Comprehensive analysis of recently discovered lncRNA-associated competing endogenous RNA network in nasopharyngeal carcinoma

Nasopharyngeal carcinoma is one of the most common malignancies of the head and neck arising from the epithelium of the nasopharynx [1]. Although nasopharyngeal cancer occurs worldwide, it is much more common in certain parts of Southeast Asia, and the high incidence of NPC in these regions results in serious health problems [2]. In addition to geographical differences, certain ethnic groups such as the Bidayuhs of Borneo, the Nagas of northern India, and the Inuits of the Arctic also seem to be predisposed to nasopharyngeal carcinoma. Males are two to three times more likely to be affected than females, with a peak age of onset between 50 and 60 years [3]. Nasopharyngeal carcinoma morphologically is recognized as a mixture of epithelial and lymphoid cells. According to the WHO classification, NPC is divided into three pathological subtypes including, keratinizing squamous cell carcinoma, nonkeratinizing squamous cell carcinoma, and undifferentiated or poorly differentiated carcinoma (lymphoepithelioma and anaplastic variants) depending on the degree of differentiation [4]. Epstein-Barr virus infection is one of the major risk factors, and several studies have confirmed the presence of this virus in tumor tissue taken from patients. Human papillomavirus (HPV) is another viral risk factor that is common among white people [5], [6]. In addition to viral factors, various studies have revealed the role of genetic factors in the development of nasopharyngeal carcinoma. A number of genes involved in the DNA repair systems, immune responses, and metabolic pathways play an important role in the pathogenesis of the disease [7]. Using genome-wide association studies, several disease-related loci have been found one of the most important of which is the HLA coding locus on chromosome 6p21. Other disease-related loci are GABBR1 (on chromosome 6p21), HCG9 (6p21), TNFRSF19 (13q12), MECOM (3q26), and CDKN2A and CDKN2B (9p21) [8]. In addition to all aforementioned factors implicated in NPC carcinogenesis, LncRNAs have recently been explained to play an active role in tumor development. About 90% of the genome is transcribed, but only 1.5% of these transcripts are translated into proteins. Transcripts that do not code for proteins are called non-coding RNAs. Initially, non-coding transcripts were thought to be junk products, but in recent years, many studies on the biogenesis and function of these transcripts have shown that non-coding RNAs play a critical role in gene expression [9]. Two important categories of non-coding RNAs based on their length, are microRNA with a length between 18 and 24 nucleotides, and long non-coding RNA (LncRNA) with a length of more than 200 nucleotides. LncRNAs can act as either oncogenes or tumor suppressors depending on tissue and downstream pathways [10].

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