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Citation: Huang R, Guo L, Chen C, Xiang Y, Li G, Zheng J, et al. (2023) System analysis identifies UBE2C as a novel oncogene target for adrenocortical carcinoma. PLoS ONE 18(8): e0289418. https://doi.org/10.1371/journal. pone.0289418

Editor: Romi Gupta, The University of Alabama at Birmingham (UAB), UNITED STATES Received: April 15, 2023 Accepted: July 18, 2023 Published: August 3, 2023

Copyright: @ 2023 Huang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability Statement: The data that support the findings of this study are available from https:// doi.org/10.6084/m9.figshare.23566341.v1.

Funding: This study was supported by the National Natural Science Foundation of China [82274512]; and the 2022 Joint funding of Guangzhou Science and Technology Bureau and Guangdong Provincial hospital [202201020327].the funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

RESEARCH ARTICLE

System analysis identifies UBE2C as a novel oncogene target for adrenocortical carcinoma

Renlun Huang1,2º, Lang Guo1,3º, Chiwei Chen1,2, Yuyang Xiang1,4, Guohao Li3, Jieyan Zheng1,2, Yanping Wu5, Xiu Yuan6, Jianfu Zhou1,2, Wenxi Gao3*, Songtao Xiang 1,2*

1 The Research Center of Integrative Cancer Medicine, Discipline of Integrated Chinese and Western Medicine, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China, 2 Department of Urology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China, 3 Department of Urology, Hubei Provincial Hospital of Traditional Chinese Medicine, Hubei University of Chinese Medicine Affiliated Hubei Hospital of Chinese Medicine, Wuhan, Hubei, China, 4 The Second Clinical College of Southern Medical University, Guangzhou, Guangdong, China, 5 First Clinical College and Affiliated Hospital, Hubei University of Traditional Chinese Medicine, Wuhan, Hubei, China, 6 Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China

@ These authors contributed equally to this work.

* gwx203@163.com (WG); tonyxst@gzucm.edu.cn (SX)

Abstract

Ubiquitin Conjugating Enzyme 2C (UBE2C) is an emerging target gene for tumor progres- sion. However, the tumorigenic effect and mechanism of UBE2C in adrenocortical carci- noma (ACC) remains unclear. Systematic investigation of the tumorigenic effect of UBE2C may help in understanding its prognostic value in adrenocortical carcinoma. First, we exploited the intersection on DFS-related genes, OS-related genes, highly expressed genes in adrenocortical carcinoma as well as differentially expressed genes (DEGs) between tumor and normal, and then obtained 20 candidate genes. UBE2C was identified to be the most significant DEG between tumor and normal. It is confirmed that high expression of UBE2C was strongly associated with poor prognosis in patients with ACC by analyzing RNA-seq data of ACC obtained from the Cancer Genome Atlas (TCGA) database imple- mented by ACLBI Web-based Tools. UBE2C expression could also promote m6A modifica- tion and stemness in ACC. We found that UBE2C expression is positively associated with the expression of CDC20, CDK1, and CCNA2 using ACLBI Web-based Tools, indicated the hyperactive cell cycle progression present in ACC with high UBE2C expression. In addition, UBE2C knockdown could significantly inhibit the proliferation, migration, invasion, EMT of adrenocortical carcinoma cells as well as the cell cycle progression in vitro. Notably, pan- cancer analysis also identified UBE2C as an oncogene in various tumors. Taken together, UBE2C was strongly associated with poor prognosis of patients with ACC by promoting cell cycle progression and EMT. This study provides a new theoretical basis for the development of UBE2C as a molecular target for the treatment of ACC.

Competing interests: The authors have declared that no competing interests exist.

Abbreviations: UBE2C, Ubiquitin Conjugating Enzyme 2C; DEGs, differentially expressed genes; EMT, epithelial-mesenchymal transition; mRNAsi, mRNA expression-based stemness index; ACC, Adrenocortical carcinoma; BLCA, Bladder Urothelial Carcinoma; BRCA, Breast invasive carcinoma; CESC, Cervical squamous cell carcinoma and endocervical adenocarcinoma; CHOL, Cholangio carcinoma; COAD, Colon adenocarcinoma; DLBC, Lymphoid Neoplasm Diffuse Large B-cell Lymphoma; ESCA, Esophageal carcinoma; GBM, Glioblastoma multiforme; HNSC, Head and Neck squamous cell carcinoma; KICH, Kidney Chromophobe; KIRC, Kidney renal clear cell carcinoma; KIRP, Kidney renal papillary cell carcinoma; LGG, Brain Lower Grade Glioma; LIHC, Liver hepatocellular carcinoma; LUAD, Lung adenocarcinoma; LUSC, Lung squamous cell carcinoma; OV, Ovarian serous cystadenocarcinoma; PAAD, Pancreatic adenocarcinoma; PCPG, Pheochromocytoma and Paraganglioma; PRAD, Prostate adenocarcinoma; READ, Rectum adenocarcinoma; SARC, Sarcoma; SKCM, Skin Cutaneous Melanoma; STAD, Stomach adenocarcinoma; TGCT, Testicular Germ Cell Tumors; THCA, Thyroid carcinoma; UCEC, Uterine Corpus Endometrial Carcinoma; UCS, Uterine Carcinosarcoma.

Introduction

Adrenocortical carcinoma (ACC) is an aggressive tumor originating in the adrenocortical cor- tex with a very low incidence about 0.5-1 per 1 million people [1] and poor prognosis with 5-year overall survival ranging from 16% to 47% [1, 2]. The 5-year survival rate of ACC at stage I is about 81%, but when the disease progresses to stage IV, the 5-year survival rate can be reduced to about 13% [3]. Disease progression is the main reason affecting the prognosis of ACC. Radical surgical excision is the only cure option for primary ACC [4]. However, the recurrence rate of ACC after surgical excision is highly [5]. Although it is prone to metabolic and endocrine toxicity, mitotane remain as the only drug approved for the treatment of advanced adrenocortical carcinoma and postoperative [6]. It follows that there is a lack of other effective drug for the treatment of ACC, so it is urgent to find new therapeutic targets. Hence, deciphering the complex molecular composition of ACC progression and developing targeted therapeutic agents, bioinformatics analysis as a convenient and effective strategy is a good choice to screen the available therapeutic targets.

Ubiquitination of modified proteins is an important cellular mechanism that targets the degradation of abnormal or short-lived proteins and plays an important role in tumor progres- sion [7]. UBE2C is a key member of the E2 ubiquitin-binding enzyme family, encoding pro- teins necessary for the destruction of target proteins [8]. Accumulating evidence suggested that overexpression of UBE2C can promote the proliferation of ACC by promoting the G2/M phase transition [9] and the activation of the Spindle and Kinechore-Associated (SKA) Com- plex [10]. Notably, the KRASG12D mutation can promote the expression of UBE2C to promote cell cycle progression and autophagy in lung cancer, which indicated that UBE2C is an attrac- tive carcinogenic genetic target for lung cancer with KRAS mutations [11]. A comprehensive bioinformatics analysis indicated the effect of UBE2C in promoting tumor progression [12], but the carcinogenic effect of UBE2C in ACC still needs to be further investigated.

In this study, we confirmed that UBE2C is a major response gene that affects the prognosis of ACC. In addition, we also explored the relationship between UBE2C expression and m6A methylation, proliferation-related and metastasis-related pathways in ACC. Moreover, in vitro experiments showed that UBE2C knockdown result in poor prognosis of ACC by inhibiting the proliferation, migration, invasion, epithelial-mesenchymal transition (EMT) of adrenocor- tical carcinoma cells as well as the cell cycle progression. And the pan-cancer analysis sug- gested that UBE2C is an oncogenic gene in various tumors. In conclusion, this study identified UBE2C as a novel oncogenic gene in promoting adrenocortical carcinoma progression and contributing to its poor prognosis.

Materials and methods

Research framework

Fig 1 showed the framework of this study.

Data retrieval, preprocessing, and analysis

Obtained from TCGA database (https://tcga-data.nci.nih.gov/tcga/), GEO database (http:// www.ncbi.nlm.nih.gov/geo), GTEx database (https://www.gtexportal.org/), these significant data were used to detect target genes related to poor prognosis in patients with ACC. These data were analyzed using R packages implemented by R version 4.0.3 (R foundation for statisti- cal computing, 2020). Conveniently, all above data retrieval, preprocessing, and analysis were performed in STRING (https://cn.string-db.org/), ACLBI Web-based Tools (https://www.aclbi. com/) or Xiantao Academic web-based Tools (https://www.xiantao.love/products).

A

B

Data Sources

The main responded gene

NIH

NATIONAL CANCER INSTITUTE GDC Data Portal

GEO Gene Expression Omnibus

Intersection genes related to poor prognosis in ACC

Groep ₿ Normal

Normal vs Tumor

UBE2C as the most DEG

12

Tumer

The diferent espredation of target genes

Öğrelated geres

9

STRING

0

4

GTEx Portal

The nabe of Tumor va Noena

DEOF

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29

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0

1

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2

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5

CONAZ

AURKE

FSCNY

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0

20

5

C

The expression of UBE2C related to poor prognosis

10.0

RiskType Hich Stoupa Low groups

I

7.5

Metastasis

5.0

High cxp

25

1.00

Overall survival probability

Log-rank P = 4.930-06 HR(High groups)=9.992

Alive

95%CI(3.722, 26.827)

1.00

II

+

0,75

Recurrenc

- High groups

10

· Dead

- Low groups

0,75

0.50

0.50

5

0.25

0.25

995000 753-1.0100

III

0

Groups

0.00

S-Years.AUCH0.855

Low exp

High groups Low groups

30 40

AT KS

0.00

05%C43 747-0.062)

e

0.00

0.25

0.50

0.75

1.00

Dead

0

2.5

5 7.5 Time (years)

10

12.5

False positive fraction

£2C

IV

pTNM_stage

newTumor

UBE2C

Status

1012

D

UBE2C promoted cell cycle progression and EMT in ACC

ceczr

CDICH

-

URA

si-UBE2C-2

-

-

si-UBE2C-1

0%.

ODC23

si Con

-

A

-

CONAZ

E-cad

A

I

6

de

A

-

COCHE

N-cad

-

-

Vimentin

**

M.

snail

-

-

MMP2

Cka

346

4

7

GAPDH

A

-

.

%

.

SW-13

1

siCon

si-UBEZC-1

si-UBERC-2

E

Pan-cancer analysis identified UBE2C as an oncogene in various tumors

UBERC log2;TPM-1)

12

**

-

Tumor

Overall survival defined by UBE2C

-

Progression-free survival defined by UBE2C

.5

Normal

=

-

UBE2C 1og2[TPM+1)

Overall Survival defined by UBE2C -

A

:

A

1

Da

S

ACC/T=79,N=250;

BUCA(1:408:N-40)

BRCA(T= 1037:10-572)

CESCIT-308,N-223

CHOL(T=36JPG)

COAD(T:45S,Nv820)

DLBC(T:4810-029)

ESCA(T=162.N= 1456)

GBM(T=153/4:2647)

HNSC(T-802:30-44)

KICH(T:63:N=113)

KIRC(T=530,N=161)

KIRP(T=286,N=121)

LAML(T=154:300)

LGG(1-510:30:2642)

LHC(T=371200276)

Porom survival

2

:

TOGA+GTER

ICGA-GTEx

Số 100

12.5

UBE2C log2;TFN+1)

12.5

Disease-free survival defined by UBE2C

UBERC log0( TPM+1)

100

10.0

6

=

-

0 0

LUACHT:5133-37)

LUSC(T=501,A=627)

MESO(TAB6,80)

OV(T-374,8x1801

PAAD(T=178.)=332)

PCPG(T=100N)=))

FRAD(=496:36297)

READ(T=165,N=789)

SARCIT-200,3829

SKCM(T=470)=1810)

STAD(T:3752:391)

TGCT(T=134N-361)

THCA(T=510,Nv/11)

THYM(T=119,N=2)

UCECIT-503,177

UCS(T-98,10-142)

Percent survival

WVM(T=802-0)

=

:

TOGA-GTER

TOGA+GTEx

0

$

Months

=

150

-

logFCP.Value
UBE2C5.2365941921.92E-25
CDC204.6099943518.72E-21
CDK14.4376580158.77E-22
CCNA23.8201557713.44E-18

Fig 1. Overview of the research design. (A) Data sources used in this research; (B) The main response genes related to poor prognosis in ACC were analyzed. (C) The expression of UBE2C is positively correlated with advanced clinicopathological characteristics and poor prognosis of ACC. (D) UBE2C expression can promote cell cycle progression and EMT. (E) Pan-cancer analysis identified UBE2C as an oncogene in various tumors.

Venn diagrams

In order to screen out the likely response gene, Venn diagrams were created to analyze the dif- ference between several dataset using a web-based tool (http://www.bioinformatics.com.cn/ static/others/jvenn/example.html).

mRNA expression-based stemness index (mRNAsi)

mRNA expression-based stemness index (mRNAsi) was identified as a measure of the tumor development according to the previously publication-n [13]. Based on the OCLR algorithm [13], the mRNAsi of ACC was calculated using ACC RNA-seq data obtained from TCGA data- base implemented by ACLBI Web-based Tools.

Cell culture

The ACC cell line SW-13 was purchased from the American Type Culture Collection (ATCC, Maryland, USA) and cultured in Leibovitz’s L-15 Medium (L-15, 11415064, Gibco, Grand Island, NY, USA) supplemented with 1% penicillin and streptomycin and 10% fetal bovine serum (Gibco). The culture of SW-13 cells needed to maintain at 37℃.

RNA interference

RNA interference (RNAi) was used to interfere with the expression of UBE2C in SW-13 cells. The siRNAs targeting UBE2C (TranSheepBio, Shanghai, China) and the scramble siRNAs were purchased. And then siRNAs targeting UBE2C were transfected into SW-13 cells using Lipofectamine™ 3000 (L3000015, ThermoFisher SCIENTIFIC) according to the manufactur- er’s instructions.

Cells counting

Cells proliferation was assessed using Neubauer counting chamber. First, RNAi technology was used to interfere with the UBE2C expression in SW-13 cells. Second, the treated SW-13 cells and non-treated SW-13 cells were seeded into the 6-well plates. Then, the SW-13 cells were digested with trypsin and resuspended in PBS. Finally, the proliferation of SW-13 cells was assessed by cell counting using Neubauer counting chamber.

Colony formation assay

The effect of UBE2C on the colony formation capabilities of SW-13 cells was detected as previ- ously described [14]. Briefly, the expression of UBE2C in SW-13 cells were interfered using RNAi technology. The non-treated SW-13 cells and treated SW-13 cells (500 cells/well) were planted in a 6-well plate. The resultant colonies were fixed with 4% paraformaldehyde, and then coomassie blue solution were used to fix and stain the resultant colonies.

Wound-healing assay and transwell assay

Wound-healing assay and transwell assay were performed as previously described [14] to detect the change of migration and invasion capabilities of SW-13 cells, respectively. In wound-healing assay, SW-13 cells in a logarithmic growth phase were collected to seeded in a 6-well plate. A wound was created mechanically using a 1 ml pipette tip. In transwell assay, the basement membrane was simulated using matrigel (354248, Corning, NY, USA).

Western blotting

Western blotting was carried out as previously reported [15]. The antibodies used for western blotting included C-myc (18583S, CST), Cyclin D1 (55506S, CST), UBE2C (14234S, CST), cleased-PARP-1 (5625S, CST), cleased-Caspase-7 (9491T, CST), E-cad (20874-1-AP, protein- tech), N-cad (22018-1-AP, proteintech), Vimentin (10366-1-AP, proteintech), snail (ab216347, abcam), MMP2 (ab92536, abcam), GAPDH (ab8245, abcam).

Statistical analyses

Statistical analyses in this study were carried out using the SPSS 24.0 software (Abbott Labora- tories, Chicago, USA). Data were shown as mean + SD. P-values less than 0.05 was identified to be statistically significant.

Results

UBE2C expression strongly associated with advanced histopathological characteristics and poor prognosis of adrenocortical carcinoma (ACC)

In order to detect the main response gene strongly associated with poor prognosis in patients with ACC, we analyzed the intersection of four gene clusters including DFS-relates genes, OS- relates genes, differentially expressed genes (DEGs), and highly expressed genes. The volcano plot showed the DEGs of the patients with ACC (Fig 2A and S1 Table). After exploiting the intersection, we obtained 20 candidate genes in ACC including CDC20, NUF2, BUB1, CCNA2, LMNB1, PTTG1, FSCN1, MELK, KIF11, CEP55, CDCA3, TROAP, CDKN3, CCNB2, CDT1, AURKB, CDT1, AURKB, BIRC5, UBE2C, CENPM, KIF4A (Fig 2B and S2 Table). To identify the major response gene affecting prognosis in patients with ACC, GO and KEGG pathways enrichment analysis were used to analyze the activated signaling pathways accompanied by the highly expression of these candidate genes (Fig 2C). Notably, UBE2C was the most significant DEG between ACC and normal (Fig 2D and $3 Table). We also found that UBE2C was highly expressed in ACC especially in stage III and stage IV using Xiantao Academic Web-based Tools (Fig 3A). To further study the correlation between UBE2C expression and histopathological characteristics of ACC, we tested UBE2C within the ACC dataset to better describe its func- tionality (Fig 3B and S4 Table). These analyses confirmed that ACC patients with high UBE2C expression tended to have a poor prognosis compared to those with low UBE2C expression (Fig 3C-3E). Taken together, UBE2C was highly expressed and strongly correlated with poor prognosis in patients with ACC.

UBE2C expression promoted m’A methylation and stemness in ACC

In order to understand the mode of UBE2C regulating downstream pathway, we explored the correlation between UBE2C expression and m6A methylation in ACC. Based on the identifica- tion and analysis of the m6A methylation regulators by Juan Xu’s research [16], a circle was used to describe the interaction of expression on 20 m6A regulators in ACC using ACLBI Web-based Tools (Fig 4A). And then the expression levels of UBE2C were categorized into two groups including G1 group (above 75th percentile of UBE2C expression) and G2 group (below 25th percentile of UBE2C expression). The result showed that G1 group contained 16 significantly overexpressed m6A regulators compared with G2 group (Fig 4B and S5 Table). We found that UBE2C expression was positively associated with the mRNAsi in ACC using ACLBI Web-based Tools, which suggested that UBE2C may lead to poor prognosis in patients with ACC via promoting self-renewal of ACC stem cells (Fig 4C and 4D).

Fig 2. Differentially expressed genes in ACC and functional enrichment analysis. (A) Volcano plot: blue dots point different down-regulated genes and red dots point different up-regulated genes in ACC; (B) Venn diagrams: intersected with the DEGs, High-expression genes, OS-related genes, and DFS-related genes in ACC; (C) GO enrichment analysis and KEGG enrichment analysis of the 20 candidate genes; (D) the expression comparison of the 20 candidate genes between normal obtained for GTEx database and tumor obtained for TCGA database. * P < 0.05, ** P < 0.01, *** P < 0.001, the asterisk represents the degree of statistical significance (*P).

A

B

Up

Stable

60

Down

OS-related genes

DEGS

-log10 (p-value)

DFS-related genes

288

2526

High-expresstion genes

40

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130

20

491

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307

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cysteine-type endopeptidase inhibitor activity.

0.02

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mitotic nuclear division.

mitotic sister chromatid segregation.

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GeneRatio

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GeneRatio

Group

Normal

12

Tumor

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The ratio of Tumor vs Normal

The different expresssion of target genes

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UBE2C

CDT1

PTTG1

CDKN3

KIF11

KIF4A

CEP55

MELK

BUB1

LMNB1

BIRC5

NUF2

CENPM

CCNB2

CDC20

TROAP

CCNA2

AURKB

CDCA3

FSCN1

0

UBE2C

FSCN1

PTTG1

CDC20

CCNA2

BIRC5

CDT1

LMNB1

AURKB

CCNB2

TROAP

MELK KIF11

CEP55

CDKN3

CENPM

NUF2

CDCA3

KIF4A

BUB1

https://doi.org/10.1371/journal.pone.0289418.g002

Fig 3. UBE2C expression indicated advanced clinical characteristics in ACC. (A) the expression of UBE2C in different tumor status and different pathologic stages; (B) Sankey diagram: each column represents a characteristic variable, different colors represent different types or stages, and the lines represent the distribution of the same sample in different characteristic variables; (C) the relationship between UBE2C expression and survival time as well as survival status in ACC; (D) the KM survival curve of the UBE2C in ACC; (E) the ROC curve and AUC value of the UBE2C at different times in ACC. * P < 0.05, ** P < 0.01, *** P < 0.001, the asterisk represents the degree of statistical significance (*P).

A

B

8

**

12

The expression of UBE2C Log2 (FPKM+1)

The expression of UBE2C Log2 (FPKM+1)

I

10

Metastasis

6

High exp

8

**

Alive

II

**

Recurrence

4

6

ns

4

III

Low exp

2

Dead

2

IV

0

0

Tumor free

With tumor

Stage I

Stage II Stage III Stage IV Pathologic stage

pTNM_stage

newTumor

UBE2C

Status

Tumor status

C

D

1.00

Log-rank P = 4.93e-06

10.0

RiskType

. High groups

Log2(TPM+1)

Overall survival probability

HR(High groups)=9.992 95%CI(3.722, 26.827)

. Low groups

0.75

!!

7.5

- High groups

+

- Low groups

0.50

5.0

0.25

2.5

0.00

Median time:2.6

Status

Groups

High groups

39

17

4

2

0

0

Alive

· Dead

Low groups

40

33

8

4

10

20

2

0

2.5

5

7.5

10

12.5

Time

E

Time (years)

5

1.00

0

True positive fraction

0.75

0.50

Type

UBE2C

1-Years,AUC=0.885

95%CI(0.753-1.018)

0.25

3-Years,AUC=0.936

95%CI(0.888-0.985)

5-Years,AUC=0.855

0.00

95%CI(0.747-0.962)

z-score of expression

-1012

0.00

0.25

0.50

0.75

1.00

False positive fraction

https://doi.org/10.1371/journal.pone.0289418.g003

UBE2C expression activated the molecular pathways of cell cycle, proliferation, and metastasis

At first, a previously published geneset [17] was analyzed for understanding the correlation between UBE2C expression and the activation of several signaling pathway in ACC implemented by ACLBI

Fig 4. UBE2C expression promoted m6A methylation and stemness in ACC. (A) The correlation of expression on 20 m6A regulators in ACC. The size of each circle represents the prognosis of each m6A regulator and scaled through P-value. The m6A regulating protein of three RNA modifies is represented by different colors of circles. The line connecting the m6A regulators represents the interaction between them. (B) Heatmap: A heatmap of m6A-related gene expression, in which different color represent expression trends in different groups. G1 group was defined as above 75th percentile of UNE2C expression, and G2 group was defined as below 25th percentile of UNE2C expression. (C) The correlation between UBE2C expression and mRNAsi of ACC. (D) As described above, comparison of mRNAsi between G1 group and G2 group. * P < 0.05, ** P < 0.01, *** P < 0.001, the asterisk represents the degree of statistical significance (*P).

A

B

Group

Group G1 G2

METTL3 ***

7.47e-04

3

ZC3H13*

3.26e-02

2

GF2BP GF2BP

8.34e-08

1

F2BP3

RBM15 ***

WTAP ***

8.36e-04

0

RBMX

HORNPO

RBM15B ***

7.94e-05

-1

YTHDO

HINRN

VIRMA ***

5.31e-04

-2

B1

-3

YTHDF3 **

2.64e-03

YTHDO

FTO

RBMX ***

1.13e-06

HNRNPC ***

2.40e-06

YTHDF

ALKBH5

Writers

HNRNPA2B1 ***

3.29e-07

Readers

YTHDC1 **

2.91e-03

YTHDF2

31113

Erasers

YTHDF2 **

1.16e-03

Positive correlation with P < 0.001

YTHDF1 **

4.27e-03

ALKBH5 **

2.39e-03

YTHDF3

WIAP

Negative correlation with P < 0.001

METTL14

2.01e-01

METTL14

IRMA

logrank test, P

YTHDC2

1.65e-01

METTL3

3.41e-01

RBMIS

BM15B

FTO

0.05

☐ 0.001 ☐ le-05

IGF2BP2 **

6.14e-03

IGF2BP1 **

5.99e-03

IGF2BP3 **

9.77e-03

C

D

log.(S)=10.69, p=1.64e-05, @spearman= 0.46, Cl950% [0.26, 0.63], “pairs = 79

wilcox.tests p=2.1e-05


1.00

1.00 -

0,75

0.75 -

..

mRNAsi score

Group

mRNAsi

..

0.50

G1

G2

0.50 -

..

..

0.25 -

0.25

0.00 -

0.00

2.5

5.0

7.5

10.0

Log2 (UBE2C expression)

G1

G2

https://doi.org/10.1371/journal.pone.0289418.g004

Web-based Tools, and the results showed that UBE2C expression was positively correlated with the activation of cell cycle, proliferation, and metastasis (Fig 5). To further explore the downstream sig- naling pathways activated by UBE2C, we analyzed DEGs between G1 group and G2 group as described above (Fig 6A-6C and S6 Table). Based on STRING protein-protein interaction network [18], we found that there are 10 candidate proteins closely related to UBE2C protein expression (Fig 6D). And based on LogFC and P-value (LogFC ≥ 2 or LogFC ≤-2, P-value < 0.05), we identified 349 significantly DEGs (Fig 6E). And then, we screened out a cluster containing 4 genes related to cell cycle by intersecting the two data sets (Fig 6E and S7 Table).

Fig 5. UBE2C expression was correlated with the activation of several signal pathway in ACC.

log.(S)=11.48.p = 0.091. [[pouren”=0.19, Class[-0.40,0.04], figar=79

log. (S) = 11.13, p= 0.134, Bspearman=0.17, Class[-0.06,0.38], figars=79

log.(S) = 7.84,p = 1.77e-48, Buceomen” 0.9Z Clayu[0.95,0.98]. rgan=79

log.(S) - 11.06, p=0.045, Pracaman”0.23, Clos.[0.00,0.43], Fpsis ” 79

0.5.

0.8.

1.00.

Tumor_Inflammation_Signature

Cellular_response_to_hypoxia

0.80+

Tumor_proliferation_signature

0.4.

0.6.

0.75.

EMT_markers

..

..

0.78+

0.3.

0.50.

0.4 .

0.76+

..

0.2.

0.25.

..

0.2.

2.5

Log2 (UBE2C TPM + 1)

5.0

7.5

10.0

0.74+

2.5

Log2 (UBE2C TPM + 1)

5.0

75

10.0

2.5

5.0

7.5

10.0

2.5

7.5

10.0

Log2 (UBE2C TPM + 1)

Log2 (UBE2C TPM + 1)

5.0

log.(S) = 11.11,p = 0.099, Bspearman=0.19, Class[-0.04,0.40], ripan= 79

log.(S) = 11.12.p = 0.124, Bspcama= 0.17, Class[-0.05,0.39], ngain=79

log.(S) = 11.47, p = 0.136, 1 spearman= = 0.17, Class[-0.38, 0.06], ngan= 79

log.(s) =9.79, p=1.74c-17, 8 spearman= 0.78, Class/0.67, 0.86], [gain=79

0.75-

0.75.

0.3.

0.70-

0.78.

ECM-related_genes

0.70+

0.2.

Angiogenesis

0.65-

8

8

Apoptosis

DNA_repair

0.76-

0.60-

0.1.

0.65+

%

&

.

0.55-

0.74.

. .

..

9

0.0.

0.50-

..

0.60-

%

0.72.

2.5

5.0

75

10.0

0.45.

Log2 (UBE2C TPM + 1)

2.5

5.0

7.5

10.0

2.5

5.0

7.5

10.0

2.5

5.0

7.5

Log2 (UBE2C TPM + 1)

Log2 (UBE2C TPM + 1)

10.0

Log2 (UBE2C TPM + 1)

log.(S) = 8.64,p= 1.87e-35, @speaman=0.93, Class.(0.89,0.96], ngan= 79

log.(S) = 11.48, p = 0.129, 6spramun= = 0.17, Class[-0.38, 0.06], ngain= 79

log.(s) = 11.06, p =0.047, [spearman=0.22, CI gos [0.00,0.43], ngain= 79

log.(S) = 11.50,p = 0.082, spearman == 0,20, Class[-0.41,0,03], (gars= 79

0.8.

0.6.

0.68+

0.5.

0.7.

~0.66+

0.70.

G2M_checkpoint

Inflammatory_response

PI3K_AKT_mTOR_pathway

P53_pathway

0.4.

0.64.

60.6.

0.65.

..

0.3.

0.62+

0.5.

0.2.

.

2.5

5.0

7.5

10.0

2.5

5.0

7.5

10.0

2.5

5.0

7.5

10.0

2.5

5.0

Log2 (UBE2C TPM + 1)

7.5

10.0

Log2 (UBE2C TPM + 1)

Log2 (UBE2C TPM + 1)

Log2 (UBE2C TPM + 1)

log.(s) = 9.50, p= 1.860-15, Papaman=0.75, Cios[0.63,0.83]. mais = 79

log.(s) = 11.37, p= 0.621, pipewww/F-0.06, Class.[-0.28,0.17], [pains=79

log, (s) = 11.55,p=0.020, Tapewwan == 0.26, Class[-0.46,-0.04], [gains=79

log.(S) = 11.65, p=2.74e-04, Psptamar?” -0.40, Clos[-0.57,-0.19], rgan=79

IL-10_Anti-inflammatory_Signaling_Pathway

Genes_up-regulated_by_reactive_oxigen_species_(ROS)

0.76.

0.900·

0.8.

0.81.

0.875·

0.72.

..

0.7.

MYC_targets

%

-

TGFB

9

:

0.78.

0.850.

0.68+

0.6.

0.75.

..

0.825·

0.5.

0.64-

..

2.5

5.0

7.5

10.0

2.5

5.0

7.5

10.0

2.5

5.0

7.5

10.0

2.5

5.0

7.5

Log2 (UBE2C TPM + 1)

10.0

Log2 (UBE2C TPM + 1)

Log2 (UBE2C TPM + 1)

Log2 (UBE2C TPM + 1)

log.(s) = 9.19.p = 9.310-27, Pipewwan=0.88, Cl spu.[0.82,0.92]. ngang=79

log.(S) = 11.01.p=0.018, Bupewne == 0.27, Chytr: [0.04,0,46], ngang= 79

log.(S) = 11.04.p=0.000, Pipeamas =0.24, Clos [0.02 0.45]. Physis = 79

0.75.

DNA_replication

0.70-

Collagen_formation

0.5.

Degradation_of_ECM

0.4.

..

..

0.65.

8 0.4.

0.3+

0.60.

..

A

0.55.

0.3.

25

5.0

7.5

Log2 (UBE2C TPM + 1)

10.0

2.5

7.5

Log2 (UBE2C TPM + 1)

5.0

10.0

2.5

7.5

Log2 (UBE2C TPM + 1)

5.0

10.0

https://doi.org/10.1371/journal.pone.0289418.g005

A

B

25

P

1

UBE2C

group

3

group

Down-regulation

0

2

GI

None

TROAP 0

G2

Up-regulation

1

CDKI

8

0

20

0

MK167

00

-1

O

PBK

-Log10 (P-value)

CEP55

90

MYBL.2

-2

O

-3

15

0

TKI

.

.

10

5

0

-1

0

1

5

Log2 (Fold change)

C

GO (Up)

GO (Down)

viral transcription

xenobiotic metabolic process

viral gene expression-

terpenoid metabolic process-

sister chromatid segregation-

steroid metabolic process-

ribosome biogenesis-

retinol metabolic process

ribonucleoprotein complex biogenesis-

-log10(p.adjust)

retinoid metabolic process-

Count

regulation of mitotic cell cycle phase transition-

retinoic acid metabolic process-

3

regulation of mRNA metabolic process

response to xenobiotic stimulus

6

regulation of cell cycle phase transition-

16

oxidative demethylation- ·

9

nuclear-transcribed mRNA catabolic process-

organic acid biosynthetic process-

12

nuclear division-

monocarboxylic acid biosynthetic process-

nuclear chromosome segregation-

Count

long-chain fatty acid metabolic process-

-log10(p.adjust)

ncRNA metabolic process-

lipid modification

mitotic sister chromatid segregation-

100

3.5

mitotic nuclear division-

125

fatty acid metabolic process-

fatty acid biosynthetic process-

3,0

mRNA catabolic process-

150

175

drug metabolic process

2.5

chromosome segregation

200

diterpenoid metabolic process

2.0

RNA splicing, via transesterification reactions-

cellular response to xenobiotic stimulus-

RNA splicing

cellular modified amino acid metabolic process

RNA catabolic process

cellular hormone metabolic process

DNA replication

carboxylic acid biosynthetic process-

0.02

0.03

0.04

0.05

0.06

0.025

0.050

0.075

0.100

Enrichment Ratio

Enrichment Ratio

0.125

D

E

CDC27

UBA1

CDK1

CDC23

CDC20

ANAPC10

UBE2C

A

345

4

7

ANAPC2

CCNA2

CDC16

ANAPC11

?

logFCP.Value
UBE2C5.2365941921.92E-25
CDC204.6099943518.72E-21
CDK14.4376580158.77E-22
CCNA23.8201557713.44E-18

Fig 6. UBE2C expression with the activation of the molecular pathways of cell cycle, proliferation, and metastasis. (A) Volcano plot: blue dots point different down-regulated genes and red dots point different up-regulated genes; (B) Heatmap: DEGs between G1 group and G2 group. G1 group was defined as above 75th percentile of UNE2C expression, and G2 group was defined as below 25th percentile of UNE2C expression as described above; (C) GO enrichment analysis of these genes; (D) 10 candidate proteins related to UBE2C protein were identified using STRING database; (E) Venn diagrams: the intersection between 11 candidate proteins obtained from STRING database and 349 candidate genes obtained from significant DEGs between G1 group and G2 group.

https://doi.org/10.1371/journal.pone.0289418.g006

Pan-cancer analysis identified UBE2C as an oncogene in various tumor

In this paper, pan-cancer analysis using TCGA dataset and GTEx dataset were all implemented by ACLBI web-based Tools. We found that UBE2C is almost overexpressed in all tumor includ- ing ACC, BLCA, BRCA, CESC, CHOL, COAD, DLBC, ESCA, GBM, HNSC, KICH, KIRC, KIRP, LGG, LIHC, LUAD, LUSC, OV, PAAD, PCPG, PRAD, READ, SARC, SKCM, STAD, TGCT, THCA, UCEC, and UCS by means of the comparison on UBE2C expression between the tumor and normal obtained from TCGA dataset and GTEx dataset, respectively (Fig ZA). Moreover, UBE2C expression will leads to poor prognosis in various tumors (Fig 7B and 7C). More importantly, we found that UBE2C expression is positively associated with hyperactive MSI as well as TMB, especially in ACC (Fig 7D). This may imply that UBE2C can be used as a predictor of the efficacy of immunotherapy for patients with ACC. The relationship between UBE2C expression and immune infiltration in various tumors were also explored. And we found that UBE2C overexpression was positive correlation with the infiltration of Th1, Th2 as well as negative correlation with the infiltration of Treg, M2 macrophages (Fig 7E). But the relation between the Th1/Th2 immune balance and ACC progression need more studies. In conclusion, we found that UBE2C was highly expressed in various tumors and strongly associ- ated with poor prognosis, but also predicted the hyperactivity of MSI and TMB, especially in ACC.

UBE2C knockdown weakened proliferation, migration, and invasion via inhibiting ACC cycle progression and EMT in vitro

At first, we assessed the effects of UBE2C on adrenocortical carcinoma cell growth. Morpho- logical changes of SW-13 cells showed that transfected with control or UBE2C siRNAs strongly inhibited proliferation of adrenocortical carcinoma cell (Fig 8A). The clone formation assays further verified the promoting effect of UBE2C on the proliferation of SW-13 cells (Fig 8B). To test our hypothesis that UBE2C is involved in tumor invasion, siRNAs were used to transiently silence UBE2C expression. And then the effect of UBE2C on migration and invasion in adre- nocortical carcinoma cell were further investigated. Transwell assay results demonstrated that UBE2C siRNAs stimulation remarkably suppressed the invasion of adrenocortical carcinoma cell compared to treated with a scramble siRNA (Fig 8C). We assessed migration capacity through wound-healing assays in vitro with taking a picture and calculating the distance trav- elled at a 0-hour, 24-hour and 48-hour time point. Compared to SW-13 cells treated with a scramble siRNA, those receiving UBE2C siRNAs stimulation travelled a shorter distance (Fig 8D). For tumor invasion requiring both degradation of ECM components and cell migration, we performed western blotting and found that UBE2C knockdown indeed inhibited EMT of adrenocortical carcinoma cells, manifested as the decreased expression of N-cad, Vimentin, snail, MMP2 and increased expression of E-cadherin (Fig 8E). Moreover, western blotting indicated that UBE2C siRNAs can inhibit proliferation, inhibit damage repair of DNA, and induced apoptosis in ACC cells, characterized by the increased expression of cleased-Caspase- 7 as well as the decreased expression of cleased-PARP-1, C-myc, cyclin D1 (Fig 8F). In conclu- sion, these results demonstrated that UBE2C knockdown can weaken proliferation, migration, and invasion of adrenocortical carcinoma cell via inhibiting cycle progression and EMT.

Discussion

Adrenocortical carcinoma is a rare tumor with a very low incidence. However, patients with adrenocortical carcinoma usually have poor prognosis. When patients with adrenocortical car- cinoma progressed from the stage I to the stage IV, the 5-year survival rate would be reduced

A

B

UBE2C log2(TPM+1)

12

**



UBE2C log2(TPM+1]

Overall survival defined by UBE2C

10.0


Tumor

8

7.5

Normal

9

5.0

PIHRAD

BRCA(T=1097;N=572)

Percent survival

nhigh()=2376

4

2.5

0

0.0

ACC(T=79;N=258)

BLCA(T=408;N=40)

CESC(T=306;N=22)

CHOL(T=36;N=9)

COAD(T=455;N=820)

DLBC(T=48;N=929)

ESCA(T=162;N=1456)

GBM(T=153;N=2647)

HNSC(T=502;N=44)

KICH(T=65;N=113)

KIRC(T=530;N=161)

KIRP(T=288;N=121)

LAML(T=151;N=0)

LGG(T=510;N=2642)

LIHC(T=371;N=276)

2

0

0

50

100

50 200

250

300

350

Months

TCGA+GTEx

TCGA+GTEx

Disease-free survival defined by UBE2C

12.5

UBE2C log2[TPM+1)

12.5




UBE2C log2(TPM+1)

9

10.0

10.0

Logrank pup

7.5

7.5

2

Percent survival

5.0

5.0

0

mow)-2375

2.5

2.5

2

0.0

0.0

LUAD(T=513;N=637)

LUSC(T=501;N=627)

MESO(T=86;N=0)

OV(T=374;N=180)

PAAD(T=178;N=332)

PCPG(T=180;N=3)

PRAD(T=496;N=297)

READ(T=165;N=789)

SARC(T=260;N=2)

SKCM(T=470;N=1810)

STAD(T=375;N=391)

TGCT(T=134;N=361)

THCA(T=510;N=711)

THYM(T=119;N=2)

UCEC(T=543;N=177)

UCS(T=56;N=142)

UVM(T=80;N=0)

8

p

50

100

150

200

250

Months

TCGA+GTEx

TCGA+GTEx

C

D

Correlation between UBE2C and MSI

Overall survival defined by UBE2C

Progression-free survival defined by UBE2C

ACC

MESO

-log10(p-value)

SE

SLAD

TNM

BLCA

2

Correlation

· 0.05

PAAD GBM

· 0.10

· 0.15

CHOL

sapr

· 0.20

LUAD

PRAD

ESCA

TGCT

KIRP

SKCM

OV

HINSC

LGG

BET

READ

DIBe

BLOC

CESC

COAD

-0.1

0.0

0.1

0.2

Correlation between UBE2C and TMB

PAAD

-log10(p-value)

LUAD

7.5

15

BRCA

PRAD

Y

2.5

SARC

KICH LGG

Correlation

STAD

· 0.2

CHOL

· 0.4

BLCA

· 0.6

LUSC

MESO

KIRC

UCS

SKCM

UVM

PAP

GBM

PCPG

READ

CESC

HN &

UCEC

TGCT

0.036033456789 11 13 15 17 19 Hazard Ratio

0.3125

LIHC

2 3 4

Hazard Ratio

ESCA

KIRP

COAD

THYM

E

-0.50

-0.25

0.00

0.25

0.50

stroma score

* p < 0.05

microenvironment score

immune score

** p < 0.01 p<0.001

T cell regulatory (Tregs)

T cell gamma delta



T cell NK


Correlation

T cell CD8+ naive

T cell CD8+ effector memory

0.8

T cell CD8+ central memory

0.4

T cell CD8+

0.0

T cell CD4+ naive


T cell CD4+ memory

-0.4

T cell CD4+ effector memory ***

T cell CD4+ central memory

T cell CD4+ Th2

T cell CD4+ Thi ***

T cell CD4+ (non-regulatory)

Plasmacytold dendritic cell

Neutrophil NK cell

Myeloid dendritic cell activated

Myeloid dendritic cell


Monocyte

Mast cell **


Macrophage M2

Macrophage M1

Macrophage

Hematopoietic stem cell

Granulocyte-monocyte progenitor

Eosinophil

Endothelial cell

Common myeloid progenitor

Common lymphoid progenitor

Class-switched memory B cell

B cell plasma

B cell naive

B cell memory

B cell

ACC

BLCA

BRCA

CESC

CHOL

COAD

DLBC

ESCA

GBM

HNSC

KICH

KIRC

KIRP

LAML

LGG

LIHC

LUAD

LUSC

MESO

OV

PAAD

PCPG

PRAD

READ

SARC

SKCM

STAD

TGCT

THCA

THYM

UCEC

UCS

UVM

XCELL

CancerPvalueHazard Ratio(95% CI)
ACC<0.00017.53042(3.00242.18.88713)
BLCA0.5410.91236(0.6799,1.2243)
BRCA0.03961.40483(1.08626,1.94197)
CESC0.93011.02098(0 64194,1.62385)
CHOL0.37081.54796(0.5946,4.02991)
COAD0.64921.0948(0.74103,1.61745)
DLBC0.68350.74063(0.17482,3.13756)
ESCA0.19191.39263(0.84685.2.29029)
GBM0.65890.92258(0.64507.1.31947)
HNSC0.60721.07269[0.82089,1.40173)
KICH0.11683.5179(0.73047,16.94203)
KIRC<0.00012.35792(1.70902,3.25318)H
KIRP30-043.56766(1.80248,7,06149)
LAML0.36370.82274(0.54005.1.25342)
LGG<0.00012.4858(1.69163,3.65282)-
LIHC0.03251.461 16(1.03203,2.06873)
LUAD0.00491.5263(1.13703,2.04883)
LUSC0.52960.91685(0.69944.1.20184)
MESO<0.00013.32015(2.01772.5.4633)
0.80051.03416(0.79701,1.34186)
PAAD0,0071.76976(1.16844.2.68054)
PRAD0.1292.9522(0.72977.11.94274)
READ0.70851.16399(0.52513,2.5801)
SARC0.19071.30256(0.87672,1.93524)
SKCM0,0171.38793(1.06035.1.81671)
STAD0.79820.95826(0.69115.1.3286)
TGCT0.74450.71632(0.09633.5.32657)
THCA0.42231.51447(0.54951,4.17397)
THYM0.03570.17924(0:03603,0,89173)
UCEC0.00611.83146(1.1881,2.82321)
UCS0.66950.86293(0.43849,1.69823)
UVM0.05332.35483(0.988,5.61257)TTTTTTTTTTTTTTm
CancerPvalueHazard Ratio(95% CI)
ACC4c-043.25309(1.68492.6.28076)
BLCA0.67561.06588(0,7906,1,437)
BRCA0.02151.47137(1.05868.2.04494)
CESC0.21421.34126(0.84395.2.13161)
CHOL0.19971.80151(0.73269.4.42946)
COAD0.51690.88918(0.62334,1.2684)
DLBC0.94721.04149(0,31253.47105)
ESCA0.15711.38313(0.88258.2.16757)
GBM0.08760.73102(0.51027.1.04727) H
HNSC0.18371.2119(0.91288.1.60888)
KICH0.29431.93051(0.56472,6.59956)
KIRC40.00013.19513(2.24956.4.53815)
KIRP<0.00013.51068(1.94117.6.34919)
LGG50-041.6695(1.24955,2 2306)
LIHC3c-041.72377(1.28171.2.31829)-
LUAD0.11821.24388(0,94596,1.63563)
LUSC0.71391.06272(0.76763.1.47126)
MESO0.00182.40485(1.38489.4.17601)
OV0.39260.90116(0.70987,1.14399)
PAAD0.00571.72929(1.17267,2.55012)
PCPG0.06822.41501(0.93623.6.22949)
PRAD<0.00012.70933(1.74072,4 2169)
READ0.66031.1564(0.6049.2.21973)
SARC0.04941.39778(1.00085.1.95214)
SKCM0.04341.20032(1.00683.1.57363)
STAD0.45960.87545(0.61535.1.2455)
TGCT0.27391.46299(0.74002.2.89226}
THCA0.00212.50265(1.39535.4.48865)
THYM0.59331.27924(0.51809,3.15867)
UCEC30-041.99268(1 376.2.88576)
UCS0.33881.37933(0.71363.2.66602)
UVM0.00463.15255(1.42421,6.97831)

Fig 7. Pan-cancers analysis of UBE2C. (A) the different expression of UBE2C in 33 tumors. (B) the overall survival and disease-free survival defined by UBE2C in pan-cancer. (C) Forest plot: P-value, risk factor HR, and 95% confidence interval of the overall survival and disease-free survival defined by UBE2C in 33 tumors. (D) Spearman correlation analysis of UBE2C expression with MSI and TMB. The abscissa and the size of the dots in the figure represent the correlation coefficient, and the ordinate represent different tumors. The different colors represent the P-value; (E)

Heatmap plot: spearman correlation analysis between immune infiltration scores and UBE2C expression in 33 tumor tissues using XCELL method. * P < 0.05, ** P < 0.01, *** P < 0.001, the asterisk represents the degree of statistical significance (*P).

https://doi.org/10.1371/journal.pone.0289418.g007

by more than 60%. Unfortunately, only mitotane with limited therapeutical effects can be used for patients with advanced adrenocortical carcinoma or postoperative recurrence. Hence, it is a major challenge for the scientific community to develop more safe and more effective anti- ACC drugs. A new understanding of pathogenesis and an in-depth exploration of novel drug targets are urgently needed in ACC to find anti-cancer drugs.

It is helpful to excavate potential oncogene and to better integrate biological evidence for understanding the mechanism of tumor progression using web-based tools or database. We screened out 20 oncogenes including CDC20, NUF2, BUB1, CCNA2, LMNB1, PTTG1, FSCN1, MELK, KIF11, CEP55, CDCA3, TROAP, CDKN3, CCNB2, CDT1, AURKB, CDT1, AURKB, BIRC5, UBE2C, CENPM, KIF4A by analyzing TCGA data sets and GTEx data sets implemented by ACLBI Web-based Tools. We not only found these 20 oncogenes were highly expressed in tumor tissues, but also study the differential expression levels of these genes between tumor and normal. These results identified UBE2C as the significant DEG between tumor and normal.

Ubiquitin-proteasome system (UPS) is one of the major pathways for protein degradation through a series of steps such as substrate recognition, ubiquitin coupling and proteasome- ubiquitinated substrate degradation [19, 20]. Unlike autophagy, UPS primarily degrades single unfolded peptides with capacity of entering narrow channels of the proteasome [21]. Human UBE2C (also known as UBCH10) is located on chromosome 20q13.12 [22]. UBE2C can pro- mote anaphase-promoting complex (APC/C) specifically combine with protein degradation pathway, and plays a key role in regulating the cell cycle, apoptosis, and transcriptional pro- cesses by catalyzing degradation of proteins [8, 23, 24]. APC/C, a multi-subunit complexes, can accelerate the mitotic progression from metaphase to anaphase by catalyzing the multi- ubiquitination of key regulatory factors in the cell cycle [25]. Hence, the abnormal expression of UBE2C will cause the hyperactivity of the APC/C-dependent ubiquitination in tumor cells, which accelerates the cell cycle and eventually leads to malignant transformation. It is well known that the KRASG12D target have ushered in a new era in the treatment of KRAS-mutant oncology drugs [26]. Remarkably, a study discovered that KrasG12D mutation regulates the cell cycle by promoting the expression of UBE2C, which ultimately promotes tumor cell growth [11]. That validates UBE2C as a potential therapeutic target for lung cancer with KRASG12D mutations. Accumulating evidence also suggested that the high expression of UBE2C is strongly related to poor prognosis in patients with breast cancer [24, 27], lung adenocarcinoma [28] or gastric cancer [29]. On the one hand, based on the description of hallmarks of cancer proposed by Professor Douglas Hanahan [30], it has been confirmed that UBE2C can promote tumor growth [31], angiogenesis [32], tumor metastasis [33, 34], anchorage-independent growth [35], stemness [36], resist apoptosis [37, 38], induce immunosuppressive microenvi- ronment [39], and enhance glycolytic activity [40, 41]. On the other hand, high expression of UBE2C will lead to treatment failure attributed to overactive anchorage-independent growth and reduced oxidative stress-induced cell apoptosis resulting in chemotherapy resistance [35], and reduce radiosensitivity [38], respectively. In short, a series of studies shown that UBE2C is highly expressed in tumors tissues and able to promote tumor progression.

In this study, we identified UBE2C as a potential oncogene after analyzing the TCGA data- set implemented by ACLBI Web-based Tools. Interestingly, we found that UBE2C only signifi- cantly expressed in patients with ACC stage III and stage IV using Xiantao Academic Web-

Fig 8. UBE2C knockdown weakened proliferation, migration, and invasion. (A) Morphological changes of SW-13 cells transfected with control or UBE2C siRNA. (B) SW-13 cells were transfected with control or UBE2C siRNA, and colonies were counted after 14 days. (C) SW-13 cells were transfected with control or UBE2C siRNA, and cell invasion was determined by transwell assay. (D) SW-13 cells were transfected with control or UBE2C siRNA, and cell migration was detected by wound healing assay. (E-F) Western blotting assay of the indicated proteins in SW-13 cells were transfected with UBE2C or control siRNA for 48 h. * P < 0.05, ** P < 0.01, *** P < 0.001, the asterisk represents the degree of statistical significance (*P) (n = 3).

A

150

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siCon

si-UBE2C-1

si-UBE2C-2

Cell number (*104)

100

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siCon

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24h

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F

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E-cad

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siCon

UBE2C

1.00 0.51 0.53

C-myc

1.00

0.58 0.54

Vimentin

cleased-PARP-1

1.00

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1.00 0.71 0.75

snail

Cyclin D1

cleased-Caspase-7

1.00

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1.00

0.36

0.38

1.00 1.78 1.69

MMP2

GAPDH

GAPDH

1.00

0.88

0.91

GAPDH

https://doi.org/10.1371/journal.pone.0289418.9008

based Tools. Hence, patients with Advanced ACC or postoperative recurrence ACC are lack of effective treatment strategies. UBE2C is mainly expressed in advanced ACC, which may be a theoretical basis for solving these contradictions in ACC. Moreover, we evaluated the correla- tion between the expression levels of UBE2C and the function of m6A in ACC. At first, we identified the m6A methylation modification patterns in ACC mediated by 20 regulators using ACLBI Web-based Tools (Fig 4A). Accumulating evidence showed that more than 60% RNA modifications in mammalian cells are methylation modification, and m6A methylation is the most common, abundant, and conservative internal RNA modification [42]. M6A methylation can speed up transcription and participate in proteins translation and mRNA degradation [43-45]. m6A methylation modification can directly or indirectly regulate target genes, which can affect biological behaviors such as the proliferation, metastasis, and immune escape of tumor cells [46]. Hence, explaining the relationship between UBE2C and m6A regulators in ACC can enhance our understanding of the mechanism of UBE2C promoting the tumor development. In vitro experiments data showed that suppressing UBE2C expression can inhibit metastasis and proliferation, weaken DNA damage repair, and induce the apoptosis. Our preliminary results suggested that UBE2C can activate the C-myc signaling pathway to promote cell cycle progression as well as activate the snail signaling pathway to induce EMT in ACC. A study uncovered that PARP-1 can activate the snail signaling pathway to induce EMT in melanoma cells [47]. These results cued that the mechanism of UBE2C promoting prolifera- tion and metastasis of ACC will be more complicated, and further investigations are still needed to clarify this important issue.

Conclusions

In summary, the present study demonstrates that UBE2C is strongly correlation with poor prognosis in patients with ACC via promoting cell cycle progression and EMT. This study not only uncovers the mechanism of UBE2C in promoting ACC proliferation and metastasis but also provides a novel rationale for developing UBE2C as a potential molecular target for the treatment of advanced ACC.

Supporting information

S1 Table. The DEGs of the patients with ACC. The differentially expressed genes between patients with ACC and normal were analyzed. RNA-sequencing expression profiles of 79 patients with ACC were downloaded from the TCGA database. And RNA-sequencing expres- sion profiles of 258 normal were downloaded from GTEx database. These data were analyzed using R packages implemented by R version 4.0.3 in ACLBI Web-based Tools (https://www. aclbi.com/). “LogFC ≥ 2 or LogFC ≤-2, P-value < 0.05” was defined as a screening criterion for identifying differentially expressed genes.

(XLSX)

S2 Table. 20 candidate genes in ACC were identified. The intersection of four gene clusters was analyzed including DFS-relates genes, OS-relates genes, differentially expressed genes (DEGs), and highly expressed genes. (XLSX)

S3 Table. UBE2C was the most significant DEG between ACC and normal. RNA-sequenc- ing expression profiles of 79 patients with ACC were downloaded from the TCGA database. And RNA-sequencing expression profiles of 258 normal were downloaded from GTEx data- base. These data were analyzed using R packages implemented by R version 4.0.3 in ACLBI

Web-based Tools (https://www.aclbi.com/). (XLSX)

S4 Table. UBE2C expression within the ACC dataset. UBE2C expression and corresponding clinical information of 79 patients with ACC were described in detail. (XLSX)

S5 Table. G1 group contained 16 significantly overexpressed m6A regulators compared with G2 group. The result showed that GI group (above 75th percentile of UBE2C expression) contained 16 significantly overexpressed m6A regulators compared with G2 group (below 25th percentile of UBE2C expression).

(XLSX)

S6 Table. DEGs between G1 group and G2 group. The result showed the differentially expressed genes between G1 group (above 75th percentile of UBE2C expression) and G2 group (below 25th percentile of UBE2C expression). (XLSX)

S7 Table. A cluster containing 4 genes related to cell cycle by intersecting the two data sets. The candidate proteins obtained from STRING database; and the significant DEGs between GI group (above 75th percentile of UBE2C expression) and G2 group (below 25th percentile of UBE2C expression) were analyzed from the TCGA dataset. “LogFC ≥ 2 or LogFC ≤ -2, P- value < 0.05” was defined as a screening criterion.

(XLSX)

S1 Raw images.

(PDF)

Acknowledgments

We thank the research team members for their hard work.

Author Contributions

Conceptualization: Songtao Xiang.

Data curation: Lang Guo.

Formal analysis: Jianfu Zhou, Wenxi Gao.

Funding acquisition: Songtao Xiang.

Investigation: Guohao Li, Xiu Yuan.

Methodology: Renlun Huang, Jieyan Zheng.

Project administration: Yanping Wu.

Validation: Chiwei Chen, Yuyang Xiang.

Writing - original draft: Renlun Huang.

Writing - review & editing: Songtao Xiang.

References

1. Bianchini M, Puliani G, Chiefari A, Mormando M, Lauretta R, Appetecchia M. Metabolic and Endocrine Toxicities of Mitotane: A Systematic Review. Cancers (Basel). 2021; 13(19). Epub 2021/10/14. https:// doi.org/10.3390/cancers13195001 PMID: 34638485; PubMed Central PMCID: PMC8508479.

2. Fassnacht M, Libé R, Kroiss M, Allolio B. Adrenocortical carcinoma: a clinician’s update. Nature reviews Endocrinology. 2011; 7(6):323-35. Epub 2011/03/10. https://doi.org/10.1038/nrendo.2010.235 PMID: 21386792.

3. Fassnacht M, Johanssen S, Quinkler M, Bucsky P, Willenberg HS, Beuschlein F, et al. Limited prognos- tic value of the 2004 International Union Against Cancer staging classification for adrenocortical carci- noma: proposal for a Revised TNM Classification. Cancer. 2009; 115(2):243-50. Epub 2008/11/26. https://doi.org/10.1002/cncr.24030 PMID: 19025987.

4. Gaujoux S, Mihai R. European Society of Endocrine Surgeons (ESES) and European Network for the Study of Adrenal Tumours (ENSAT) recommendations for the surgical management of adrenocortical carcinoma. The British journal of surgery. 2017; 104(4):358-76. Epub 2017/02/16. https://doi.org/10. 1002/bjs. 10414 PMID: 28199015.

5. Lombardi CP, Raffaelli M, Boniardi M, De Toma G, Marzano LA, Miccoli P, et al. Adrenocortical carci- noma: effect of hospital volume on patient outcome. Langenbeck’s archives of surgery. 2012; 397 (2):201-7. Epub 2011/11/10. https://doi.org/10.1007/s00423-011-0866-8 PMID: 22069043.

6. Puglisi S, Calabrese A, Basile V, Pia A, Reimondo G, Perotti P, et al. New perspectives for mitotane treatment of adrenocortical carcinoma. Best practice & research Clinical endocrinology & metabolism. 2020; 34(3):101415. Epub 2020/03/18. https://doi.org/10.1016/j.beem.2020.101415 PMID: 32179008.

7. Deng L, Meng T, Chen L, Wei W, Wang P. The role of ubiquitination in tumorigenesis and targeted drug discovery. Signal Transduct Target Ther. 2020; 5(1):11. Epub 2020/04/17. https://doi.org/10.1038/ s41392-020-0107-0 PMID: 32296023; PubMed Central PMCID: PMC7048745.

8. Xie C, Powell C, Yao M, Wu J, Dong Q. Ubiquitin-conjugating enzyme E2C: a potential cancer bio- marker. The international journal of biochemistry & cell biology. 2014; 47:113-7. Epub 2013/12/24. https://doi.org/10.1016/j.biocel.2013.11.023 PMID: 24361302.

9. Ren L, Yang Y, Li W, Zheng X, Liu J, Li S, et al. CDK1 serves as a therapeutic target of adrenocortical carcinoma via regulating epithelial-mesenchymal transition, G2/M phase transition, and PANoptosis. Journal of translational medicine. 2022; 20(1):444. Epub 2022/10/03. https://doi.org/10.1186/s12967- 022-03641-y PMID: 36184616; PubMed Central PMCID: PMC9528181.

10. Yu S, Ma J. Spindle and Kinetochore-Associated Complex Is Associated With Poor Prognosis in Adre- nocortical Carcinoma. J Surg Res. 2022; 277:50-9. Epub 2022/04/24. https://doi.org/10.1016/j.jss. 2022.03.022 PMID: 35460921.

11. Zhang S, You X, Zheng Y, Shen Y, Xiong X, Sun Y. The UBE2C/CDH1/DEPTOR axis is an oncogene and tumor suppressor cascade in lung cancer cells. The Journal of clinical investigation. 2023; 133(4). Epub 2022/12/23. https://doi.org/10.1172/JCI162434 PMID: 36548081; PubMed Central PMCID: PMC9927933.

12. Dastsooz H, Cereda M, Donna D, Oliviero S. A Comprehensive Bioinformatics Analysis of UBE2C in Cancers. International journal of molecular sciences. 2019; 20(9). Epub 2019/05/10. https://doi.org/10. 3390/ijms20092228 PMID: 31067633; PubMed Central PMCID: PMC6539744.

13. Malta TM, Sokolov A, Gentles AJ, Burzykowski T, Poisson L, Weinstein JN, et al. Machine Learning Identifies Stemness Features Associated with Oncogenic Dedifferentiation. Cell. 2018; 173(2):338-54 e15. Epub 2018/04/07. https://doi.org/10.1016/j.cell.2018.03.034 PMID: 29625051; PubMed Central PMCID: PMC5902191.

14. Huang R, Wang S, Wang N, Zheng Y, Zhou J, Yang B, et al. CCL5 derived from tumor-associated mac- rophages promotes prostate cancer stem cells and metastasis via activating beta-catenin/STAT3 sig- naling. Cell Death Dis. 2020; 11(4):234. Epub 2020/04/18. https://doi.org/10.1038/s41419-020-2435-y PMID: 32300100; PubMed Central PMCID: PMC7162982.

15. Wang S, Liu X, Huang R, Zheng Y, Wang N, Yang B, et al. XIAOPI Formula Inhibits Breast Cancer Stem Cells via Suppressing Tumor-Associated Macrophages/C-X-C Motif Chemokine Ligand 1 Path- way. Frontiers in pharmacology. 2019; 10:1371. Epub 2019/12/06. https://doi.org/10.3389/fphar.2019. 01371 PMID: 31803057; PubMed Central PMCID: PMC6874098.

16. Li Y, Xiao J, Bai J, Tian Y, Qu Y, Chen X, et al. Molecular characterization and clinical relevance of m(6) A regulators across 33 cancer types. Molecular cancer. 2019; 18(1):137. Epub 2019/09/16. https://doi. org/10.1186/s12943-019-1066-3 PMID: 31521193; PubMed Central PMCID: PMC6744659.

17. Wei J, Huang K, Chen Z, Hu M, Bai Y, Lin S, et al. Characterization of Glycolysis-Associated Molecules in the Tumor Microenvironment Revealed by Pan-Cancer Tissues and Lung Cancer Single Cell Data. Cancers. 2020; 12(7). Epub 2020/07/09. https://doi.org/10.3390/cancers12071788 PMID: 32635458; PubMed Central PMCID: PMC7408567.

18. Szklarczyk D, Morris JH, Cook H, Kuhn M, Wyder S, Simonovic M, et al. The STRING database in 2017: quality-controlled protein-protein association networks, made broadly accessible. Nucleic acids research. 2017; 45(D1):D362-d8. Epub 2016/12/08. https://doi.org/10.1093/nar/gkw937 PMID: 27924014; PubMed Central PMCID: PMC5210637.

19. . Liu B, Jiang S, Li M, Xiong X, Zhu M, Li D, et al. Proteome-wide analysis of USP14 substrates revealed its role in hepatosteatosis via stabilization of FASN. Nature communications. 2018; 9(1):4770. Epub 2018/11/15. https://doi.org/10.1038/s41467-018-07185-y PMID: 30425250; PubMed Central PMCID: PMC6233205.

20. Glickman MH, Ciechanover A. The ubiquitin-proteasome proteolytic pathway: destruction for the sake of construction. Physiological reviews. 2002; 82(2):373-428. Epub 2002/03/28. https://doi.org/10.1152/ physrev.00027.2001 PMID: 11917093.

21. Pohl C, Dikic I. Cellular quality control by the ubiquitin-proteasome system and autophagy. Science (New York, NY). 2019; 366(6467):818-22. Epub 2019/11/16. https://doi.org/10.1126/science.aax3769 PMID: 31727826.

22. Guo J, Wu Y, Du J, Yang L, Chen W, Gong K, et al. Deregulation of UBE2C-mediated autophagy repression aggravates NSCLC progression. Oncogenesis. 2018; 7(6):49. Epub 2018/06/16. https://doi. org/10.1038/s41389-018-0054-6 PMID: 29904125; PubMed Central PMCID: PMC6002383 ETHICAL APPROVAL: The experimental protocol was approved by the Research Ethics Committee of Binzhou Medical University, China (No. 2017-014-01) and the written informed consent was obtained from all subjects.

23. Guo L, Ding Z, Huang N, Huang Z, Zhang N, Xia Z. Forkhead Box M1 positively regulates UBE2C and protects glioma cells from autophagic death. Cell cycle (Georgetown, Tex). 2017; 16(18):1705-18. Epub 2017/08/03. https://doi.org/10.1080/15384101.2017.1356507 PMID: 28767320; PubMed Central PMCID: PMC5602297.

24. Psyrri A, Kalogeras KT, Kronenwett R, Wirtz RM, Batistatou A, Bournakis E, et al. Prognostic signifi- cance of UBE2C mRNA expression in high-risk early breast cancer. A Hellenic Cooperative Oncology Group (HeCOG) Study. Annals of oncology: official journal of the European Society for Medical Oncol- ogy. 2012; 23(6):1422-7. Epub 2011/11/08. https://doi.org/10.1093/annonc/mdr527 PMID: 22056852.

25. Primorac I, Musacchio A. Panta rhei: the APC/C at steady state. J Cell Biol. 2013; 201(2):177-89. Epub 2013/04/17. https://doi.org/10.1083/jcb.201301130 PMID: 23589490; PubMed Central PMCID: PMC3628523.

26. Mao Z, Xiao H, Shen P, Yang Y, Xue J, Yang Y, et al. KRAS(G12D) can be targeted by potent inhibitors via formation of salt bridge. Cell discovery. 2022; 8(1):5. Epub 2022/01/26. https://doi.org/10.1038/ s41421-021-00368-w PMID: 35075146; PubMed Central PMCID: PMC8786924.

27. Kariri Y, Toss MS, Alsaleem M, Elsharawy KA, Joseph C, Mongan NP, et al. Ubiquitin-conjugating enzyme 2C (UBE2C) is a poor prognostic biomarker in invasive breast cancer. Breast cancer research and treatment. 2022; 192(3):529-39. Epub 2022/02/07. https://doi.org/10.1007/s10549-022-06531-5 PMID: 35124721; PubMed Central PMCID: PMC8960565.

28. Guo W, Sun S, Guo L, Song P, Xue X, Zhang H, et al. Elevated TOP2A and UBE2C expressions corre- late with poor prognosis in patients with surgically resected lung adenocarcinoma: a study based on immunohistochemical analysis and bioinformatics. Journal of cancer research and clinical oncology. 2020; 146(4):821-41. Epub 2020/02/28. https://doi.org/10.1007/s00432-020-03147-4 PMID: 32103339.

29. Zhang HQ, Zhao G, Ke B, Ma G, Liu GL, Liang H, et al. Overexpression of UBE2C correlates with poor prognosis in gastric cancer patients. European review for medical and pharmacological sciences. 2018; 22(6):1665-71. Epub 2018/04/10. https://doi.org/10.26355/eurrev 201803 14578 PMID: 29630110.

30. Hanahan D. Hallmarks of Cancer: New Dimensions. Cancer discovery. 2022; 12(1):31-46. Epub 2022/ 01/14. https://doi.org/10.1158/2159-8290.CD-21-1059 PMID: 35022204.

31. Lu ZN, Song J, Sun TH, Sun G. UBE2C affects breast cancer proliferation through the AKT/mTOR sig- naling pathway. Chinese medical journal. 2021; 134(20):2465-74. Epub 2021/10/09. https://doi.org/10. 1097/CM9.0000000000001708 PMID: 34620747; PubMed Central PMCID: PMC8654430.

32. Wang Y, Shi F, Tao R, Wu J, Gu J, Yang R, et al. The Relationship Between UBE2C and AGGF1 Over- expression and Tumor Angiogenesis in Non-Small Cell Lung Cancer. Cancer management and research. 2021; 13:5919-30. Epub 2021/08/07. https://doi.org/10.2147/CMAR.S320393 PMID: 34354374; PubMed Central PMCID: PMC8331115.

33. Liu Y, Zhao R, Chi S, Zhang W, Xiao C, Zhou X, et al. UBE2C Is Upregulated by Estrogen and Promotes Epithelial-Mesenchymal Transition via p53 in Endometrial Cancer. Molecular cancer research: MCR. 2020; 18(2):204-15. Epub 2019/10/31. https://doi.org/10.1158/1541-7786.MCR-19-0561 PMID: 31662448.

4. Lin S, Qiu L, Liang K, Zhang H, Xian M, Chen Z, et al. KAT2A/E2F1 Promotes Cell Proliferation and Migration via Upregulating the Expression of UBE2C in Pan-Cancer. Genes. 2022; 13(10). Epub 2022/ 10/28. https://doi.org/10.3390/genes13101817 PMID: 36292703; PubMed Central PMCID: PMC9602169.

35. Rawat A, Gopal G, Selvaluxmy G, Rajkumar T. Inhibition of ubiquitin conjugating enzyme UBE2C reduces proliferation and sensitizes breast cancer cells to radiation, doxorubicin, tamoxifen and letro- zole. Cellular oncology (Dordrecht). 2013; 36(6):459-67. Epub 2013/09/28. https://doi.org/10.1007/ s13402-013-0150-8 PMID: 24072565.

36. Hu Y, Liu H, Xiao X, Yu Q, Deng R, Hua L, et al. Bone Marrow Mesenchymal Stem Cell-Derived Exo- somes Inhibit Triple-Negative Breast Cancer Cell Stemness and Metastasis via an ALKBH5-Dependent Mechanism. Cancers (Basel). 2022; 14(24). Epub 2022/12/24. https://doi.org/10.3390/ cancers 14246059 PMID: 36551544; PubMed Central PMCID: PMC9776833.

37. Chen M, Liu LX. MiR-525-5p Repressed Metastasis and Anoikis Resistance in Cervical Cancer via Blocking UBE2C/ZEB1/2 Signal Axis. Digestive diseases and sciences. 2020; 65(8):2442-51. Epub 2019/11/05. https://doi.org/10.1007/s10620-019-05916-9 PMID: 31679088.

38. . Zhou Y, Zhang J, Gong J, Tang X, Zhang C. UBE2C mediated radiotherapy resistance of head and neck squamous cell carcinoma by regulating oxidative-stress-relative apoptosis. Aging. 2022; 14 (17):7003-13. Epub 2022/09/08. https://doi.org/10.18632/aging.204265 PMID: 36069832; PubMed Central PMCID: PMC9512496.

39. Huang R, Liu J, Li H, Zheng L, Jin H, Zhang Y, et al. Identification of Hub Genes and Their Correlation With Immune Infiltration Cells in Hepatocellular Carcinoma Based on GEO and TCGA Databases. Fron- tiers in genetics. 2021; 12:647353. Epub 2021/05/18. https://doi.org/10.3389/fgene.2021.647353 PMID: 33995482; PubMed Central PMCID: PMC8120231.

40. Cao JZ, Nie G, Hu H, Zhang X, Ni CM, Huang ZP, et al. UBE2C promotes the progression of pancreati cancer and glycolytic activity via EGFR stabilization-mediated PI3K-Akt pathway activation. Journal of gastrointestinal oncology. 2022; 13(3):1444-53. Epub 2022/07/16. https://doi.org/10.21037/jgo-22-516 PMID: 35837197; PubMed Central PMCID: PMC9274053.

41. Yang YF, Chang YC, Tsai KW, Hung MH, Kang BH. UBE2C triggers HIF-1a-glycolytic flux in head and neck squamous cell carcinoma. Journal of cellular and molecular medicine. 2022; 26(13):3716-25. Epub 2022/05/27. https://doi.org/10.1111/jcmm.17400 PMID: 35615976; PubMed Central PMCID: PMC9258705.

42. Chen XY, Zhang J, Zhu JS. The role of m(6)A RNA methylation in human cancer. Molecular cancer. 2019; 18(1):103. Epub 2019/05/31. https://doi.org/10.1186/s12943-019-1033-z PMID: 31142332; PubMed Central PMCID: PMC6540575.

43. Meyer KD, Patil DP, Zhou J, Zinoviev A, Skabkin MA, Elemento O, et al. 5’ UTR m(6)A Promotes Cap- Independent Translation. Cell. 2015; 163(4):999-1010. Epub 2015/11/26. https://doi.org/10.1016/j.cell. 2015.10.012 PMID: 26593424; PubMed Central PMCID: PMC4695625.

44. Wang X, Zhao BS, Roundtree IA, Lu Z, Han D, Ma H, et al. N(6)-methyladenosine Modulates Messen- ger RNA Translation Efficiency. Cell. 2015; 161(6):1388-99. Epub 2015/06/06. https://doi.org/10.1016/ j.cell.2015.05.014 PMID: 26046440; PubMed Central PMCID: PMC4825696.

45. Wang X, Lu Z, Gomez A, Hon GC, Yue Y, Han D, et al. N6-methyladenosine-dependent regulation of messenger RNA stability. Nature. 2014; 505(7481):117-20. Epub 2013/11/29. https://doi.org/10.1038/ nature 12730 PMID: 24284625; PubMed Central PMCID: PMC3877715.

46. Cao X, Geng Q, Fan D, Wang Q, Wang X, Zhang M, et al. m(6)A methylation: a process reshaping the tumour immune microenvironment and regulating immune evasion. Molecular cancer. 2023; 22(1):42. Epub 2023/03/02. https://doi.org/10.1186/s12943-022-01704-8 PMID: 36859310; PubMed Central PMCID: PMC9976403.

47. Rodríguez MI, Peralta-Leal A, O’Valle F, Rodriguez-Vargas JM, Gonzalez-Flores A, Majuelos-Melguizo J, et al. PARP-1 regulates metastatic melanoma through modulation of vimentin-induced malignant transformation. PLOS genetics. 2013; 9(6):e1003531. Epub 2013/06/21. https://doi.org/10.1371/ journal.pgen. 1003531 PMID: 23785295; PubMed Central PMCID: PMC3681683.