“…In our analysis, intense PPIA expression was observed in most of the LUAD tissues, while limited expression was shown in the peritumoral tissues.The high expression of PPIA was related to the poor survival of LUAD patients,which was consistent with the correlation between the overexpression of PPIA and the overall survival of liver hepatocellular carcinoma and colorectal cancer [21,22].ROC curve analysis indicated that PPIA could be a promising diagnostic biomarker to differentiate LUAD from normal tissues.In addition,the progression of LUAD may be associated with the upregulation of PPIA.Notably,the expression of PPIA was positively correlated with high N stage,high pathological stage.Patients with LUAD with higher expression levels of PPIA exhibited signi cantly shorter overall survival times.The increased expression of PPIA in LUAD with pathological stage of III/IV and lymph node metastasis further indicates that PPIA may be involved in the progression and malignant transformation of LUAD. In subgroup analyses, patients of LUAD with high PPIA expression had shorter OS than patients with low PPIA levels and were characterized by TNM stage,pathological stage,male and female,whole age,anatomic neoplasm subdivision of left and peripheral,smoke and non-smoke,smoked for less than 40 years.In M0 stage,the OS was shorter in patients with high expression of PPIA, while in the M1 phase, the epitopes of PPIA were not correlated with OS,which may be related to the aforementioned viewpoint that the anti-tumor properties of CypA may be more effective in the initial stages of cancer development [27].The current results indicated that PPIA may serve as a biomarker for the progress of LUAD.Therefore, in clinical work, LUAD patients with high expression of PPIA have a higher risk of recurrence, and follow-up examinations should be performed more frequently.…”