change) &#x003E;1 and adj. P-value &#x003C;0.01 were considered statistically significant.</p>
</sec>
<sec>
<title>KEGG and GO enrichment analyses of DEGs</title>
<p>The Database for Annotation, Visualization and Integrated Discovery (DAVID; <uri xlink:href="http://david.ncifcrf.gov">http://david.ncifcrf.gov</uri>) (version 6.7) (<xref rid="b10-or-38-05-2607" ref-type="bibr">10</xref>) is an online biological information database that integrates biological data and analysis tools, and provides a comprehensive set of functional annotation information of genes and proteins for users to extract biological information. KEGG is a database resource for understanding high-level functions and biological systems from large-scale molecular datasets generated by high-throughput experimental technologies (<xref rid="b11-or-38-05-2607" ref-type="bibr">11</xref>). GO is a major bioinformatics tool to annotate genes and analyze biological process of these genes (<xref rid="b12-or-38-05-2607" ref-type="bibr">12</xref>). To analyze the function of DEGs, biological analyses were performed using DAVID online database. P&#x003C;0.05 was considered statistically significant.</p>
</sec>
<sec>
<title>PPI network construction and module analysis</title>
<p>The PPI network was predicted using Search Tool for the Retrieval of Interacting Genes (STRING; <uri xlink:href="http://string-db.org">http://string-db.org</uri>) (version 10.0) (<xref rid="b13-or-38-05-2607" ref-type="bibr">13</xref>) online database. Analyzing the functional interactions between proteins may provide insights into the mechanisms of generation or development of diseases. In the present study, PPI network of DEGs was constructed using STRING database, and an interaction with a combined score &#x003E;0.4 was considered statistically significant. Cytoscape (version 3.4.0) is an open source bioinformatics software platform for visualizing molecular interaction networks (<xref rid="b14-or-38-05-2607" ref-type="bibr">14</xref>). The plug-in Molecular Complex Detection (MCODE) (version 1.4.2) of Cytoscape is an APP for clustering a given network based on topology to find densely connected regions (<xref rid="b15-or-38-05-2607" ref-type="bibr">15</xref>). The PPI networks were drawn using Cytoscape and the most significant module in the PPI networks was identified using MCODE. The criteria for selection were as follows: MCODE scores &#x003E;5, degree cut-off=2, node score cut-off=0.2, Max depth=100 and k-score=2. Subsequently, the KEGG and GO analyses for genes in this module were performed using DAVID.</p>
</sec>
<sec>
<title>Hub genes selection and analysis</title>
<p>The hub genes were selected with degrees &#x2265;10. A network of the genes and their co-expression genes was analyzed using cBioPortal (<uri xlink:href="http://www.cbioportal.org">http://www.cbioportal.org</uri>) (<xref rid="b16-or-38-05-2607" ref-type="bibr">16</xref>,<xref rid="b17-or-38-05-2607" ref-type="bibr">17</xref>) online platform. The biological process analysis of hub genes was performed and visualized using Biological Networks Gene Oncology tool (BiNGO) (version 3.0.3) plugin of Cytoscape (<xref rid="b18-or-38-05-2607" ref-type="bibr">18</xref>). Hierarchical clustering of hub genes was constructed using UCSC Cancer Genomics Browser (<uri xlink:href="http://genome-cancer.ucsc.edu">http://genome-cancer.ucsc.edu</uri>) (<xref rid="b19-or-38-05-2607" ref-type="bibr">19</xref>). The overall survival and disease-free survival analyses of hub genes were performed using Kaplan-Meier curve in cBioPortal. The expression profiles of TOP2A and CDK1 were analyzed and displayed using online database Serial Analysis of Gene Expression (SAGE; <uri xlink:href="http://www.ncbi.nlm.nih.gov/SAGE">http://www.ncbi.nlm.nih.gov/SAGE</uri>). The relationship between expression patterns and tumor grades, hepatitis virus infection status, satellites and vascular invasion were analyzed using online database Oncomine (<uri xlink:href="http://www.oncomine.com">http://www.oncomine.com</uri>) (<xref rid="b20-or-38-05-2607" ref-type="bibr">20</xref>&#x2013;<xref rid="b22-or-38-05-2607" ref-type="bibr">22</xref>).</p>
</sec>
</sec>
</sec>
<sec sec-type="results">
<title>Results</title>
<sec>
<title/>
<sec>
<title>Identification of DEGs in HCC</title>
<p>After standardization of the microarray results, DEGs (1,558 in GSE19665, 1,330 in GSE33006 and 717 in GSE41804) were identified. The overlap among the 3 datasets contained 273 genes as shown in the Venn diagram (<xref rid="f1-or-38-05-2607" ref-type="fig">Fig. 1A</xref>), consisting of 189 downregulated genes and 84 upregulated genes between liver cancer tissues and non-cancerous tissues.</p>
</sec>
<sec>
<title>KEGG and GO enrichment analyses of DEGs</title>
<p>To analyze the biological classification of DEGs, functional and pathway enrichment analyses were performed using DAVID. GO analysis results showed that changes in biological processes (BP) of DEGs were significantly enriched in protein activation cascade, complement activation, defense response, mitotic cell cycle and cell cycle process (<xref rid="tI-or-38-05-2607" ref-type="table">Table I</xref>). Changes in molecular function (MF) were mainly enriched in carbohydrate binding, oxidoreductase activity, mannose-binding, scavenger receptor activity and monosaccharide binding (<xref rid="tI-or-38-05-2607" ref-type="table">Table I</xref>). Changes in cell component (CC) of DEGs were mainly enriched in the extracellular region, membrane attack complex and chromosome (<xref rid="tI-or-38-05-2607" ref-type="table">Table I</xref>). KEGG pathway analysis revealed that the downregulated DEGs were mainly enriched in complement and coagulation cascades, glycolysis/gluconeogenesis and metabolic pathways, while the upregulated DEGs were mainly enriched in oocyte meiosis, cell cycle and progesterone-mediated oocyte maturation.</p>
</sec>
<sec>
<title>PPI network construction and module analysis</title>
<p>The PPI network of DEGs was constructed (<xref rid="f1-or-38-05-2607" ref-type="fig">Fig. 1B</xref>) and the most significant module was obtained using Cytoscape (<xref rid="f1-or-38-05-2607" ref-type="fig">Fig. 1C</xref>). The functional analyses of genes involved in this module were analyzed using DAVID. Results showed that genes in this module were mainly enriched in cell division, mitotic nuclear division and cell cycle (<xref rid="tII-or-38-05-2607" ref-type="table">Table II</xref>).</p>
</sec>
<sec>
<title>Hub gene selection and analysis</title>
<p>A total of 16 genes were identified as hub genes with degrees &#x2265;10. The names, abbreviations and functions for these hub genes are shown in <xref rid="tIII-or-38-05-2607" ref-type="table">Table III</xref>. A network of the hub genes and their co-expression genes was analyzed using cBioPortal online platform (<xref rid="f2-or-38-05-2607" ref-type="fig">Fig. 2A</xref>). The biological process analysis of the hub genes is shown in <xref rid="f2-or-38-05-2607" ref-type="fig">Fig. 2B</xref>. Hierarchical clustering showed that the hub genes could basically differentiate the liver cancer samples from the non-cancerous samples (<xref rid="f2-or-38-05-2607" ref-type="fig">Fig. 2C</xref>). Subsequently, the overall survival analysis of the hub genes was performed using Kaplan-Meier curve. HCC patients with BUB1, CCNB2, CDC20, CDK1, KIF20A, KIF2C, RACGAP1 and CEP55 alteration showed worse overall survival (<xref rid="f3-or-38-05-2607" ref-type="fig">Fig. 3A</xref>). Nonetheless, HCC patients with BUB1, CDC20, KIF20A, NUSAP1, RACGAP1, PRC1 and CEP55 alteration showed worse disease-free survival (<xref rid="f3-or-38-05-2607" ref-type="fig">Fig. 3B</xref>).</p>
<p>Among these genes, TOP2A and CDK1 showed the highest node degrees with 33, suggesting that they may play important roles in the carcinogenesis or progression of HCC. Using the data from cBioPortal, we noted that HCC patients who had an association of genomic alterations in TOP2A showed reductions in overall and disease-free survival. However, those observations were not statistically significant (P=0.506 for overall survival and P=0.124 for disease-free survival). In addition, the CDK1 alteration was significantly associated with worse overall survival but not disease-free survival (P=0.00111 for overall survival and P=0.280 for disease-free survival) (<xref rid="f3-or-38-05-2607" ref-type="fig">Fig. 3B</xref>). The expression profile of TOP2A and CDK1 in human tissue was displayed using SAGE. We found that TOP2A mRNA in brain, retina, breast, pancreas, liver, kidney, colon and peritoneum displayed higher levels as compared with the matched normal tissues (<xref rid="f4-or-38-05-2607" ref-type="fig">Fig. 4A</xref>). CDK1 mRNA in brain, retina, thyroid, breast, pancreas, liver and prostate displayed higher levels as compared with the matched normal tissues (<xref rid="f4-or-38-05-2607" ref-type="fig">Fig. 4B</xref>). Oncomine analysis of cancer vs. normal tissue showed that TOP2A and CDK1 were significantly overexpressed in HCC in the different datasets (<xref rid="f5-or-38-05-2607" ref-type="fig">Fig. 5A and B</xref>). In the Wurmbach Liver dataset, higher mRNA levels of TOP2A and CDK1 were associated with tumor grade, hepatitis virus infection status, satellites and vascular invasion (<xref rid="f6-or-38-05-2607" ref-type="fig">Fig. 6A-H</xref>).</p>
</sec>
</sec>
</sec>
<sec sec-type="discussion">
<title>Discussion</title>
<p>Hepatocellular carcinoma (HCC) is the fifth most common malignant tumor worldwide and its mortality rate has increased in recent years (<xref rid="b1-or-38-05-2607" ref-type="bibr">1</xref>). The main etiology factors of HCC include chronic infection with hepatitis viruses, gene mutations, cell damage, alcoholic liver diseases and aflatoxin poisoning (<xref rid="b23-or-38-05-2607" ref-type="bibr">23</xref>). The most common cause is chronic infection with hepatitis B virus (HBV) or hepatitis C virus (HCV), accounting for over 80&#x0025; of HCC cases. However, the molecular mechanisms of HCC remain poorly understood. Cell cycle regulators play important roles in HCC. Mutation of cyclin D1 (CCND1), c-myc or Ras, hypermethylation of cyclin D2 (CCND2) promoter and aberrant expression of p53 or p21 have been reported to be involved in HCC (<xref rid="b24-or-38-05-2607" ref-type="bibr">24</xref>,<xref rid="b25-or-38-05-2607" ref-type="bibr">25</xref>). In addition, splicing alterations of NT5E, Sulf1 or SLC39A14 have been reported to be associated with HCC (<xref rid="b26-or-38-05-2607" ref-type="bibr">26</xref>&#x2013;<xref rid="b28-or-38-05-2607" ref-type="bibr">28</xref>). Most cases of HCC without an early finding are not candidates for curative therapies, which may be one of the reasons for the poor patient prognosis. Thus, potential markers for diagnosis and treatment with high efficiency are urgently demanded. Microarray technology enables us to explore the genetic alterations in HCC, and has been proved to be a useful approach to identify new biomarkers in other diseases.</p>
<p>In the present study, 3 mRNA microarray datasets were analyzed to obtain DEGs between liver cancer tissues and non-cancerous tissues. A total of 273 DEGs were identified among the 3 datasets, including 189 downregulated genes and 84 upregulated genes. GO and KEGG enrichment analyses were performed to explore interactions among the DEGs. The upregulated genes were mainly enriched in oocyte meiosis, mitotic cell cycle and cell cycle, while the downregulated genes were mainly enriched in protein activation cascade, complement activation and complement and coagulation cascades. Previous studies have reported that dysregulation of the cell cycle process and mitotic cell cycle play important roles in the carcinogenesis or progression of tumors (<xref rid="b24-or-38-05-2607" ref-type="bibr">24</xref>,<xref rid="b25-or-38-05-2607" ref-type="bibr">25</xref>,<xref rid="b29-or-38-05-2607" ref-type="bibr">29</xref>). In addition, recent studies have brought forward a tumor-promoting role for complement activation (<xref rid="b30-or-38-05-2607" ref-type="bibr">30</xref>). Moreover, oxidoreductase activity often plays a major role in antioxidant defense and can encode tumor suppressors that are frequently altered in tumors (<xref rid="b31-or-38-05-2607" ref-type="bibr">31</xref>,<xref rid="b32-or-38-05-2607" ref-type="bibr">32</xref>). In a word, all these theories are consistent with our results. GO enrichment analysis revealed that changes in the most significant modules were mainly enriched in cell division, nuclear division and mitotic cell cycle process, while changes in KEGG were mainly enriched in cell cycle, progesterone-mediated oocyte maturation and oocyte meiosis.</p>
<p>We selected 16 DEGs as hub genes with degrees &#x2265;10. Among these hub genes, TOP2A and CDK1 showed the highest node degrees with 33. TOP2A, which forms breaks in double-stranded DNA and alters DNA structure during transcription, has been shown to be correlated with early age onset, microvascular invasion, shorter patient survival, chemoresistance and recurrence in HCC (<xref rid="b33-or-38-05-2607" ref-type="bibr">33</xref>,<xref rid="b34-or-38-05-2607" ref-type="bibr">34</xref>). Thus, it is regarded as a target for anticancer agents, such as epirubicin, doxorubicin, etoposide and temozolomide (<xref rid="b35-or-38-05-2607" ref-type="bibr">35</xref>&#x2013;<xref rid="b37-or-38-05-2607" ref-type="bibr">37</xref>). In HER2-amplified breast cancer, HER2 and TOP2A genes are frequently co-amplified (<xref rid="b38-or-38-05-2607" ref-type="bibr">38</xref>). However, TOP2A overexpression in HCC is independent from HER2 amplification or overexpression (<xref rid="b39-or-38-05-2607" ref-type="bibr">39</xref>). In addition, TOP2A overexpression has also been found in lung, colon and ovarian cancers, and may be regarded as a valuable biomarker for diagnosis, treatment and prognosis of tumors (<xref rid="b40-or-38-05-2607" ref-type="bibr">40</xref>&#x2013;<xref rid="b42-or-38-05-2607" ref-type="bibr">42</xref>). In the present study, PPI network showed that TOP2A directly interacts with CDK1, RACGAP1, BIRC5 and PRC1, indicating a key role of TOP2A in HCC. Cyclin-dependent kinase 1 (CDK1), a serine/threonine kinase, regulates cell cycle progression by binding to cyclin B to form a complex called cyclin B-CDK1. miR-582-5p was found to regulate the progression of HCC by inhibiting the expression of CDK1 (<xref rid="b43-or-38-05-2607" ref-type="bibr">43</xref>). CDK1 overexpression has also been found in lung, pancreas and other cancers. In addition to its role in cell cycle progression, cyclin B-CDK1 could interact with apoptin and regulate the subcellular localization of apoptin, leading to apoptosis and carcinogenesis (<xref rid="b44-or-38-05-2607" ref-type="bibr">44</xref>). Survivin inactivates and blocks CDK1 by increasing the level of Wee1 and thus, inactivates and blocks the pro-apoptotic activity of CDK1 (<xref rid="b45-or-38-05-2607" ref-type="bibr">45</xref>). Cyclin B-CDK1 is also involved in connecting mitotic arrest and apoptosis by mediating the phosphorylation of anti-apoptotic Bcl-2 (<xref rid="b46-or-38-05-2607" ref-type="bibr">46</xref>). We assessed the expression of TOP2A and CDK1 in relation to overall and disease-free survival. Gene alteration in TOP2A showed reductions in overall and disease-free survival. However, in the present study, those observations were not statistically significant. In addition, the CDK1 alteration was significantly associated with worse overall survival, but not disease-free survival. Nevertheless, several clinical studies have shown that overexpression of TOP2A is significantly associated with shorter survival times (<xref rid="b37-or-38-05-2607" ref-type="bibr">37</xref>,<xref rid="b39-or-38-05-2607" ref-type="bibr">39</xref>). We speculate that the reason may be that survival analyses in cBioPortal were performed on the basis of the relationship between gene mutation and prognosis, while gene overexpression usually arises from mutation or amplification. Thus, overexpression of TOP2A in HCC may arise from gene amplification rather than mutation, and further research is needed to confirm our hypothesis. Oncomine analysis showed that higher mRNA levels of TOP2A and CDK1 were associated with tumor grade, hepatitis virus infection status, satellites and vascular invasion, indicating vital roles of TOP2A and CDK1 in the carcinogenesis or progression of HCC.</p>
<p>RACGAP1, a Rac- and Cdc42-specific GAP, can suppress Rac and activate RhoA, leading to the promotion of pseudopod extension and invasion (<xref rid="b47-or-38-05-2607" ref-type="bibr">47</xref>). Moreover, RACGAP1 shows a relationship with AURKA, a negative prognostic indicator in gastric cancer (<xref rid="b48-or-38-05-2607" ref-type="bibr">48</xref>). BIRC5, also called survivin, is overexpressed and plays important roles in cell division and proliferation in a majority of cancers including HCC. PRC1 is involved in the microtubule organization in eukaryotes and is upregulated in breast tumors (<xref rid="b49-or-38-05-2607" ref-type="bibr">49</xref>). Recent research has found that it can be a novel regulator of early HCC recurrence via potentiating Wnt signaling (<xref rid="b50-or-38-05-2607" ref-type="bibr">50</xref>). High expression of CDC20 is associated with sex, differentiation, tumor-node-metastasis (TNM) stage, and p53 expression of HCC (<xref rid="b51-or-38-05-2607" ref-type="bibr">51</xref>). The protein kinase CDC25C acts as an activator of cyclin B-CDK1 that regulates the G2/M transition in HCC cells (<xref rid="b52-or-38-05-2607" ref-type="bibr">52</xref>). HCC patients with relatively low CXCL12 mRNA levels exhibit worse overall survival (<xref rid="b53-or-38-05-2607" ref-type="bibr">53</xref>). A recent study found that the transcriptional activity of c-FOS could be induced by membrane melanoma cell adhesion molecule (MCAM), and it is important for MCAM-induced liver tumorigenesis (<xref rid="b54-or-38-05-2607" ref-type="bibr">54</xref>). High expression of SPC24 is associated with worse disease-free and overall survival in HCC patients (<xref rid="b55-or-38-05-2607" ref-type="bibr">55</xref>). High expression of KIF20A is involved in the development and progression of various cancers such as pancreatic, bladder and breast cancer. A recent study found that the glioma-associated oncogene 2/KIF20A axis is crucial for the proliferation of human HCC cells (<xref rid="b56-or-38-05-2607" ref-type="bibr">56</xref>).</p>
<p>Literature retrieval results showed that the interaction among HCC and hub genes NUSAP1, CEP55, BUB1, CCNB2, KIF2C and RACGAP1 has not been widely reported. NUSAP1 regulates mitosis, and high expression of NUSAP1 is involved in the progression of prostate cancer (<xref rid="b57-or-38-05-2607" ref-type="bibr">57</xref>). CEP55 is a centrosome-associated protein, which plays an important role in regulating the cell cycle. Overexpression of CEP55 was found to promote the proliferation of several cancers, such as pulmonary adenocarcinoma, breast cancer and anaplastic thyroid carcinoma (<xref rid="b58-or-38-05-2607" ref-type="bibr">58</xref>&#x2013;<xref rid="b60-or-38-05-2607" ref-type="bibr">60</xref>). BUB1, a component of the spindle assembly checkpoint, is overexpressed and plays important roles in the progression of breast cancer (<xref rid="b61-or-38-05-2607" ref-type="bibr">61</xref>). However, BUB1 has been reported to have a controversial role in spindle assembly checkpoint activation (<xref rid="b62-or-38-05-2607" ref-type="bibr">62</xref>,<xref rid="b63-or-38-05-2607" ref-type="bibr">63</xref>), which needs further investigation. CCNB2 is overexpressed in bladder, lung and colorectal cancers, and is associated with invasion, metastasis and poor prognosis of cancers (<xref rid="b64-or-38-05-2607" ref-type="bibr">64</xref>,<xref rid="b65-or-38-05-2607" ref-type="bibr">65</xref>). KIF2C plays an important role in the segregation of chromosomes in mitosis, and is overexpressed in various cancers and may be associated with the chemoresistance of ovarian cancer (<xref rid="b66-or-38-05-2607" ref-type="bibr">66</xref>,<xref rid="b67-or-38-05-2607" ref-type="bibr">67</xref>). In addition, we also performed hierarchical clustering for hub genes. Results showed that these hub genes differentiated HCC samples from non-cancerous samples, and may be candidates for diagnostic biomarkers. Moreover, alteration of BUB1, CDC20, KIF20A, RACGAP1 and CEP55 is involved in worse overall and disease-free survival, indicating that these genes may play important roles in the carcinogenesis, progression, invasion or recurrence of HCC.</p>
<p>In conclusion, the present study was designed to identify DEGs that may be involved in the carcinogenesis or progression of HCC. A total of 273 DEGs and 16 hub genes were identified and may be regarded as diagnostic biomarkers for HCC. However, further studies are needed to elucidate the biological function of these genes in HCC.</p>
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<title>Acknowledgements</title>
<p>The present study was supported by a grant (no. 81271838) from the National Science Foundation of China.</p>
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<ref-list>
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<floats-group>
<fig id="f1-or-38-05-2607" position="float">
<label>Figure 1.</label>
<caption><p>Venn diagram, PPI network and the most significant module of DEGs. (A) DEGs were selected with a fold change &#x003E;2 and P-value &#x003C;0.01 among the mRNA expression profiling sets GSE19665, GSE33006 and GSE41804. The 3 datasets showed an overlap of 273 genes. (B) The PPI network of DEGs was constructed using Cytoscape. (C) The most significant module was obtained from PPI network with 15 nodes and 102 edges. Upregulated genes are marked in light red; downregulated genes are marked in light blue.</p></caption>
<graphic xlink:href="OR-38-05-2607-g00.tif"/>
</fig>
<fig id="f2-or-38-05-2607" position="float">
<label>Figure 2.</label>
<caption><p>Interaction network and biological process analysis of the hub genes. (A) Hub genes and their co-expression genes were analyzed using cBioPortal. Nodes with bold black outline represent hub genes. Nodes with thin black outline represent the co-expression genes. (B) The biological process analysis of hub genes was constructed using BiNGO. The color depth of nodes refers to the corrected P-value of ontologies. The size of nodes refers to the numbers of genes that are involved in the ontologies. P&#x003C;0.01 was considered statistically significant. (C) Hierarchical clustering of hub genes was constructed using UCSC. The samples under the pink bar are non-cancerous samples and the samples under the blue bar are HCC samples. Upregulation of genes is marked in red; downregulation of genes is marked in blue.</p></caption>
<graphic xlink:href="OR-38-05-2607-g01.tif"/>
</fig>
<fig id="f3-or-38-05-2607" position="float">
<label>Figure 3.</label>
<caption><p>(A) Overall survival and (B) disease-free survival analyses of hub genes were performed using cBioPortal online platform. P&#x003C;0.05 was considered statistically significant.</p></caption>
<graphic xlink:href="OR-38-05-2607-g02.tif"/>
</fig>
<fig id="f4-or-38-05-2607" position="float">
<label>Figure 4.</label>
<caption><p>Expression profiles for (A) TOP2A and (B) CDK1 in human cancers analyzed using SAGE.</p></caption>
<graphic xlink:href="OR-38-05-2607-g03.tif"/>
</fig>
<fig id="f5-or-38-05-2607" position="float">
<label>Figure 5.</label>
<caption><p>Oncomine analysis of cancer vs. normal tissue of (A) TOP2A and (B) CDK1. Heat maps of TOP2A and CDK1 gene expression in clinical hepatocellular carcinoma samples vs. normal tissues. 1. Hepatocellular carcinoma vs. normal liver, Chen, Mol Biol Cell, 2002 (<xref rid="b20-or-38-05-2607" ref-type="bibr">20</xref>). 2. Hepatocellular carcinoma vs. normal liver, Roessler, Cancer Res, 2010 (<xref rid="b21-or-38-05-2607" ref-type="bibr">21</xref>). 3. Hepatocellular carcinoma vs. normal liver, Roessler, Cancer Res, 2010 (<xref rid="b21-or-38-05-2607" ref-type="bibr">21</xref>). 4. Hepatocellular carcinoma vs. normal liver, Wurmbach, Hepatology, 2007 (<xref rid="b22-or-38-05-2607" ref-type="bibr">22</xref>).</p></caption>
<graphic xlink:href="OR-38-05-2607-g04.tif"/>
</fig>
<fig id="f6-or-38-05-2607" position="float">
<label>Figure 6.</label>
<caption><p>Association between the expression of TOP2A and CDK1 and tumor grade, hepatitis virus infection status, satellites and vascular invasion in the Wurmbach Liver dataset. (A-D) TOP2A mRNA expression in HCC compared to normal liver tissues. (E-H) CDK1 mRNA expression in hepatocellular carcinoma samples.</p></caption>
<graphic xlink:href="OR-38-05-2607-g05.tif"/>
<graphic xlink:href="OR-38-05-2607-g06.tif"/>
</fig>
<table-wrap id="tI-or-38-05-2607" position="float">
<label>Table I.</label>
<caption><p>GO and KEGG pathway enrichment analysis of DEGs in HCC samples.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="bottom">Term</th>
<th align="center" valign="bottom">Description</th>
<th align="center" valign="bottom">Count in gene set</th>
<th align="center" valign="bottom">P-value</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top">Downregulated</td>
<td/>
<td/>
<td/>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;GO:0072376</td>
<td align="left" valign="top">Protein activation cascade</td>
<td align="center" valign="top">16</td>
<td align="left" valign="top">5.27E-15</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;GO:0006956</td>
<td align="left" valign="top">Complement activation</td>
<td align="center" valign="top">14</td>
<td align="left" valign="top">5.47E-15</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;GO:0006952</td>
<td align="left" valign="top">Defense response</td>
<td align="center" valign="top">41</td>
<td align="left" valign="top">2.24E-09</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;GO:0030246</td>
<td align="left" valign="top">Carbohydrate binding</td>
<td align="center" valign="top">13</td>
<td align="left" valign="top">0.00398</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;GO:0005537</td>
<td align="left" valign="top">Mannose-binding</td>
<td align="center" valign="top">&#x00A0;&#x00A0;4</td>
<td align="left" valign="top">0.0216</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;GO:0016491</td>
<td align="left" valign="top">Oxidoreductase activity</td>
<td align="center" valign="top">18</td>
<td align="left" valign="top">0.0216</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;GO:0005615</td>
<td align="left" valign="top">Extracellular space</td>
<td align="center" valign="top">42</td>
<td align="left" valign="top">1.89E-11</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;GO:0005576</td>
<td align="left" valign="top">Extracellular region</td>
<td align="center" valign="top">80</td>
<td align="left" valign="top">2.41E-10</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;GO:0044421</td>
<td align="left" valign="top">Extracellular region part</td>
<td align="center" valign="top">69</td>
<td align="left" valign="top">6.95E-09</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;Hsa04610</td>
<td align="left" valign="top">Complement and coagulation cascades</td>
<td align="center" valign="top">10</td>
<td align="left" valign="top">1.37E-07</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;Hsa05020</td>
<td align="left" valign="top">Prion diseases</td>
<td align="center" valign="top">&#x00A0;&#x00A0;6</td>
<td align="left" valign="top">0.000106</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;Hsa00232</td>
<td align="left" valign="top">Caffeine metabolism</td>
<td align="center" valign="top">&#x00A0;&#x00A0;3</td>
<td align="left" valign="top">0.000665</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;Hsa01100</td>
<td align="left" valign="top">Metabolic pathways</td>
<td align="center" valign="top">25</td>
<td align="left" valign="top">0.00296</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;Hsa00010</td>
<td align="left" valign="top">Glycolysis/gluconeogenesis</td>
<td align="center" valign="top">&#x00A0;&#x00A0;5</td>
<td align="left" valign="top">0.00958</td>
</tr>
<tr>
<td align="left" valign="top">Upregulated</td>
<td/>
<td/>
<td/>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;GO:0022402</td>
<td align="left" valign="top">Cell cycle process</td>
<td align="center" valign="top">45</td>
<td align="left" valign="top">4.36E-34</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;GO:0007049</td>
<td align="left" valign="top">Cell cycle</td>
<td align="center" valign="top">48</td>
<td align="left" valign="top">9.01E-34</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;GO:0000278</td>
<td align="left" valign="top">Mitotic cell cycle</td>
<td align="center" valign="top">41</td>
<td align="left" valign="top">6.08E-33</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;GO:0000793</td>
<td align="left" valign="top">Condensed chromosome</td>
<td align="center" valign="top">15</td>
<td align="left" valign="top">3.67E-13</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;GO:0005819</td>
<td align="left" valign="top">Spindle</td>
<td align="center" valign="top">17</td>
<td align="left" valign="top">3.67E-13</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;GO:0005694</td>
<td align="left" valign="top">Chromosome</td>
<td align="center" valign="top">23</td>
<td align="left" valign="top">1.05E-12</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;Hsa04110</td>
<td align="left" valign="top">Cell cycle</td>
<td align="center" valign="top">&#x00A0;&#x00A0;9</td>
<td align="left" valign="top">3.84E-07</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;Hsa04114</td>
<td align="left" valign="top">Oocyte meiosis</td>
<td align="center" valign="top">&#x00A0;&#x00A0;6</td>
<td align="left" valign="top">0.00058</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;Hsa04914</td>
<td align="left" valign="top">Progesterone-mediated oocyte maturation</td>
<td align="center" valign="top">&#x00A0;&#x00A0;5</td>
<td align="left" valign="top">0.00156</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="tfn1-or-38-05-2607"><p>GO, Gene Ontology; KEGG, Kyoto Encyclopedia of Genes and Genomes; DEGs, differentially expressed genes; HCC, hepatocellular carcinoma.</p></fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="tII-or-38-05-2607" position="float">
<label>Table II.</label>
<caption><p>GO and KEGG pathway enrichment analysis of DEGs in the most significant module.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="bottom">Pathway ID</th>
<th align="center" valign="bottom">Pathway description</th>
<th align="center" valign="bottom">Count in gene set</th>
<th align="center" valign="bottom">FDR</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top">GO:0051301</td>
<td align="left" valign="top">Cell division</td>
<td align="center" valign="top">14</td>
<td align="center" valign="top">9.99E-19</td>
</tr>
<tr>
<td align="left" valign="top">GO:0000280</td>
<td align="left" valign="top">Nuclear division</td>
<td align="center" valign="top">13</td>
<td align="center" valign="top">4.42E-17</td>
</tr>
<tr>
<td align="left" valign="top">GO:0007067</td>
<td align="left" valign="top">Mitotic nuclear division</td>
<td align="center" valign="top">12</td>
<td align="center" valign="top">3.42E-16</td>
</tr>
<tr>
<td align="left" valign="top">GO:1903047</td>
<td align="left" valign="top">Mitotic cell cycle process</td>
<td align="center" valign="top">13</td>
<td align="center" valign="top">1.75E-14</td>
</tr>
<tr>
<td align="left" valign="top">GO:0000278</td>
<td align="left" valign="top">Mitotic cell cycle</td>
<td align="center" valign="top">13</td>
<td align="center" valign="top">6.11E-14</td>
</tr>
<tr>
<td align="left" valign="top">GO:0005819</td>
<td align="left" valign="top">Spindle</td>
<td align="center" valign="top">&#x00A0;&#x00A0;9</td>
<td align="center" valign="top">7.60E-11</td>
</tr>
<tr>
<td align="left" valign="top">GO:0000793</td>
<td align="left" valign="top">Condensed chromosome</td>
<td align="center" valign="top">&#x00A0;&#x00A0;7</td>
<td align="center" valign="top">1.36E-08</td>
</tr>
<tr>
<td align="left" valign="top">GO:0000777</td>
<td align="left" valign="top">Condensed chromosome kinetochore</td>
<td align="center" valign="top">&#x00A0;&#x00A0;6</td>
<td align="center" valign="top">1.98E-08</td>
</tr>
<tr>
<td align="left" valign="top">GO:0000779</td>
<td align="left" valign="top">Condensed chromosome, centromeric region</td>
<td align="center" valign="top">&#x00A0;&#x00A0;6</td>
<td align="center" valign="top">2.18E-08</td>
</tr>
<tr>
<td align="left" valign="top">GO:0015630</td>
<td align="left" valign="top">Microtubule cytoskeleton</td>
<td align="center" valign="top">10</td>
<td align="center" valign="top">3.12E-08</td>
</tr>
<tr>
<td align="left" valign="top">Hsa04110</td>
<td align="left" valign="top">Cell cycle</td>
<td align="center" valign="top">&#x00A0;&#x00A0;6</td>
<td align="center" valign="top">5.20E-08</td>
</tr>
<tr>
<td align="left" valign="top">Hsa04914</td>
<td align="left" valign="top">Progesterone-mediated oocyte maturation</td>
<td align="center" valign="top">&#x00A0;&#x00A0;4</td>
<td align="center" valign="top">3.91E-05</td>
</tr>
<tr>
<td align="left" valign="top">Hsa04114</td>
<td align="left" valign="top">Oocyte meiosis</td>
<td align="center" valign="top">&#x00A0;&#x00A0;4</td>
<td align="center" valign="top">8.19E-05</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="tfn2-or-38-05-2607"><p>GO, Gene Ontology; KEGG, Kyoto Encyclopedia of Genes and Genomes; DEGs, differentially expressed genes; FDR, false discovery rate.</p></fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="tIII-or-38-05-2607" position="float">
<label>Table III.</label>
<caption><p>Functional roles of 16 hub genes with degree &#x2265;10.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="bottom">No.</th>
<th align="center" valign="bottom">Gene symbol</th>
<th align="center" valign="bottom">Full name</th>
<th align="center" valign="bottom">Function</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;1</td>
<td align="left" valign="top">BIRC5</td>
<td align="left" valign="top">Baculoviral IAP repeat containing 5</td>
<td align="left" valign="top">BIRC5 may prevent apoptotic cell death and is highly expressed in most tumors</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;2</td>
<td align="left" valign="top">BUB1</td>
<td align="left" valign="top">BUB1 mitotic checkpoint serine/threonine kinase</td>
<td align="left" valign="top">BUB1 promotes the progression of breast cancer</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;3</td>
<td align="left" valign="top">CCNB2</td>
<td align="left" valign="top">Cyclin B2</td>
<td align="left" valign="top">CCNB2 (cyclin B2) is associated with invasion, metastasis and poor prognosis of several cancers</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;4</td>
<td align="left" valign="top">CDC20</td>
<td align="left" valign="top">Cell division cycle 20</td>
<td align="left" valign="top">High expression of CDC20 is associated with development and progression of HCC</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;5</td>
<td align="left" valign="top">CDC25C</td>
<td align="left" valign="top">Cell division cycle 25C</td>
<td align="left" valign="top">CDC25C can regulate the G2/M transition in HCC cells</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;6</td>
<td align="left" valign="top">CDK1</td>
<td align="left" valign="top">Cyclin-dependent kinase 1</td>
<td align="left" valign="top">CDK1 can regulate the cell cycle progression, apoptosis and carcinogenesis of tumor cells</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;7</td>
<td align="left" valign="top">CEP55</td>
<td align="left" valign="top">Centrosomal protein 55</td>
<td align="left" valign="top">High expression of CEP55 can promote the proliferation of lung, breast and thyroid cancers</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;8</td>
<td align="left" valign="top">CXCL12</td>
<td align="left" valign="top">C-X-C motif chemokine ligand 12</td>
<td align="left" valign="top">High expression of CXCL12 in tumor cells may impede tumor spread</td>
</tr>
<tr>
<td align="left" valign="top">&#x00A0;&#x00A0;9</td>
<td align="left" valign="top">FOS</td>
<td align="left" valign="top">FBJ murine osteosarcoma viral oncogene homolog</td>
<td align="left" valign="top">FOS has been implicated as a regulator of cell proliferation, differentiation and transformation</td>
</tr>
<tr>
<td align="left" valign="top">10</td>
<td align="left" valign="top">KIF20A</td>
<td align="left" valign="top">Kinesin family member 20A</td>
<td align="left" valign="top">High expression of KIF20A is involved in the development and progression of various cancers</td>
</tr>
<tr>
<td align="left" valign="top">11</td>
<td align="left" valign="top">NUSAP1</td>
<td align="left" valign="top">Nucleolar and spindle associated protein 1</td>
<td align="left" valign="top">High expression of NUSAP1 is involved in the progression of prostate cancer</td>
</tr>
<tr>
<td align="left" valign="top">12</td>
<td align="left" valign="top">KIF2C</td>
<td align="left" valign="top">Kinesin family member 2C</td>
<td align="left" valign="top">KIF2C is overexpressed in various cancers and may be associated with the chemoresistance of ovarian cancer</td>
</tr>
<tr>
<td align="left" valign="top">13</td>
<td align="left" valign="top">RACGAP1</td>
<td align="left" valign="top">Rac GTPase activating protein 1</td>
<td align="left" valign="top">RACGAP1 plays a regulatory role in cytokinesis, cell growth and differentiation</td>
</tr>
<tr>
<td align="left" valign="top">14</td>
<td align="left" valign="top">PRC1</td>
<td align="left" valign="top">Protein regulator of cytokinesis 1</td>
<td align="left" valign="top">PRC1 may be a novel regulator of early HCC recurrence</td>
</tr>
<tr>
<td align="left" valign="top">15</td>
<td align="left" valign="top">SPC24</td>
<td align="left" valign="top">SPC24, NDC80 kinetochore complex component</td>
<td align="left" valign="top">High expression of SPC24 is associated with worse disease-free survival and overall survival in HCC</td>
</tr>
<tr>
<td align="left" valign="top">16</td>
<td align="left" valign="top">TOP2A</td>
<td align="left" valign="top">Topoisomerase (DNA) II &#x03B1;</td>
<td align="left" valign="top">TOP2A acts as a target for several anticancer agents and mutations of this gene have been associated with drug resistance</td>
</tr>
</tbody>
</table>
</table-wrap>
</floats-group>
</article>