Screening and identification of MSX1 for predicting progestin resistance in endometrial cancer

Abstract

Background: Progestin resistance is a critical obstacle for endometrial conservative therapy. Therefore, the studies to acquire a more comprehensive understanding of the mechanisms and specific biomarkers to predict progestin resistance are very important. However, the pivotal roles of essential molecules of progestin resistance are still unexplored.Methods: We downloaded GSE121367 with gene expression profiles of medroxyprogesterone acetate (MPA) resistant and sensitive cell lines from the GEO database. The "limma" R language package was applied to identify differentially expressed genes (DEGs). Gene ontology and pathway enrichment analysis was performed through the database of DAVID. Meanwhile, we conducted GSEA analysis to identify pathway enrichments. Protein-protein interaction construction of top genes was conducted to screen hub genes by STRING and visualized in Cytoscape. A high connectivity degree of hub genes were picked out to perform the differential expression, methylation validation and overall survival analysis in the Gene Expression Profiling Interactive Analysis database, Human Protein Atlas database and Kaplan-Meier plotter online tool, respectively. In addition, microRNAs and upstream transcription factors of hub genes were predicted by miRTarBase and Network Analyst database.Results: A total number of 3282 differentially expressed genes were identified. Functional enrichment analysis demonstrated that these genes were mostly enriched in negative regulation of DNA binding, chronic inflammatory response and cell adhesion molecules pathway. We screened out ten hub genes including CDH1, JAG1, PTGES, EPCAM, CNTNAP2, TBX1, MSX1, KRT19, OAS1 and DAB2 among different groups. The genomic alteration rates of hub genes were low based on the current uterine corpus endometrial carcinoma sample sets. Their relevant microRNA and transcription factor were detected and has-miR-335-5p, has-miR-124-3p, MAZ and TFDP1 were the most prominent. The methylation status of CDH1, JAG1, EPCAM and MSX1 were decreased, corresponding to their high protein expression in endometrial cancers, which also indicated better overall survival. The homeobox protein of MSX1 showed significantly tissue specificity.Conclusions: Our study identified ten hub genes associated with progestin resistance of endometrial cancer and screened out the gene of MSX1 which promised to be the specific indicator. This would