Fig. 4

Outlines for H19 functions during tumor progression. Various stress conditions drive genomic instability in its wide meaning of mutation and chromosomal abnormalities. In some cases, such as severe reduction in P53 levels, H19 upregulation in sub-clones of stressed cells is a direct cancerous reaction to stress that drives proliferation and accelerates mutational rate. H19 acts to enable a selfish cellular survival plan and reacts to stress conditions by accelerating proliferation rate. H19 subsequently promotes the metastatic cascade from EMT in the primary tumor to metastasizing in secondary sites, depending on extracellular and intercellular context