HOXC-AS1 and EZH2 interaction increase HOXC9 expression and promote the malignant transformation of oral leukoplakia.

To investigate the role of HOXC9 in the transformation of oral leukoplakia (OLK) to oral squamous cell carcinoma (OSCC) and its effectiveness as a new molecular marker for oral leukoplakia carcinogenesis. : We assessed HOXC9 in OLK and OSCC using immunohistochemistry (IHC). Colony formation and transwell experiment were employed to appraise the function of HOXC9 in the malignant transformation of OLK. ChIP-qPCR, CO-IP, RIP-qPCR, RNA pull down and mass spectrometry were using to evaluate the molecular mechanism of HOXC9. HOXC9 expression was higher in patients with OSCC than in those with OLK, which is associated with increased malignant transformation of OLK. Functional experiments suggested that HOXC9 induces the acquisition of cancer stem cells (CSCs) and epithelial-to-mesenchymal transition (EMT). Subsequently, we found that the HOXC9-mediated malignant phenotype was reversed by HOXC-AS1 depletion. Mechanistically, HOXC-AS1 regulates H3K27me3 methylation and EZH2 as a potential HOXC-AS1-HOXC9 interacting protein. Finally, we found that the 251-619nt nucleotide of HOXC-AS1 competitively binds to EZH2. HOXC-AS1 competitively binds to EZH2, inhibiting its binding to H3 in the HOXC9 promoter region, resulting in a decrease in H3K27me3 and enhanced expression of HOXC9, thereby promoting CSCs and EMT in oral leukoplakia, ultimately leading to malignant transformation into oral squamous cell carcinoma.