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Li J, Yang L, Yao Y, Gu P, Xie Y, Yin H, Xue M, Jiang Y, Dai J, Ma J. Associations between long-term night shift work and incidence of chronic obstructive pulmonary disease: a prospective cohort study of 277,059 UK Biobank participants. BMC Med 2024; 22:16. [PMID: 38225649 PMCID: PMC10790498 DOI: 10.1186/s12916-023-03240-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 12/20/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Little is known about the effects of night shifts and their interactions with genetic factors on chronic obstructive pulmonary disease (COPD). In this study, we aim to investigate relationships between long-term night shift work exposure and COPD risk, and assess modification effects of genetic predisposition. METHODS A total of 277,059 subjects who were in paid employment or self-employed were included in the UK Biobank. Information on current and lifetime employment was obtained, and a weighted COPD-specific genetic risk score (GRS) was constructed. We used Cox proportional hazard models to investigate associations between night shift work and COPD risk, and their interaction with COPD-specific GRS. RESULTS The cohort study included 277,059 participants (133,063 men [48.03%]; mean [SD] age, 52.71 [7.08] years). During a median follow-up of 12.87 years, we documented 6558 incidents of COPD. From day work, irregular night shifts to regular night shifts, there was an increased trend in COPD incidence (P for trend < 0.001). Compared with day workers, the hazard ratio (HR) and 95% confidence interval (CI) of COPD was 1.28 (1.20, 1.37) for subjects with rarely/sometimes night shifts and 1.49 (1.35, 1.66) for those with permanent night shifts. Besides, the longer durations (especially in subjects with night shifts ≥ 10 years) and increasing monthly frequency of night shifts (in workers with > 8 nights/month) were associated with a higher COPD risk. Additionally, there was an additive interaction between night shifts and genetic susceptibility on the COPD risk. Subjects with permanent night shifts and high genetic risk had the highest risk of COPD (HR: 1.90 [95% CI: 1.63, 2.22]), with day workers with low genetic risk as a reference. CONCLUSIONS Long-term night shift exposure is associated with a higher risk of COPD. Our findings suggest that decreasing the frequency and duration of night shifts may offer a promising approach to mitigating respiratory disease incidence in night shift workers, particularly in light of individual susceptibility.
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Affiliation(s)
- Jia Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Liangle Yang
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Yuxin Yao
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Pei Gu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Yujia Xie
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Haoyu Yin
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Mingyue Xue
- Zane Cohen Centre for Digestive Diseases, Mount Sinai Hospital, Toronto, ON, M5T3L9, Canada
| | - Yu Jiang
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China
| | - Jianghong Dai
- Department of Epidemiology and Biostatistics, School of Public Health, Xinjiang Medical University, Urumqi, 830017, China.
| | - Jixuan Ma
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, 430030, Hubei, China.
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Lingas EC. A Narrative Review of the Carcinogenic Effect of Night Shift and the Potential Protective Role of Melatonin. Cureus 2023; 15:e43326. [PMID: 37577272 PMCID: PMC10416670 DOI: 10.7759/cureus.43326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2023] [Indexed: 08/15/2023] Open
Abstract
Since the IARC (International Agency for Research on Cancer) announcement in 2007 indicating the possibility of night-shift work carrying carcinogenesis risk, multiple studies on a global level have been conducted to investigate the correlation between night-shift work and cancer development. Circadian rhythm disruption and decreased melatonin production have been postulated as potential contributing factors. There is also growing evidence that night-shift workers tend to adopt unhealthier lifestyles which contribute to poorer health and increase the risk of developing diseases such as cancer. No experimental study has been specifically dedicated to testing specific methods that could decrease cancer risk in night-shift workers. While there are a few studies that investigate melatonin's concurrent use with chemotherapy in cancer patients, there is yet to be seen for studies that investigate melatonin specifically as a cancer prevention method. This narrative review aims to examine current evidence of healthcare night-shift work's risk in cancer incidence, potential pathogenesis, and its significance in clinical practice.
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Nam MW, Lee Y, Mun E, Lee W. The association between shift work and the incidence of reflux esophagitis in Korea: a cohort study. Sci Rep 2023; 13:2536. [PMID: 36781911 PMCID: PMC9925718 DOI: 10.1038/s41598-023-29567-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 02/07/2023] [Indexed: 02/15/2023] Open
Abstract
Shift work has adverse health effects such as diabetes, cardiovascular disease, sleep disturbance, depression, and breast cancer. Gastro-esophageal reflux disease (GERD) results in lesions such as reflux esophagitis (RE) and Barrett's esophagus. This study investigated the association between shift work and RE. A cohort study was conducted with 140,553 participants who were followed up at least once from 2012 to 2018. Type of working and shift types were collected using standardized questionnaires. Esophagogastroduodenoscopy (EGD) was performed by experienced endoscopists who were blinded to the aims of this study. According to the Los Angeles classification, RE was categorized based on the extent of esophageal mucosal breaks. During the 469,217.2 person-years of follow-up, 35,185 participants developed incident cases of RE. The multivariable adjusted hazard ratio (95% confidence intervals) for incident cases comparing shift work to fixed day work was 1.09 (1.04-1.13). This association was more strongly observed in the younger age group (18-39 years old) and the female group. In conclusion, shift work was significantly associated with the incidence of RE. Particularly, the results were more significant in the younger and female groups.
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Affiliation(s)
- Min-Woo Nam
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, South Korea
| | - Yesung Lee
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, South Korea
| | - Eunchan Mun
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, South Korea
| | - Woncheol Lee
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, South Korea.
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Palagini L, Miniati M, Massa L, Folesani F, Marazziti D, Grassi L, Riemann D. Insomnia and circadian sleep disorders in ovarian cancer: Evaluation and management of underestimated modifiable factors potentially contributing to morbidity. J Sleep Res 2022; 31:e13510. [PMID: 34716629 DOI: 10.1111/jsr.13510] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/13/2021] [Accepted: 09/26/2021] [Indexed: 12/21/2022]
Abstract
Ovarian cancer is the leading cause of gynaecological cancer deaths and the seventh most commonly diagnosed cancer among women worldwide, so that, as it is related to substantial and increasing disease burden, the management of ovarian cancer survivors should be a priority. Such issues involve prevention and management of emotional distress, anxiety/depressive symptoms, and maintenance of quality of life from initial diagnosis to post-treatment. Within this framework, sleep disturbances, in particular insomnia, are emerging as modifiable determinants of mental health, also contributing to substantial morbidity among cancer, including ovarian cancer. To this aim we conducted a systematic review according to PRISMA guidelines on prevalence and management of insomnia and circadian sleep disorders in ovarian cancer, while selecting 22 papers. Insomnia was evaluated in ovarian cancer and, while circadian sleep disturbances were poorly assessed in ovarian cancer, insomnia increased from 14% to 60% of patients. Insomnia was associated with cancer-related comorbid conditions such as emotional distress, anxiety/depressive symptoms and low quality of life. Despite this evidence, no studies have been conducted about insomnia treatment in ovarian cancer. The burden of insomnia and circadian sleep disorders in patients with ovarian cancer still needs to be addressed, and requires a call to action for the evaluation and management of these potential modifiable factors that might contribute to ovarian cancer morbidity.
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Affiliation(s)
- Laura Palagini
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
- Department of Clinical and Experimental Medicine, Psychiatric Clinic, University of Pisa, Pisa, Italy
| | - Mario Miniati
- Department of Clinical and Experimental Medicine, Psychiatric Clinic, University of Pisa, Pisa, Italy
| | - Lucia Massa
- Department of Clinical and Experimental Medicine, Psychiatric Clinic, University of Pisa, Pisa, Italy
| | - Federica Folesani
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Psychiatric Clinic, University of Pisa, Pisa, Italy
- UniCamillus - Saint Camillus University of Health Sciences, Rome, Italy
| | - Luigi Grassi
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Kim JY, Lee DW, Kim MJ, Shin JE, Shin YJ, Lee HN. Secondhand smoke exposure, diabetes, and high BMI are risk factors for uterine cervical cancer: a cross-sectional study from the Korea national health and nutrition examination survey (2010-2018). BMC Cancer 2021; 21:880. [PMID: 34332564 PMCID: PMC8325852 DOI: 10.1186/s12885-021-08580-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 06/17/2021] [Indexed: 11/23/2022] Open
Abstract
Background Human papilloma virus infection and tobacco smoking are the major risk factors for cervical cancer. There are limited studies searching other risk factors for cervical cancer and the results are not consistent. This study investigated the relations between cervical cancer and possible risk factors, including secondhand cigarette smoke exposure, diabetes, body mass index (BMI), and work schedule. Methods In this cross-sectional study, 29,557 women completed a cervical cancer questionnaire and were selected using 2010–2018 data from the Korea National Health and Nutrition Examination Survey. Details in secondhand smoke exposure, diabetes, BMI, and work schedule were assessed with participants’ health interviews and health-related surveys. Results Two hundred sixty-two women (0.89%) in the sample were diagnosed with cervical cancer. Domestic secondhand smoke exposure, diabetes, and high BMI significantly increased cervical cancer risk. Respective odds ratios and 95% confidence intervals were: 1.547 (1.042–2.297), 2.156 (1.535–3.027), and 1.036 (1.006–1.067). Weekly work hours, and work schedule were not significantly related to cervical cancer incidence. Conclusion Among Korean women, passive exposure to cigarette smoke at home, diabetes, and high BMI increase risk for cervical cancer.
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Affiliation(s)
- Ji Young Kim
- Department of Obstetrics and Gynecology, Bucheon St, Mary's Hospital, College of Medicine, The Catholic University of Korea, 327, Sosa-ro, Bucheon-si, Gyeonggi-do, 14647, Seoul, Republic of Korea
| | - Dae Woo Lee
- Department of Obstetrics and Gynecology, Bucheon St, Mary's Hospital, College of Medicine, The Catholic University of Korea, 327, Sosa-ro, Bucheon-si, Gyeonggi-do, 14647, Seoul, Republic of Korea
| | - Min Jeong Kim
- Department of Obstetrics and Gynecology, Bucheon St, Mary's Hospital, College of Medicine, The Catholic University of Korea, 327, Sosa-ro, Bucheon-si, Gyeonggi-do, 14647, Seoul, Republic of Korea
| | - Jae Eun Shin
- Department of Obstetrics and Gynecology, Bucheon St, Mary's Hospital, College of Medicine, The Catholic University of Korea, 327, Sosa-ro, Bucheon-si, Gyeonggi-do, 14647, Seoul, Republic of Korea
| | - Yeun Joo Shin
- Department of Obstetrics and Gynecology, Bucheon St, Mary's Hospital, College of Medicine, The Catholic University of Korea, 327, Sosa-ro, Bucheon-si, Gyeonggi-do, 14647, Seoul, Republic of Korea
| | - Hae Nam Lee
- Department of Obstetrics and Gynecology, Bucheon St, Mary's Hospital, College of Medicine, The Catholic University of Korea, 327, Sosa-ro, Bucheon-si, Gyeonggi-do, 14647, Seoul, Republic of Korea.
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Brito-Marcelino A, Duarte-Tavares RJ, Marcelino KB, Silva-Neto JA. Cervical cancer related to occupational risk factors: review. Rev Bras Med Trab 2020; 18:103-108. [PMID: 32783011 DOI: 10.5327/z1679443520200419] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 12/18/2019] [Indexed: 11/05/2022] Open
Abstract
Background Occupational risk factors are associated with many types of neoplasms including cervical cancer. Objective To review the specialized literature for evidence on the relationship between cervical cancer and exposure to occupational hazards. Methods Literature search in electronic databases using keywords cervical cancer and occupational risk. Results Workers occupationally exposed to tobacco, fungi or bacteria, metalworking fluids and tetrachloroethylene used in dry cleaning and for metal degreasing exhibited higher susceptibility to cervical cancer. Conclusion Few studies sought to investigate relationships between cervical cancer and occupational hazards, which hinders the attempts at establishing a causal link.
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Affiliation(s)
- Arthur Brito-Marcelino
- Emergency Hospital of Sergipe - Aracaju (SE), Brazil. Emergency Hospital of Sergipe Brazil
| | | | - Katienne Brito Marcelino
- Department of Medicine, Universidade de Gurupi - Gurupi (TO), Brazil. Department of Medicine Universidade de Gurupi Brazil
| | - Julio Alves Silva-Neto
- Department of Pharmacology, Universidade de São Paulo - Ribeirão Preto (SP), Brazil. Universidade de São Paulo Department of Pharmacology Universidade de São Paulo Brazil
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Current Resources for Evidence-Based Practice, July 2019. J Obstet Gynecol Neonatal Nurs 2019; 48:478-491. [PMID: 31194933 DOI: 10.1016/j.jogn.2019.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Leung L, Grundy A, Siemiatycki J, Arseneau J, Gilbert L, Gotlieb WH, Provencher DM, Aronson KJ, Koushik A. Shift Work Patterns, Chronotype, and Epithelial Ovarian Cancer Risk. Cancer Epidemiol Biomarkers Prev 2019; 28:987-995. [PMID: 30842128 DOI: 10.1158/1055-9965.epi-18-1112] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 12/03/2018] [Accepted: 02/26/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Shift work causing circadian disruption is classified as a "probable carcinogen" and may contribute to the pathogenesis of hormone-sensitive cancers. This study investigated shift work exposure in relation to epithelial ovarian cancer (EOC) risk. METHODS In a population-based case-control study with 496 EOC cases and 906 controls, lifetime occupational histories were collected and used to calculate cumulative years of shift work exposure, average number of night shifts per month, and average number of consecutive night shifts per month. ORs and 95% confidence intervals (CI) for associations with EOC risk were estimated using logistic regression. Associations were also examined according to chronotype and menopausal status. RESULTS More than half of the cases (53.4%) and controls (51.7%) worked evening and/or night shifts. There was no clear pattern of increasing EOC risk with increasing years of shift work; the adjusted OR of EOC comparing the highest shift work category versus never working shift work was 1.20 (95% CI, 0.89-1.63). This association was more pronounced among those self-identified as having a "morning" chronotype (OR, 1.64; 95% CI, 1.01-2.65). Associations did not greatly differ by menopausal status. CONCLUSIONS These results do not strongly demonstrate a relationship between shift work and EOC risk. IMPACT This study collected detailed shift work information and examined shift work patterns according to shift times and schedules. The findings highlight that chronotype should be considered in studies of shift work as an exposure.
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Affiliation(s)
- Lisa Leung
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Anne Grundy
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
- Department of Social and Preventative Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Jack Siemiatycki
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
- Department of Social and Preventative Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Jocelyne Arseneau
- Gynecologic Oncology Unit, McGill University Health Centre, Montreal, Quebec, Canada
| | - Lucy Gilbert
- Gynecologic Oncology Unit, McGill University Health Centre, Montreal, Quebec, Canada
| | - Walter H Gotlieb
- Gynecologic Oncology and Colposcopy, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec, Canada
| | - Diane M Provencher
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Kristan J Aronson
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Ontario, Canada
| | - Anita Koushik
- Université de Montréal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
- Department of Social and Preventative Medicine, Université de Montréal, Montreal, Quebec, Canada
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Zhu B, Liu Q, Han Q, Zeng B, Chen J, Xiao Q. Downregulation of Krüppel‑like factor 1 inhibits the metastasis and invasion of cervical cancer cells. Mol Med Rep 2018; 18:3932-3940. [PMID: 30132534 PMCID: PMC6131627 DOI: 10.3892/mmr.2018.9401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 08/08/2018] [Indexed: 02/06/2023] Open
Abstract
Cervical cancer is one of the most common malignancies that seriously threatens women's health. Krüppel‑like factors (KLFs) have been reported to be associated with the progression of cervical cancer. The role of KLF1 in cervical cancer, which still remains unclear, was investigated in the present study. The expression of KLF1 was detected in different cervical cell lines by reverse transcription‑quantitative polymerase chain reaction (RT‑qPCR) and western blotting. Cell proliferation, metastasis and invasion were respectively detected by Cell Counting Kit‑8, wound healing and transwell assays. Associated factor expression was also detected by RT‑qPCR and western blotting. In addition, the phosphorylation levels of phosphatidylinositol‑3‑kinase (PI3K) and protein kinase B (Akt) were determined by western blot analysis. The results revealed that KLF1 expression was promoted in SiHa, Caski and C4‑1 cervical cancer cells. However, KLF1 knockdown suppressed cell proliferation, metastasis and invasion in SiHa cervical cancer cells. KLF1 knockdown also inhibited the expressions of Ki67, metastasis‑associated antigen 1 and matrix metalloproteinase (MMP)‑2. KLF1 knockdown promoted the expressions of nonmetastatic clone 23 type 1 and tissue inhibitor of metalloproteinase‑2, and the expression of MMP‑9 was promoted slightly as well. In addition, KLF1 knockdown inhibited the PI3K/Akt signaling pathway. Hence, it was concluded that KLF1 promoted metastasis and invasion via the PI3K/Akt signaling pathway in cervical cancer cells.
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Affiliation(s)
- Bisheng Zhu
- Oncology Department, Xingning Central Hospital, The First Affiliated Hospital of Hubei University of Science and Technology, Xianning, Hubei 437000, P.R. China
| | - Qisheng Liu
- Department of Gastroenterology, Xingning Central Hospital, The First Affiliated Hospital of Hubei University of Science and Technology, Xianning, Hubei 437000, P.R. China
| | - Qi Han
- Oncology Department, Xingning Central Hospital, The First Affiliated Hospital of Hubei University of Science and Technology, Xianning, Hubei 437000, P.R. China
| | - Bohang Zeng
- Oncology Department, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510260, P.R. China
| | - Jingqi Chen
- Oncology Department, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510260, P.R. China
| | - Qiuju Xiao
- Oncology Department, Xingning Central Hospital, The First Affiliated Hospital of Hubei University of Science and Technology, Xianning, Hubei 437000, P.R. China
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