Identification of key genes controlling cancer stem cell characteristics in gastric cancer

BACKGROUND Self-renewal of gastric cancer stem cells(GCSCs)is considered to be the underlying cause of the metastasis,drug resistance,and recurrence of gastric cancer(GC).AIM To characterize the expression of stem cell-related genes in GC.METHODS RNA sequencing results and clinical data for gastric adenoma and adenocarcinoma samples were obtained from The Cancer Genome Atlas database,and the results of the GC mRNA expression-based stemness index(mRNAsi)were analyzed.Weighted gene coexpression network analysis was then used to find modules of interest and their key genes.Survival analysis of key genes was performed using the online tool Kaplan-Meier Plotter,and the online database Oncomine was used to assess the expression of key genes in GC.RESULTS mRNAsi was significantly upregulated in GC tissues compared to normal gastric tissues(P<0.0001).A total of 16 modules were obtained from the gene coexpression network;the brown module was most positively correlated with mRNAsi.Sixteen key genes(BUB1,BUB1 B,NCAPH,KIF14,RACGAP1,RAD54 L,TPX2,KIF15,KIF18 B,CENPF,TTK,KIF4 A,SGOL2,PLK4,XRCC2,a n d C1 orf112)were identified in the brown module.The functional and pathway enrichment analyses showed that the key genes were significantly enriched in the spindle cellular component,the sister chromatid segregation biological process,the motor activity molecular function,and the cell cycle and homologous recombination pathways.Survival analysis and Oncomine analysis revealed that the prognosis of patients with GC and the expression of three genes(RAD54 L,TPX2,and XRCC2)were consistently related.CONCLUSION Sixteen key genes are primarily associated with stem cell self-renewal and cell proliferation characteristics.RAD54 L,TPX2,and XRCC2 are the most likely therapeutic targets for inhibiting the stemness characteristics of GC cells.

Prognostic significance of the preoperative hemoglobin to albumin ratio for the short-term survival of gastric cancer patients

BACKGROUND Hemoglobin and albumin are associated with the prognosis of gastric cancer(GC)patients. However, the prognostic value of the hemoglobin to albumin ratio(HAR) for the short-term survival of GC patients with D2 radical resection has not been studied.AIM To investigate the significance of the HAR in evaluating the short-term survival of GC patients after D2 radical resection and to construct a nomogram to predict the prognosis in GC patients after surgery, thus providing a reference for the development of postoperative individualized treatment and follow-up plans.METHODS Cox regression and Kaplan-Meier analysis was used for prognostic analysis.Logistic regression was used to analyze the relationships between HAR and the clinicopathological characteristics of the GC patients. A prognostic nomogram model for the short-term survival of GC patients was constructed by R software.RESULTS HAR was an independent risk factor for the short-term survival of GC patients.GC patients with a low HAR had a poor prognosis(P < 0.001). Low HAR was markedly related to high stage [odds ratio(OR) = 0.45 for Ⅱ vs Ⅰ;OR = 0.48 for Ⅲ vs Ⅰ], T classification(OR = 0.52 for T4 vs T1) and large tumor size(OR = 0.51 for ≥4 cm vs < 4 cm)(all P < 0.05). The nomogram model was based on HAR, age,CA19-9, CA125 and stage, and the C-index was 0.820.CONCLUSION Preoperative low HAR was associated with short-term survival in GC patients.The prognostic nomogram model can accurately predict the short-term survival of GC patients with D2 radical resection.