Abstract: Objective To investigate the expression levels of forkhead box transcription gene C1 (FOXC1) and epithelial cadherin (E-Cadherin) in hepatocellular carcinoma (HCC) tissues, analyze the correlation of FOXC1 and E-Cadherin with prognosis, and explore the impact of FOXC1 and E-cadherin on the biological behavior of HCC cells.Methods A total of 85 patients with primary hepatocellular carcinoma who underwent radical resection in our hospital from April 2017 to April 2022 were selected for the study. Tumor focal tissues and adjacent tissues were collected during the operation. The expression levels of FOXC1 and E-Cadherin were determined by immunohistochemistry, and their correlation with prognosis of patients was analyzed. The HepG2 cell line was divided into sh FOXC1 group, sh NC group and blank control group. The proliferation and invasion ability of the cells were determined by plate cloning assay and Transwell assay.Results The positive expression rates of FOXC1 protein and E-Cadherin in HCC tissues were 74.12% and 28.24%, respectively. Meanwhile, in adjacent tissues, the rates were 43.53% and 100.00%, respectively.These differences were statistically significant (P<0.05). The positive expression rate of FOXC1 and E-cadherin was significantly higher in patients with TNM stage Ⅲ~Ⅳ, low to moderate differentiation, and tumor diameter ≥3 cm. Conversely, the positive expression rates of E-cadherin was notably decreased in these patients. These differences were statistically significant (P<0.05). Spearman analysis revealed that FOXC1 expression was negatively correlated with prognosis (P<0.05), while E-Cadherin expression was positively correlated with prognosis (P<0.05). In the cell experiment, the expression of FOXC1 protein in the blank control group and sh NC group was higher than that in normal hepatocytes, and the expression of E-cadherin protein was lower than that in normal hepatocytes, with statistically significant differences (P<0.05). Downregulation of FOXC1 significantly impaired the proliferation and invasion of hepatocellular carcinoma cells (P<0.05).Conclusion The expression of FOXC1 and E-cadherin is correlated with the prognosis of hepatocellular carcinoma. FOXC1 promotes the proliferation of cancer cells and inhibits the expression of E-cadherin to promote the process of epithelial-mesenchymal transition, enhance the invasiveness of hepatocellular carcinoma cells, and affect clinical prognosis.

Key words: Forkhead box protein C1, Epithelial cadherin, Cancer of the liver, The prognosis, Biological behavior