High expression of fibroblast activation protein (FAP) predicts poor outcome in high-grade serous ovarian cancer
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RESEARCH ARTICLE
Open Access
High expression of fibroblast activation protein (FAP) predicts poor outcome in high-grade serous ovarian cancer Min Li1†, Xue Cheng2†, Rong Rong3†, Yan Gao4,5, Xiuwu Tang1*
and Youguo Chen1*
Abstract Background: High-grade serous ovarian cancer (HGSOC) is a fatal form of ovarian cancer. Previous studies indicated some potential biomarkers for clinical evaluation of HGSOC prognosis. However, there is a lack of systematic analysis of different expression genes (DEGs) to screen and detect significant biomarkers of HGSOC. Methods: TCGA database was conducted to analyze relevant genes expression in HGSOC. Outcomes of candidate genes expression, including overall survival (OS) and progression-free survival (PFS), were calculated by Cox regression analysis for hazard rates (HR). Histopathological investigation of the identified genes was carried out in 151 Chinese HGSOC patients to validate gene expression in different stages of HGSOC. Results: Of all 57,331 genes that were analyzed, FAP was identified as the only novel gene that significantly contributed to both OS and PFS of HGSOC. In addition, FAP had a consistent expression profile between carcinoma-paracarcinoma and early-advanced stages of HGSOC. Immunological tests in paraffin section also confirmed that up-regulation of FAP was present in advanced stage HGSOC patients. Prediction of FAP network association suggested that FN1 could be a potential downstream gene which further influenced HGSOC survival. Conclusions: High-level expression of FAP was associated with poor prognosis of HGSOC via FN1 pathway. Keywords: Fibroblast activation protein (FAP), The Cancer genome atlas program (TCGA), High-grade serous ovarian cancer (HGSOC), Survival
Background Ovarian cancer is one of the major causes of death in females globally. According to 2018 global cancer statistics, 295,414 new cases and 184,799 deaths were reported [1]. In gynecological oncology, ovarian cancer is less prevalent than breast cancer and cervix cancer, however the death rate of OC is the highest [1]. The most recent 2020 cancer statistics in United States also confirmed that ovarian cancer is the fifth cause of deaths * Correspondence: [email protected]; [email protected] † Min Li, Xue Cheng and Rong Rong contributed equally to this work. 1 Department of Gynecology & Obstetrics, the First Affiliated Hospital of Soochow University, No.188, Shizi Street, Suzhou, Jiangsu Province 215006, China Full list of author information is available at the end of the article
of females (13,940 patients, 5% of total cancer-related death), only trailing by lung & bronchus cancer, breast cancer, colon & rectum cancer, and pancreas cancer [2]. According to the NIH Surveillance, Epidemiology, and End Results program (SEER) survival statistics (2009– 2015), 5-year survivorship of ovarian cancer is only 47.6% [3], which remained virtually unchanged since the last decade [4]. Based on the immunohistological variation, serous ovarian cancer is the most common subtype of ovarian can
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