Hsa_circ_0023642 promotes proliferation, invasion, and migration of gastric cancer by sponging microRNA‐223

Abstract Background Circular RNAs (circRNAs) have a closed‐loop structure and are associated with various cellular biological processes, including carcinogenesis and cancer development. However, our knowledge of circRNAs in gastric cancer (GC) remains limited. Thus, this study aimed to investigate the role and underlying molecular mechanisms of hsa_circ_0023642 in GC. Materials and methods Bioinformatic analysis revealed that hsa_circ_0023642 was upregulated in GC. Chromogenic in situ hybridization (CISH) chips was used to explore the relationship between the expression of hsa_circ_0023642 and the malignant degree, clinical stage, and prognosis of patients with GC. The role of hsa_circ_0023642 in GC was assessed in vitro, and biotin‐coupled RNA pull‐down was conducted to evaluate the interaction in between hsa_circ_0023642 and miR‐223. Results The current study showed that hsa_circ_0023642 was upregulated in GC and presented a high positive correlation with the malignant progression of GC. In addition, in vitro experiments showed that the silencing of hsa_circ_0023642 in GC cell lines MKN‐45 and SGC‐7901 significantly reduced the proliferation, invasion, and migration of GC cells. We confirmed that hsa_circ_0023642 could serve as a sponge of miR‐223, subsequently promoting GC progression. Conclusion This study shows that the upregulation of hsa_circ_0023642 affects the malignant progression, clinical stage, and prognosis of GC which provides a new molecular target for the therapy of GC.

circRNA may be produced by a process called reverse splicing. 5,6 This non-canonical splicing can produce three types of circRNAs, namely exon circRNA (circRNA), circular intron RNA, and exon-intron loop RNA. CircRNA can play an important role in regulating cancer progression, such as cancer metastasis, apoptosis, and invasion, by acting as a miRNA sponge and forming a circRNA-miRNA axis. 7,8 Unlike other non-coding RNAs, which are stable due to their loop structure, circRNA is present in plasma, platelets, and exosomes and is therefore a potential biomarker for cancer diagnosis and treatment. 9,10 Thus, further elucidation of the function of dysregulated circRNA in cancer will help to improve cancer diagnosis and treatment.
This study was designed to explore the relationship between the malignant progression of GC and a new circRNA named hsa_ circ_0023642, whose corresponding target gene is called UVARG. In this study, we examined the expression levels of hsa_circ_0023642 in GC tissues, analyzed the correlation between their expression levels and malignant stress and clinical features, and explored the clinical significance of hsa_circ_0023642. We also studied the expression of hsa_circ_0023642 in vitro cell lines through cell proliferation and cell migration assays. Predictions and annotations of hsa_circ_0023642 molecular function with miRNA or mRNA were performed on relevant databases. F I G U R E 1 Hierarchical clustering, volcano plots, and scatter plots exhibited the differentially expressed circRNAs in gastric cancer tissues compared with paired non-gastric cancer tissues F I G U R E 2 Relative hsa_circ_0023642 expression and its clinical significance in GC CISH chip. A, The expression of hsa_circ_0023642 in CISH chip: The upper shows the expression of hsa_circ_0023642 levels was significantly higher than ANT tissues; the middle shows the expression of hsa_circ_0023642 levels was significantly higher in severe TNM tumor; the lower shows high expression of hsa_circ_0023642 has a worse overall survival. B, The expression of hsa_circ_0023642 expression levels was significantly higher than that of adjacent noncancerous tissues. C, The expression of hsa_circ_0023642 expression levels was significantly higher in severe cases of primary tumor. D, The expression of hsa_circ_0023642 expression levels can predict the degree of lymph node metastasis. E, The expression levels can predict severe clinical stage. F, Hsa_circ_0023642 can be used as an independent predictor for patients with gastric cancer. G,The survival curve showed that patients with high expression of hsa_circ_0023642 had short survival time (P = .0037). H, Hsa_circ_0023642 is a sensitive indicator for the prognosis of gastric cancer patients, the AUC was 0.6422. AUC, area under the ROC curve; GC, gastric cancer; ROC, receiver operating characteristic; ns, not significant

| Chromogenic in situ hybridization
The collected cancer and adjacent tissues were embedded in wax blocks, and the wax pieces were frozen and sliced to a thick-

| Cell proliferation assays
CCK-8 assay was performed according to the protocol provided by the manufacturer. We collected log phase cells, added adjusted cell suspension concentration to each well, and plated the cells to be tested to a density of 5000 cells/well. After incubation, CCK-8 solution was added, and the culture was continued. When considerable color change occurred, the absorbance of each well was measured at an automatic microplate reader at OD 450 nm, and cell survival rate was calculated.

| Cell migration assays
For migration assays, the drug-treated cells were digested from a six-well plate to adjust the cell density to 5 × 105/mL, 200 µL of which was inoculated into the upper chamber; the lower chamber was added to complete the medium for culture. After the cultured cells were fixed, washed, inverted, and air-dried, 100 µL of the diluted crystal violet staining solution was added for staining. The cells were washed with ddH 2 0 to remove excess crystal violet and were then photographed. For each chamber, the number of cells was counted in four random fields, and the average was calculated.

| Cell invasion assays
Matrigel was completely melted at 4°C and diluted with serum-free

| Prediction of miRNA targets
Interactions between circRNAs and miRNAs were predicted using Targetscan and starBase with the miRanda algorithm.

| Biotin-labeled pull-down assay
A biotinylated circ0023642 probe and oligo probe (RiboBio) were synthesized and incubated with streptavidin magnetic beads (Life Technologies) at 25°C for 2 hours to generate probe-coated beads.
A total of 1 × 10 7 GC cells were harvested, lysed, and sonicated. The cell lysates were incubated with probe-coated beads at 4°C overnight. The beads were then washed with buffer, and the RNA complexes bound to the beads were eluted and extracted with a RNeasy Mini Kit (Qiagen). The abundance of circ0023642 and immunoprecipitated miRNAs was measured by qRT-PCR.

| RNA extraction and quantitative reversetranscription polymerase chain reaction
Total RNA was extracted from 4-μm-thick FFPE specimens by manual for 60 seconds. The relative expression of target genes was normalized against glyceraldehyde-3-phosphate dehydrogenase (GAPDH) using the 2 −ΔCT method.

| Statistical analysis
Differences between tumor tissues and normal gastric tissues were analyzed by a paired t test, whereas categorical data were analyzed by chi-square test. We assessed the diagnostic value by establishing a receiver operating characteristic curve. GraphPad Prism7.0 (Graph Pad Software) was used to plot all graphs. For all statistical results, P < .05 was considered statistically significant.

| Expression of hsa_circ_0023642 is increased in GC tissues
We used the multi-dataset online analysis platform GEO dataset (GSE78092) to conduct an in-depth screening of GC circRNA chips. In the early screening, using "limma" R package, there were 115 circRNAs identified that were statistical significantly differently expressed (|LogFC| > 1, P < .05) between normal tissues and tumor tissues, including 82 highly expressed and 23 lowly expressed circRNA were obtained. The expression abundance and difference of hsa_circ_0023642 in cancer tissues were the highest ( Figure 1).

| Hsa_circ_0023642 is correlated with the clinicopathological features and overall survival of patients with GC
Utilizing an GS tissue microarray (TMA) containing 60 paired GS tissues and their corresponding ANT tissues, we then measured the correlation of hsa_circ_0023642 expression with clinicopathological characteristics by in situ hybridization (ISH). The results indicated that the express level of hsa_circ_0023642 was significantly higher in GS tissues than in matched ANT tissues ( Figure 2B). A univariate analysis showed that age, lymph node metastasis, T stage, TNM stage, and hsa_circ_0023642 expression level were significantly correlated with overall survival (OS) ( Figure 2C-E and Table 1). Subsequently, using these variables, the multivariate analyses indicated that the hsa_circ_0023642 expression level was an independent risk factor for OS ( Figure 2F; Table 2). Furthermore, Kaplan-Meier's survival curves showed that the patients with GS and higher hsa_circ_0023642 expression had poorer OS ( Figure 2G-H).

| Knockout of hsa_circ_0023642 suppresses the proliferation, invasion, and migration of GC cells
To

| Hsa_circ_0023642 serves as miR-223-3p sponge in GC cells
It has been known that circRNAs play many important roles, one of which is acting as miRNA sponge to regulate gene expression.
To explore miRNA sponge ability of hsa_circ_0023642 in GC cells, one miRNA (miR-223-3p) was selected from the prediction results through bioinformation analysis database (StarBase and Targetscan) ( Figure 5A). Next, we conducted an RIP assay with an antibody against AGO2 in GC cells. The results showed that hsa_circ_0023642 but not the negative control circANRIL was significantly enriched using the anti-AGO2 antibody ( Figure 5B).
Subsequently, we designed a hsa_circ_0023642-specific probe labeled with biotin to perform pull-down assay after overexpressed hsa_circ_0023642 in GC cell lines. As a positive control, the level of hsa_circ_0023642 was remarkably higher in hsa_circ_0023642 targeted probe group than oligo probe group ( Figure 5C). And we found that miR-223-3p was copiously pulled down in MKN45 and SGC7901 cells ( Figure 5D). Furthermore, a significant inverse correlation occurred between hsa_circ_0023642 and miR-223-3p in GC tissues (R 2 = −0.4839, P < .001; Figure 5E).
These results suggested that hsa_circ_0023642 could directly target miR-223-3p and function as a sponge for miR-223-3p in GC cells. We then used the Starbase and Targetscan databases to predict the target genes that mir-223-3p might act on. And FBXW7, RHOB, LELP1, and PTS were found to have higher scores in both two databases ( Figure 5F). Subsequently, we used PCR for analysis and found that only FBXW7 was consistent with the change of hsa_circ_0023642 after knockingdown or overexpression of hsa_circ_0023642 ( Figure 5G), and the expression level of FBXW7 in the tissue samples was also highly correlated with hsa_circ_0023642 ( Figure 5H).

| D ISCUSS I ON
Given the current developments in high-throughput sequencing technology, the role of circRNA in carcinogenesis and cancer development has been widely explored. 11 Functional studies on circRNAs continue to expand and deepen in a variety of physiological and pathological processes. 12 In this study, we analyzed human circRNA microarray data and found for the first time that hsa_circ_0023642 is expressed in higher levels in GC than in adjacent non-tumor tissues. It has been reported in the literature that silencing circular RNA UVRAG (also known as Hsa_circ_0023642) inhibited bladder cancer growth and metastasis by targeting the miR-223/FGFR2 axis. 13,14 However, compared with the study in bladder cancer, the level of expression and function of hsa_ circ_0023642 in GC development are still largely unknown, and the target genes we have done were different. We found the phenomenon that the clinicopathological features of these patients indicate that hsa_circ_0023642 is closely related to the clinical malignant progression of GC. We found that hsa_circ_0023642 is closely related to lymph node metastasis and prognosis. The higher the expression level of hsa_circ_0023642 is, the worse the malignant degree of gastric adenocarcinoma will be. The fact that circRNA is abundantly found in tissue or blood makes circRNA a valuable diagnostic biomarker for assessing the progression and prognosis of GC. 15 Our research is not the first to show that circRNA is relevant in the malignant progression of GC. Chen et al found that circ_0000190 is decreased in GC tissues and serum and that its expression level is correlated with tumor diameter, lymph node metastasis, distant metastasis, TNM stage, and CA19-9 level. 16 Huang found that circ_0000745 is downregulated in GC tissue and plasma samples.
Its expression in GC is related to the degree of tumor differentiation, whereas its expression in plasma is related to tumor TNM staging. 17 In other tumors, circRNA also shows tumor growth and migration and related functions. For example, Hsa_circ_0067934 is upregulated in esophageal squamous cell carcinoma (ESCC), and the higher the expression level is, the worse the degree of tumor differentiation will be. 18 In their study, hsa_circ_0067934 promotes the prolifera- CircRNA is not only a by-product of mis-splicing or splicing errors as it can also act between epithelial and mesenchymal transitions. CircRNAs are enriched in and function well at miRNA binding sites, and they work in various ways, including their action as miRNA sponges, RBP sponges, and mRNA modulators. 20,21 Moreover, hsa_circ_0000673 potentially acts as a sponge for the oncogene R-532-5p, which upregulates RUNX3, p21, and Bim expression and thus inhibits GC proliferation and invasion. 22 Circ-ZFR inhibits GC cell proliferation and promotes apoptosis through the sponge miR-130a/ miR-107 and regulation of PTEN. 23 In this study, we identified a novel circRNA, hsa_circ_0023642, which was upregulated in GC tissues and related with the malignant progression. Mechanistically, hsa_circ_0023642 was demonstrated could as a miRNA sponge to inhibit the miR-233-3p. The target genes of miR-233-3p, FBXW7, was significantly regulated by the expression of hsa_circ_0023642. Thus, we identified that hsa_circ_0023642 promoted the malignant prognosis of GC by hsa_circ_0023642/miR-233-3p/FBXW7 axis. These findings suggest hsa_circ_0023642 could play a significant role and a critical biomarker in GC.

| CON CLUS ION
In summary, hsa_circ_0023642 was expressed higher in GC compared with the non-GC. Hsa_circ_0023642 correlated with diagnosis and prognosis of GC might be used as a potential biomarker for early diagnosis and prognosis of patients with GC.