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促凝血基因在肿瘤内的高表达是胃癌血管生成、上皮间质转化及患者较差生存率的一个预测指标。

Higher intra-tumoral expression of pro-coagulation genes is a predictor of angiogenesis, epithelial mesenchymal transition and worse patient survival in gastric cancer.

作者信息

Oshi Masanori, Sarkar Joy, Tokumaru Yoshihisa, Yan Li, Kosaka Takashi, Akiyama Hirotoshi, Nagahashi Masayuki, Kunisaki Chikara, Endo Itaru, Takabe Kazuaki

机构信息

Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center Buffalo, New York 14263, USA.

Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine Yokohama 236-0004, Japan.

出版信息

Am J Cancer Res. 2022 Aug 15;12(8):4001-4014. eCollection 2022.

Abstract

Coagulation regulates angiogenesis in cancer, and is associated with tumor development and metastasis. To date, there have been no studies quantifying the state of intra-tumoral coagulation. We measured intra-tumoral coagulation gene expression using the "Hallmark-COAGULATION" gene set in the MSigDB, performing gene set variation analysis and then assigning a "coagulation score" to quantify gene expression. Clinical, histologic, and genetic data were analyzed in 807 gastric cancer patients from the TCGA_STAD and GSE84437 databases. Tumors with increased expression of pro-coagulation genes were consistently associated with higher AJCC T-categories ( = 0.018), lymph node metastasis ( = 0.036), and stage ( = 0.006) in both cohorts. Patients with high coagulation scores were found to have worse disease-specific survival and overall survival (OS) ( = 0.019 and 0.011, respectively) in TCGA, and worse OS in GSE84437 cohort ( = 0.012). Higher expression of pro-coagulation genes correlated with increased intra-tumoral angiogenesis, as well as increased proportions of lymphatic and microvascular endothelial cells, endothelial cells, and pericytes, calculated by xCell algorithm. High coagulation scores were significantly associated with low tumor mutation burden, but not with intratumor heterogeneity and homologous recombination deficiency. Gastric cancers with high coagulation scores contained higher amounts of M1 macrophages and dendritic cells, and low numbers of Th1 cells (all <0.001). Genes for epithelial mesenchymal transition (EMT), myogenesis, apical junction, transforming growth factor (TGF)-β signaling, and angiogenesis were enriched in high coagulation score-gastric cancers (all false discovery rate <0.25). In conclusion, gastric cancers expressing higher levels of pro-coagulation genes demonstrate increased angiogenesis, EMT, TGF-β signaling and worse patient prognosis.

摘要

凝血作用调节癌症中的血管生成,并与肿瘤发展和转移相关。迄今为止,尚无研究对肿瘤内凝血状态进行量化。我们使用MSigDB中的“Hallmark-COAGULATION”基因集测量肿瘤内凝血基因表达,进行基因集变异分析,然后赋予一个“凝血评分”以量化基因表达。对来自TCGA_STAD和GSE84437数据库的807例胃癌患者的临床、组织学和基因数据进行了分析。在两个队列中,促凝血基因表达增加的肿瘤始终与更高的美国癌症联合委员会(AJCC)T分类(P = 0.018)、淋巴结转移(P = 0.036)和分期(P = 0.006)相关。在TCGA队列中,发现凝血评分高的患者疾病特异性生存率和总生存期(OS)较差(分别为P = 0.019和0.011),在GSE84437队列中OS更差(P = 0.012)。促凝血基因的高表达与肿瘤内血管生成增加以及通过xCell算法计算的淋巴管和微血管内皮细胞、内皮细胞和周细胞比例增加相关。高凝血评分与低肿瘤突变负担显著相关,但与肿瘤内异质性和同源重组缺陷无关。凝血评分高的胃癌含有更多的M1巨噬细胞和树突状细胞,而Th1细胞数量较少(均P<0.001)。上皮-间质转化(EMT)、肌生成、顶端连接、转化生长因子(TGF)-β信号传导和血管生成相关基因在凝血评分高的胃癌中富集(所有错误发现率<0.25)。总之,表达较高水平促凝血基因的胃癌表现出血管生成增加、EMT、TGF-β信号传导增强以及患者预后较差。

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