FOXK1-induced upregulation of NXPH4 predicts poor prognosis and promotes hepatocellular carcinoma progression via PI3K/Akt pathway

Hepatocellular carcinoma (HCC) stands out as a remarkably diverse and complex disease, presenting a myriad of challenges when it comes to predicting prognostic outcomes. Although lactate and branched-chain amino acids (BCAA) are important for the development and progression of various tumors, their function in HCC progression remained largely unclear. The study aimed to identify molecular subtypes in HCC based on lactate metabolism and BCAA metabolism. Clustering 370 HCC patients revealed two distinctive subtypes associated with unfavorable prognosis. Differential expression analysis identified 941 DEGs in lactate metabolism subtypes and 518 in BCAA metabolism subtypes, primarily linked to tumor and metabolism pathways. Prognostic analysis identified 27 LRG-BCAA-DGEs inversely correlated with long-term survival across various cancers. Methylation analysis showed a negative correlation between methylation and mRNA expression of these genes, with limited impact on survival outcomes. NXPH4, dysregulated across tumors, exhibited complex associations with immune cells and prognostic implications in HCC. Functional analysis revealed DEGs associated with endodermal cell differentiation and metabolic pathways. NXPH4 knockdown suppressed HCC cell proliferation, migration, and invasion, indicating its potential as a therapeutic target. Additionally, NXPH4 modulated glucose metabolism via the PI3K/Akt pathway. FOXK1 was identified as a potential transcriptional regulator of NXPH4, suggesting a regulatory axis in HCC tumorigenesis. The study highlights the molecular complexity of HCC, providing insights into potential biomarkers and therapeutic targets.