RNA N6-methyladenosine demethylase FTO promotes breast tumor progression through inhibiting BNIP3
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N6-methyladenosine (m6A) modification is the most pervasive modification in mRNA, and has been considered as a new layer of epigenetic regulation on mRNA processing, stability and translation. Despite its functional significance in various physiological processes, the role of the m6A modification involved in breast cancer is yet fully understood.
We used the m6A-RNA immunoprecipitation sequencing to identify the potential targets in breast cancer. To determine the underlying mechanism for the axis of FTO-BNIP3, we performed a series of in vitro and in vivo assays in 3 breast cancer cell lines and 36 primary breast tumor tissues and 12 adjunct tissues.
We showed that FTO, a key m6A demethylase, was up-regulated in human breast cancer. High level of FTO was significantly associated with lower survival rates in patients with breast cancer. FTO promoted breast cancer cell proliferation, colony formation and metastasis in vitro and in vivo. We identified BNIP3, a pro-apoptosis gene, as a downstream target of FTO-mediated m6A modification. Epigenetically, FTO mediated m6A demethylation in the 3’UTR of BNIP3 mRNA and induced its degradation via an YTHDF2 independent mechanism. BNIP3 acts as a tumor suppressor and is negatively correlated with FTO expression in clinical breast cancer patients. BNIP3 dramatically alleviated FTO-dependent tumor growth retardation and metastasis.
Our findings demonstrate the functional significance of the m6A modification in breast cancer, and suggest that FTO may serve as a novel potential therapeutic target for breast cancer.
KeywordsBreast cancer N6-methyladenosine FTO BNIP3 Apoptosis
AlkB homolog 5
Acute myeloid leukemia
Ankyrin repeat and SOCS box protein 2
B-cell lymphoma 2
BCL2 Interacting Protein 3
Fat mass and obesity-associated
Heterogeneous Nuclear Ribonucleoprotein A2/B1
Insulin-like growth factor 2 mRNA-binding protein 2
Retinoic Acid Receptor Alpha
Wilms tumor 1 associated protein
Breast cancer continues to be a severe threat towards women in the world. It is estimated that more than 2.1 million new cases of breast cancer occurred in 2018, causing 627,000 death in women . With the advent of molecular classification in breast cancer, the 5-year survival rate for patients diagnosed with localized tumors reached 90%, however, for those patient diagnosed with advanced tumors, the 5-year survival rate was less than 30% . The mortality from breast cancer was primarily due to chemo-resistance and metastasis. Administration of novel target intervention may help to prevent initial or aggressive metastasis, thereby improving survival and clinical outcomes for patients with advanced breast tumors. While global gene expression patterns of breast cancer have been extensively studied, post-transcriptional regulation of gene expression involved in advanced breast tumors has yet fully investigated. Examining post-transcriptional gene regulation can better understand the molecular mechanism of breast cancer, providing a more comprehensive picture of the biology of cancer progression.
N6-methyladenosine (m6A) modification is the methylation of the adenosine base at the nitrogen-6 position of mRNA. The m6A modification is the most pervasive internal modification of mRNA in mammalian cells, with wide distribute (> 25%) abundance in the transcripts [3, 4]. Unlike other modifications of mRNA, the m6A modification is dynamically reversible as the DNA and histone modifications , and plays an critical role in regulating precursor mRNA maturation, translation and degradation [3, 6, 7]. The m6A modification is mainly mediated by the methyltransferase (METTL3, METTL14 and WTAP) [8, 9, 10], demethylase (FTO and ALKBH5) [5, 11] and proteins that preferentially recognized m6A methylated transcripts (YTH domain family proteins [12, 13, 14, 15, 16], HNRNPA2B1  and IGF2BP ). The m6A modification was found to regulate stem cell differentiation and self-renewal through affecting mRNA turnover during cell differentiation and embryonic development [19, 20]. Emergent evidence has shown that the m6A modification plays an important role in the occurrence and development of various human diseases [21, 22, 23, 24].
FTO was the first m6A demethylase to show m6A demethylation activity on mRNA and catalyze m6A demethylation in a ferrous iron dependent manner . Previously, FTO was known to be highly associated with increased body mass and obesity in childhood and adult [25, 26]. FTO-knockout mice showed protection from obesity but caused growth failure . Recently, FTO was shown to mediate mRNA processing of adipogenetic regulatory factors in adipogenesis by m6A demethylation . Chen and He groups showed an oncogenic role of FTO in acute myeloid leukemia (AML) . They found that FTO was high expressed in AML and inhibited ASB2 and RARA by reducing their m6A methylated level in the transcripts, resulting in enhancement of cell transformation and leukemogenesis . The elevated level of FTO was also found in cervical squamous cell carcinoma (CSCC) and glioblastoma [30, 31]. Inactivation of FTO in leukemia induced sensitivity of resistance cells to tyrosine kinase inhibitor , indicating that the FTO-m6A axis may serve as novel potential therapeutic target in human cancers . However, the underlying epigenetic regulation of FTO, as m6A demethylase, in breast cancer initiation and progression has yet to be investigated.
In the present study, we sought to determine the role of m6A modification in breast cancer, and investigated the underlying molecular mechanism by which the m6A modification affects the initiation and progression of breast cancer. We first detected the levels of the m6A modification in breast cancer, and observed that FTO was up-regulated in human breast cancer tissues. Next, we demonstrated that silence of FTO could significantly reduce breast cancer cell proliferation, colony formation and enhance cell apoptosis. Further, we identified that BNIP3, a pro-apoptotic member of the Bcl-2 family of apoptotic proteins , was the target gene of FTO in mediating breast cancer proliferation and progression. We found that silencing BNIP3 could significantly alleviate FTO-dependent tumor growth retardation in vitro and in vivo. Based on the data, we revealed the important role of m6A modification mediated by FTO in breast cancer, and proposed that FTO may act as a novel therapeutic target in breast cancer progression.
Breast cancer patient samples, cell lines and cell culture
The breast tumor and normal tissues were obtained at the Third Affiliated Hospital of Sun Yat-Sen University and were approved by the institutional review board of the hospital. The study is compliant with all relevant ethical regulations regarding research involving human participants. For fresh tissues, breast tumors and adjacent normal tissues were separately dissected at the time of surgery and immediately transferred to RNAlater (R0901, Sigma). The paraffin-embedded specimens were collected from at the Eighth Affiliated Hospital of Sun Yat-Sen University. Breast cancer cell lines MDA-MB-231, MCF-7 and 4 T1 were obtained from American Type Culture Collection (ATCC) with authentication. These cell lines were cultured in Dulbecco’s modified Eagle’s medium (DMEM, Corning, USA) with 10% fetal bovine serum (Gibco, USA) and antibiotics (Gibco, USA). Cells were grown in a 5% CO2 cell culture incubator at 37 °C.
Plasmid constructions, cell transfection, and infection
Stable knockdown of target genes was achieved by lentiviral-based short-hairpin RNA (shRNA) delivery. PLKO.1 vector with anti-puromycin or anti-hygromycin plasmid was constructed by using the primer sequences listed in
Additional file 1: Table S1. For YTHDF2 overexpressing system, YTHDF2 cDNA (NM_016258) was cloned into pCDH puro lentiviral vector (CD510B-1, System Biosciences), For shRNA knockdown and overexpression, pLKO.1 and pCDH constructs together with packing and helper plasmids PAX2 and MD2G were co-transfected into 293 T cells by Calcium Phosphate Transfection Kit (CAPHOS-1KT, Sigma). Viruses were collected, filtered, and titrated before infecting target cells with 8 mg/ml Polybrene (TR-1003, Sigma). The infected cells were screened by puromycin or hygromycin accordingly.
For immunohistochemistry (IHC) analysis, breast cancer specimens tissue slides were deparaffinized, rehydrated through an alcohol series followed by antigen retrieval with sodium citrate buffer. Tumor sections were blocked with 5% normal goat serum (Vector) with 0.1% Triton X-100 and 3% H2O2 in PBS for 60 min at room temperature and then incubated with appropriate primary antibodies 4 °C overnight. IHC staining was performed with horseradish peroxidase (HRP) conjugates using DAB detection. Nuclei were counterstained with Hoechst. Images were taken with Nikon microscopy.
Western blot analysis and antibodies
Cells in 6-well plate or 60 mm2 dishes were lysed in 80–100 ul modified RIPA buffer (P0013B, Beyotime, China) containing the complete cocktail of protease inhibitors (#11836153001, Roche, Switzerland). Protein concentrations were determined with the BCA protein assay kit (P0011, Beyotime, China). Proteins were separated by 12 or 15% SDS-PAGE and transferred to nitrocellulose filters, and blotted with related antibodies in 4 °C overnight. Secondary antibodies pre-labeled in room temperature for 1 h. The nitrocellulose filters with target protein were exposed in visualizer (4600, Tanon, China). Antibodies were purchased from the following: anti-FTO (ab124892, 1:1000, Abcam), anti-BNIP3 (ab109362, 1:1000, Abcam), anti-Bcl2 (A0208, 1:1000, ABclonal), anti-β-actin (AF1700, 1:1000, R&D system), anti-tubulin (13E5, 1:1000, Cell Signaling) and anti-caspase 3 (A2156, 1:1000, ABclonal).
RNA isolation and RT-PCR
Total RNAs were extracted by Trizol (ThermoFisher, USA) following the manufacturer’s instruction. Complementary DNA was synthesized using the SuperScript™ III First-Strand Synthesis System DNA using the PrimeScript RT reagent Kit (RR036A, Takara, Japan). Real-time reverse-transcription PCR was carried out by SYBR-Green Master mix (RR820B, Takara, Japan) in 7500 apparatus (Applied Biosystems). GAPDH was used as an internal control for the normalization. All primers used in this study are listed in Additional file 1: Table S1.
RNA m6A quantification
Total RNAs were isolated by TRIzol (ThermoFisher, USA) according to the manufacturer’s instructions. RNA quality was analyzed by NanoDrop3000. The EpiQuik m6A RNA Methylation Quantification Kit (Colorimetric) (P-9005, Epigentek, USA) was used to measure the m6A content in total RNAs. Briefly, 200 ng RNAs were coated on assay wells. Capture antibody solution and detection antibody solution were then added to assay wells separately in a suitable diluted concentration following the manufacturer’s instructions. The m6A levels were quantified colorimetrically by reading the absorbance of each well at a wavelength of 450 nm, and calculations were performed based on the standard curve.
RNA m6A dot blot assay
The poly (A) RNAs (300 ng) were spotted onto a nylon membrane (GE Healthcare). The membranes were then UV cross-linked (254 nm), blocked, incubated with m6A antibody (ABE572, 1:1000, Merck Millipore) in 4° Covernight. Antibodies pre-labeled in room temperature for 1 h. The nylon membrane with m6A dots were exposed in visualizer (4600, Tanon, China). The same 300 ng poly (A) RNAs were spotted on the membrane, stained with 0.2% methylene blue in 0.3 M sodium acetate (pH 5.2) for 2 h, and washed with ribonuclease-free water for 1 h.
RNA m6A sequence and m6A-RNA immunoprecipitation assay
Total RNAs were extracted by TRizol (ThermoFisher, USA) from stable shFTO MDA-MB-231 cells and the controls. Chemically fragmented RNA (100 nucleotides) was incubated with m6A antibody for immunoprecipitation according to the standard protocol of Magna methylated RNA immune-precipitation (MeRIP) m6A Kit (#17–10,499, Merck Millipore, USA). Enrichment of m6A containing mRNA was analyzed either by qRT-PCR with the primers listed in Additional file 1: Table S1 or by high-throughput RNA sequencing. For high-throughput sequencing, purified RNA fragments from m6A-MeRIP were used for library construction with the NEBNext Ultra RNA library Prep kit for Illumina (E7530S, NEB, USA) and were sequenced by Illumina HiSeq 2000. Library preparation and high-throughput sequencing were performed by Novogene (Guangzhou, China). Sequencing reads were aligned to the human genome GRCh37/hg19 by Bowtie2, and the m6A peaks were detected by magnetic cell sorting as described .
Cell proliferation and cell apoptosis assays
For CCK8 assay, cells were seeded at 1000 cells per well in 96-well plates with fresh medium. Cell viability was assayed using Cell Counting Kit-8 (CK04, Dojindo, Japan) at the time in 0, 48, 72, 96,120,144 h. The microplates were incubated at 37 °C for additional 4 h. Absorbance was read at 450 nm using a microplate reader (ThermoFisher, USA) and the results were expressed as a ratio of the treated over untreated cells (as 100%).
For EdU (5-Ethynyl-2′-deoxyuridine) assay, logarithmic growth stage cells were seeded in 6-well plate with corresponding concentration of EDU reagent for 3 h. Cells were washed with PBS for 5 min twice, before incubating with 4% Paraformaldehyde for 30 min. After washing with PBS for 5 min twice, samples were permeated with 0.3% TritonX-100 in PBS, and dyed with reaction solution (C0075S, Beyotime, China).The images collected with 20× and 40× visions in Nikon microscopy.
For cell apoptosis assays, cells were performed using Annexin V-PI Apoptosis Detection Kit I (WLA001a, Wanleibio, China) according to the manufacturer’s instruction, and followed by flow cytometry analysis (Beckman, USA).
Mammosphere formation assay and clonogenic assays
For mammosphere formation assay, cells were seeded into ultralow attachment plates (Corning) at a density of 20,000 viable cells/mL in a serum-free DMEM-F12 supplemented with 100× insulin, 20 ng/mL epidermal growth factor and 20 ng/mL basic fibroblast growth factor (Sigma), and 0.4% bovine serum albumin (Sigma), 100 × penicillin &streptomycin for two weeks until the mammosphere became visible.
For clonogenic assay, cells were seeded onto 35 mm2 dishes at a density of 5000 viable cells/mL in a serum-free DMEM-F12 supplemented with 100× insulin, 20 ng/mL epidermal growth factor and 20 ng/mL basic fibroblast growth factor (Sigma), and 0.4% bovine serum albumin (Sigma), 100 × penicillin &streptomycin for two weeks until the colonies became visible and stained with Crystal Violet Staining Solution.
Luciferase reporter assays and mutagenesis assay
The dual-luciferase vector pmiGLO was purchased from Promega (C838A, Promega, USA). The 3’UTR of BNIP3 was amplified by PCR using the genomic DNA from MDA-MB-231 cells as a template. A clone whose sequence was identical to the NCBI reference sequence NM_004052 was used to clone into pmiGLO vector with SacI and SalI restriction sites. Three putative m6A recognition sites were identified in 3’UTR. Mutagenesis from A to T was generated by QuikChange II Site-Directed Mutagenesis Kit (200,523, Agilent, USA) according to the instruction. Luciferase activity was measured by Dual Luciferase Reporter Gene Assay Kit (RG028, Beyotime, China) in GM2000 (Promega). Experiments were performed in triplicates. The firefly luciferase activity values were normalized to the Renilla luciferase activity values that reflect expression efficiency. Data are presented as mean values (± s.d.).
Mice were housed at five mice per cage under pathogen-free conditions. All animal care and experiments were approved by the Institutional Animal Care and Use Committee of Sun Yat-Sen University, Guangzhou, China, and the study is compliant with all relevant ethical regulations regarding animal research. Mice were euthanized when they met the institutional euthanasia criteria for tumor size and overall health condition.
For the subcutaneous implantation model, 5 4-week-old female Balb/c mice were randomly grouped and injected with 1 × 106 shCtrl, shFTO or shFTO/shBNIP3 KD 4 T1 cells. Tumors were measured with a caliper every 4 days to analyze tumor growth. Tumor volume was calculated by the formula V = ab2/2, where a and b are the tumor’s length and width, respectively. At the experimental endpoint, tumors tissues were harvested and fixed with 4% PFA for paraffin-embedded section.
For tumor metastasis mouse model, 5 4-week-old female Balb/c mice were randomly grouped and injected with 1 × 106 shCtrl, shFTO or shFTO/shBNIP3 KD 4 T1 cells via tail vein. To detect lung metastasis, mice were sacrificed 3 weeks after tumor cells injection. Lung tissues were harvested and fixed with 4% PFA for paraffin-embedded section and lung metastases were detected with the Nikon microscopy.
For orthotopic xenograft mouse model, 5 4-week-old female NOD/SCID mice were randomly grouped. After NOD/SCID were anaesthetized and the skin was incised, shCtrl or shFTO MDA-MB-231-luciferase cells (1 × 106) in 50 ul Hanks solution were orthotopically injected into mammary fat pads using a 1-ml Hamilton microliter syringe, and then the incision was closed using surgery suture threads with needle. Mice tumors were monitored by the IVIS system after luciferin injection for 15 min.
The gene expression profile dataset GSE9014, GSE11812 and GSE3188 was downloaded from GEO database. Data from GEO or RNA-Seq were analyzed by R (V3.3, http://www.bioconductor.org) with edgeR package. Fold-change (FC) of gene expression was calculated with a threshold criteria of log2FC ≥ 1.5 and P value< 0.01. KEGG pathway enrichment analysis was performed to investigate the processes of the candidate genes, by applying online tools of the KOBAS 3.0 (https://david.ncifcrf.gov/). The Search Tool for the Retrieval of Interacting Genes (STRING) database (V10.5, https://string-db.org/) was recruited to predict the potential interaction between BNIP3 and apoptosis genes at protein level. The online database of R2: Genomics Analysis and Visualization Platform (https://hgserver1.amc.nl) was applied to determine the clinical survival of the candidate genes. The relative expression of FTO was computed in breast tumor cohort (e.g. IHC samples) compared to the normal cohort, by which the value indicated the number of standard deviations away from the mean of expression in the normal population. High expression: > 1; Low expression: <− 1 (log2).
Means, SD and SEM were analyzed using Graphpad prism 7.0. Two-tailed Student’s t-test, were used to compare the statistical difference between indicated groups. Pearson analysis was used to analyze correlation between genes. Statistical significance was accepted for P-values of < 0.05.
FTO, an N6-methyladenosine RNA demethylase is up-regulated in human breast cancer
FTO significantly promoted breast cancer cell proliferation, colony formation, and reduced cell apoptosis
Silencing FTO inhibited breast tumor growth in vivo
In addition, we performed an orthotopic xenograft experiment in NOD/SCID mice. The MDA-MB-231 cells were engineered to stably express luciferase for in vivo imaging. Control and FTO-knockdown MDA-MB-231 cells were orthotopically injected into mouse mammary gland fat pads, and xenograft tumor growth was monitored accordingly. At 30 days after injection, all mice bearing FTO-knockdown cells barely had detected tumors whereas mice bearing control cells showed visible tumor growth as reflected by the luciferase signals in vivo (Fig. 3f and g). To investigate the effect on tumor metastasis, FTO-knockdown 4 T1 cells and control cells intravenously injected into BALB/c mice. As expected, silencing FTO attenuated lung metastasis in mice (Fig. 3h-j). Taken together, our results indicated that FTO plays a critical role in promoting breast tumor growth and metastasis in vivo.
RNA-Seq analysis identified BNIP3 as a downstream target of FTO-mediated m6A modification
Epigenetic silencing of BNIP3 by an FTO-m6A-dependent mechanism
BNIP3 is a tumor suppressor and is negatively correlated with FTO expression in clinical breast cancer patients
Silencing BNIP3 significantly alleviated FTO-dependent tumor growth and metastasis inhibition in vitro and in vivo
While we shed light on the epigenetic regulation by FTO in breast cancer, ALKBH5, another m6A demethylase, was previously reported to affect breast cancer stemness phenotype in hypoxia . In their study, they showed that ALKBH5 increased NANOG expression level by demethylating NANOG mRNA in the 3’UTR, promoting breast cancer stem cell renewal. In our study, we systematically analyzed the key regulators of m6A modification in breast cancer, and found that over 70% breast cancer tissues were highly expressed FTO. The global m6A methylation level was decreased in breast tumor tissues by compared to the normal ones. We further showed that high expression level of FTO was significantly related to poor clinic prognosis, indicating the role of FTO in regulation of breast cancer development. Through serial biological functional assays, we have demonstrated that FTO played a pivotal role in promoting cell proliferation, colony formation and metastasis in vitro and in vivo.
Rhein is the first potent FTO inhibitor, which could reversibly bind to FTO catalytic domain and competitively prevent the recognition of m6A modification substrates . In the study of Yan et al., Rhein was proved to increase m6A methylation in leukemia . They showed that combination therapy with Rhein and nilotinibR caused more pronounced recession of leukemia than a single agent treatment in mice. In our present study, we used Rhein to treat the 4T1-hypodermic breast tumor in mice, and found that Rhein could decrease tumor growth to a certain extent although the inhibitory effect was weaker than the tumors treated with shRNA. Development of specific potent FTO inhibitor is considered to be a preferable therapeutic strategy for breast cancers .
To decipher the molecular mechanism by which FTO promoted tumor growth in breast cancer, we analyzed the transcriptomic profiling of stable FTO knockdown MDA-MB-231 cells and control cells, MCF-7 cells treated with DMOG (a 2OG competitor which could inhibit FTO activity) and the one treated with DMSO, respectively. From the enrichment analysis, we focused on the FoxO signaling pathway, which was previously reported to be highly correlate with human cancers . FoxO proteins function as transcription factors by controling unchecked neoplastic growth and showing the anti-proliferative and pro-apoptotic effects . Previous study found that FoxO induced cell apoptosis by activating pro-apoptotic Bcl-2 [48, 49]. From our m6A RNA-sequencing analysis, we identified BNIP3, a critical member in the FoxO signaling pathway, was a candidate target of FTO-mediated m6A modification. Silencing FTO promoted BNIP3 expression in both mRNA level and protein level. We identified 3 potential m6A sites in the 3’UTR of BNIP3, and verified that the first site was the essential site to modulate the stability of BNIP3 mRNA by m6A immunoprecipitation assay and luciferase reporter assay. Our results were in line with the an earlier report showing that over 80% of FTO potential targets were negatively regulated by FTO in AML cells as FTO decreased the stability of these mRNA transcripts  and another report that m6A editing contributed to the enhancement of HIV-1 mRNA stability . Methylation in the vicinity of stop codons hinted us that the m6A reader YTHDF2 might participate in the regulation of m6A-methylated BNIP3 mRNA stability . YTHDF2 selectively bound to the N-terminal domain of m6A-containing mRNA and located the YTHDF2-mRNA complex to the cellular RNA decay sites . We further investigated whether YTHDF2 affected the BNIP3 mRNA expression level by m6A regulation. We found that overexpression of YTHDF2 had no significant effect in BNIP3 mRNA expression level in FTO-silencing cells, suggesting that FTO mediated m6A demethylation in BNIP3 mRNA to promote it stability via an YTHDF2-independent mechanism. In other words, elevated YTHDF2 expression in FTO silencing breast cancer cells could not inverse the increasing of BNIP3 mRNA expression, indicating the presence of alternative mechanism to stabilize m6A-modified BNIP3 mRNA. And it needs to be further investigated.
To determine whether BNIP3 was the main downstream target of FTO to regulate breast cancer initiation and progression, we generated double knockdown (shBNIP3 and shFTO) breast cancer cell lines. Our results showed that double knockout cells significantly alleviated the inhibitory effects on tumor growth mediated by FTO deficit, proving that FTO promoted breast tumor growth primarily via modulating BNIP3 expression by the m6A modification. Nonetheless, we found all the alleviations were limited that could not recur in the control group, which indicating that the FTO-m6A-BNIP3 signaling pathway may partially explain the effects on breast cancer initiation and progression caused by FTO. It would be very interesting to explore other potential molecular mechanisms involved in epigenetic modulation mediated by FTO.
In summary, we provided compelling evidence that FTO, the key m6A demethylase, was up-regulated in human breast cancer. High expression level of FTO was significantly associated with poor clinical outcome in human breast patients. FTO dramatically promoted breast cancer cell proliferation, colony formation and metastasis through epigenetically down-regulating BNIP3. FTO demethylated m6A in the 3’UTR of BNIP3 and caused its degradation. BNIP3 acted as tumor suppressor and alleviated FTO-dependent tumor growth and metastasis. Altogether, our findings suggest that FTO may serve as a novel potential therapeutic target for breast cancer.
We thank Dr. Xiongbin Lu (Indiana University School of Medicine, USA) and Dr. Yang Mao (Sun Yat-Sen University, China) for helpful discussions.
This work was supported in part by grants from National Natural Science Foundation of China 31701114 (G. Wan), 81602972 (X. Xiong); Science and Technology Planning Project of Guangdong Province 2017A010105004 (X. Wu), 2017A010103009, 2017B020227009 (B. Wei); Fundamental Research Funds for University-Key Cultivation Project of Young Teacher in Sun Yat-Sen University 17ykzd11 (G. Wan), Fundamental Research Funds for the Central Universities 16ykjc23 (B. Wei). The funders were not involved in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Availability of data and materials
Please contact the corresponding authors for all data requests.
GW, XW, BW and YN generated conception and designed this study. YN, ZL, AW and GW developed the methodology and performed the assays. HC, HL, LS, YW and XX analyzed and interpreted the data (e.g. statistical analysis and clinical analysis). XL, BW, HC and XW provided administrative, technical, or material support (e.g. tissue obtainment and database construction). YN and GW organized the data and wrote the manuscript. The study supervisors were GW, XW and BW. All authors reviewed the manuscript. All authors read and approved the final manuscript.
Ethics approval and consent to participate
All experiments were approved by the Ethics Committee of the Third Affiliated Hospital of Sun Yat-Sen University (No.2–145) and by the Animal Ethics Committee of Sun Yat-Sen University (No.03–07).
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All authors give consent for the publication of the manuscript in Molecular Cancer.
The authors declare that they have no competing interests.
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