| Background and objectiveOvarian cancer is the third most common gynecologic malignancy in the world and has the highest mortality rate among gynecologic cancers.Serous ovarian cancer is one of the most common ovarian malignancies.Because of its insidious onset,early clinical symptoms are not obvious,and patients often have abdominal dissemination by the time of detection,resulting in unsatisfactory treatment and poor prognosis.BIRC5 has been a hot topic in cancer research since its discovery,and it has biological functions such as inhibiting apoptosis and promoting cell proliferation.There are differences in histological morphology and prognosis between high-grade and low-grade serous ovarian cancer.So,is BIRC5 differentially expressed in high-grade and low-grade serous ovarian cancer?And is BIRC5 associated with prognostic differences between high-grade and low-grade serous ovarian cancer?The aim of this study was to screen for key molecules that discriminate between high-grade and low-grade serous ovarian cancer and provide a reference for clinicopathological diagnosis and prognostic assessment.Materials and Methods1.Differentially expressed genes between high-grade serous ovarian cancer and low-grade serous ovarian cancer were identified using three GEO series.2.Functional enrichment analysis to explore the biological processes and pathways belonging to differentially expressed genes between high-grade and low-grade serous ovarian cancer.3.A protein-protein interaction network was constructed and key Hub genes were screened,which further refined the scope of the study.4.Obtained Hub genes were repeatedly validated by prognostic correlation,coexpression,and immunohistochemistry analysis using databases such as GTEx,Oncomine,Kaplan-Meier plotter,cBioportal,and HPA.5.Thirty-eight cases of high-grade serous ovarian cancer,20 cases of low-grade serous ovarian cancer and 20 cases of borderline serous tumors were collected and diagnosed in the gynecology department of the First People’s Hospital of Kunshan City between January 2014 and August 2021.None of the patients underwent chemotherapy or radiotherapy before operation,and the clinicopathologic data were complete.6.Immunohistochemistry was used to detect the expression of key molecules in high-grade and low-grade serous ovarian cancer and borderline serous ovarian tumor.7.SPSS22.0 software was used to further analyze the relationship between the expression levels of key molecules and patients’ pathological grade,age,preoperative serum CA125 concentration,FIGO stage,TP53 expression and Ki-67 expression,and to analyze the relationship between key molecules and prognosis of ovarian cancer patients.Results1.In comparison with low-grade serous ovarian cancer,79 upregulated genes and 85 downregulated genes were selected in high-grade serous ovarian cancer,whose biological functions are primarily enriched for cell cycle processes and chromosome segregation.Among the 10 hub genes further screened,BIRC5 was negatively associated with overall survival in ovarian cancer patients(P= 0.044).2.In immunohistochemistry studies,BIRC5 expression in high-grade serous ovarian cancer was higher than in low-grade serous ovarian cancer and borderline serous tumors,statistically significant compared to the pathological grade of ovarian serous tumors(P<0.05),and positively correlated with clinical FIGO staging and Ki-67(P<0.05).Conclusions1.BIRC5 expression was positively correlated with FIGO stage and Ki-67 expression in patients with ovarian serous tumors(P=0.0175,P<0.0001).2.BIRC5 can be used for the differential diagnosis of high-grade and low-grade serous ovarian cancer,and can be used as a key molecule to evaluate the prognosis of patients with ovarian cancer.3.BIRC5 is an oncogenic gene that may promote the development of ovarian cancer by regulating Ki-67 expression. |
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