In recent years, PCa has become the most common and deadly solid cancer and genitourinary tumor in men worldwide [52], with a diagnosis rate of 12% and a mortality rate of 9%, and its incidence rises with age [53]. The traditional clinical treatment options include resection, radiotherapy, chemotherapy, and endocrine therapy [54]. The tumor heterogeneity leads to limitations in conventional treatment and makes it difficult to effectively manage and risk assess patients [55, 56]. Recent studies have demonstrated the imperative of identifying new effective biomarkers and promising immune-related therapeutic targets that can be used to guide cancer treatment in clinical practice [57]. In this study, we found a high correlation between ROMO1 expression and clinical features such as the occurrence of PCa, subtypes classified by consistent clustering. Also, ROMO1 correlated with the level of immune cell infiltration and immune pathways in PCa.
Table 3
Functional annotation of GO_BP for candidate genes.
NO. | Term Category_BP | Count | PValue | Fold.Enrichment | FDR |
1 | GO:0006468:protein phosphorylation | 6 | 0.00 | 8.18 | 0.14 |
2 | GO:0006366:transcription from RNA polymerase II promoter | 5 | 0.00 | 6.06 | 0.64 |
3 | GO:1904668:positive regulation of ubiquitin protein ligase activity | 2 | 0.01 | 138.21 | 0.62 |
4 | GO:0030071:regulation of mitotic metaphase/anaphase transition | 2 | 0.01 | 138.21 | 0.64 |
5 | GO:0018105:peptidyl-serine phosphorylation | 3 | 0.02 | 14.93 | 0.64 |
6 | GO:0051301:cell division | 4 | 0.02 | 7.11 | 0.64 |
7 | GO:0000086:G2/M transition of mitotic cell cycle | 3 | 0.02 | 13.62 | 0.64 |
8 | GO:0006355:regulation of transcription, DNA-templated | 7 | 0.02 | 2.89 | 0.69 |
9 | GO:0045862:positive regulation of proteolysis | 2 | 0.02 | 65.47 | 0.69 |
10 | GO:0031572:G2 DNA damage checkpoint | 2 | 0.03 | 62.19 | 0.69 |
11 | GO:0045736:negative regulation of cyclin-dependent protein serine/threonine kinase activity | 2 | 0.03 | 56.54 | 0.69 |
12 | GO:0051439:regulation of ubiquitin-protein ligase activity involved in mitotic cell cycle | 2 | 0.05 | 54.08 | 0.69 |
13 | GO:0045892:negative regulation of transcription, DNA-templated | 4 | 0.04 | 4.99 | 0.74 |
14 | GO:0000281:mitotic cytokinesis | 2 | 0.04 | 42.89 | 0.74 |
Firstly, we selected consistent clustering and principal component analysis to identify 260 valid samples containing one normal group and four tumor subtypes. Secondly, the limmaR package was selected to differentially analyze the four groups of tumor subtypes from the normal group, respectively. Finally, 3521 DEGs were identified and functionally annotated, and these differentially expressed genes were found to be mainly enriched in ah immune-related pathways. Next, WGCNA and MEGENA were applied to construct co-expression networks of differentially expressed genes to identify gene modules associated with tumorigenesis and heterogeneity, and 29 overlapping genes were identified by calculation. Then, the Lasso Cox regression model was constructed to identify ROMO1, PLK1, and KIF4A5 as the optimal core genes. Subsequently, when analyzing the relationship between the expression of hub genes and tumor-infiltrating immune cells, it was found that the expression of ROMO1, PLK1, and KIF4A were all associated with tumor-infiltrating immune cells, which in turn led to the alteration of the tumor microenvironment alterations, which in turn lead to tumor heterogeneity. Finally, we found that nutlin-3, fluorouracil, and others could be potential therapeutic agents for ROMO1, and PD318088 and selumetinib could be potential therapeutic agents for PLK1. In conclusion, our study provides a new theoretical basis for the diagnosis and treatment of PCa.
Polo-like kinase 1 (PLK1) is a member of a family of serine/threonine protein kinases that are widely found in eukaryotic cells [58]. Its specific functions are mainly in cell cycle processes, including controlling mitotic entry and the G2/M checkpoint, coordinating centrosomes and the cell cycle, regulating spindle assembly and chromosome segregation, performing multiple functions during mid-spindle and abscission, promoting DNA replication, participating in the cytoplasmic division and meiosis, and playing an important role in the initiation, maintenance, and completion of mitosis [59–61]. The pharmacological inhibition of PLK1 in triple-negative breast cancer has been reported to increase the anti-proliferative activity of drug-resistant cells, which in turn causes G2/M phase block and increasing the phosphorylation of cell cycle proteins inducing apoptosis.[62]. Also, in PCa, mitotic kinase polo-like kinase 1 (PLK1) is expressed at elevated levels and is associated with tumor grade [63]. In the present study, we also found a significant prognostic effect of PLK1, with expression in different subtypes of the prostate gland also differing significantly from normal samples, and found that PLK1 expression was also associated with tumor-infiltrating immune cells, further demonstrating the reliability of PLK1 as a biomarker for PCa.
Table 4
Drugs that interact with the hub gene.
NO. | SYMBOL | DRUE | COR | FDR |
1 | KIF4A | Compound 23 citrate | 0.12 | 0.00 |
2 | KIF4A | ML239 | -0.15 | 0.00 |
3 | KIF4A | PD318088 | 0.17 | 0.00 |
4 | KIF4A | SID 26681509 | -0.12 | 0.01 |
5 | KIF4A | STF-31 | -0.11 | 0.01 |
6 | KIF4A | VAF-347 | 0.12 | 0.05 |
7 | KIF4A | YM-155 | -0.14 | 0.00 |
8 | KIF4A | erlotinib | 0.13 | 0.00 |
9 | KIF4A | fluorouracil | 0.12 | 0.00 |
10 | KIF4A | lapatinib | 0.14 | 0.00 |
11 | KIF4A | necrosulfonamide | -0.11 | 0.02 |
12 | KIF4A | niclosamide | -0.13 | 0.00 |
13 | KIF4A | nutlin-3 | 0.13 | 0.00 |
14 | KIF4A | selumetinib | 0.17 | 0.00 |
15 | KIF4A | serdemetan | 0.11 | 0.01 |
16 | KIF4A | trametinib | 0.16 | 0.02 |
17 | KIF4A | trifluoperazine | 0.12 | 0.02 |
18 | KIF4A | vandetanib | 0.10 | 0.03 |
19 | PLK1 | Compound 23 citrate | 0.03 | 0.47 |
20 | PLK1 | ML239 | -0.08 | 0.05 |
21 | PLK1 | PD318088 | 0.06 | 0.23 |
22 | PLK1 | SID 26681509 | -0.06 | 0.23 |
23 | PLK1 | STF-31 | -0.17 | 0.00 |
24 | PLK1 | VAF-347 | 0.07 | 0.28 |
25 | PLK1 | YM-155 | -0.09 | 0.044 |
26 | PLK1 | erlotinib | 0.01 | 0.91 |
27 | PLK1 | fluorouracil | -0.08 | 0.04 |
28 | PLK1 | lapatinib | 0.05 | 0.29 |
29 | PLK1 | necrosulfonamide | -0.04 | 0.41 |
30 | PLK1 | niclosamide | -0.10 | 0.016 |
31 | PLK1 | nutlin-3 | 0.05 | 0.25 |
32 | PLK1 | selumetinib | 0.07 | 0.14 |
33 | PLK1 | serdemetan | 0.01 | 0.81 |
34 | PLK1 | trametinib | 0.13 | 0.07 |
35 | PLK1 | trifluoperazine | 0.06 | 0.24 |
36 | PLK1 | vandetanib | 0.00 | 0.99 |
37 | ROMO1 | Compound 23 citrate | 0.12 | 0.00 |
38 | ROMO1 | ML239 | 0.02 | 0.71 |
39 | ROMO1 | PD318088 | 0.10 | 0.02 |
40 | ROMO1 | SID 26681509 | 0.02 | 0.63 |
41 | ROMO1 | STF-31 | 0.04 | 0.38 |
42 | ROMO1 | VAF-347 | -0.09 | 0.13 |
43 | ROMO1 | YM-155 | -0.02 | 0.78 |
44 | ROMO1 | erlotinib | 0.12 | 0.00 |
45 | ROMO1 | fluorouracil | 0.16 | 0.00 |
46 | ROMO1 | lapatinib | 0.11 | 0.01 |
47 | ROMO1 | necrosulfonamide | 0.11 | 0.02 |
48 | ROMO1 | niclosamide | -0.05 | 0.23 |
49 | ROMO1 | nutlin-3 | 0.18 | 2.01 |
50 | ROMO1 | selumetinib | 0.10 | 0.03 |
51 | ROMO1 | serdemetan | 0.12 | 0.00 |
52 | ROMO1 | trametinib | 0.07 | 0.39 |
53 | ROMO1 | trifluoperazine | 0.13 | 0.00 |
54 | ROMO1 | vandetanib | 0.05 | 0.32 |
Kinesin superfamily protein 4A (KIF4A) is found in all eukaryotes and belongs to a family of KIFs that are highly conserved [64]. KIF4A has important roles in DNA repair, DNA replication, spindle organization, cytoplasmic division, and intracellular transport [65]. KIF4A has been previously reported to be aberrantly expressed in many cancers, revealing its function and role in different tumors [66–68]. KIF4A can promote PCa cell growth through AR and AR-V7-dependent signaling [66]. In the present study, KIF4A expression in different subtypes of the prostate was also significantly different from normal samples, and KIF4A expression was also found to be associated with tumor-infiltrating immune cells.
Reactive oxygen species (ROS) modulator 1 (ROMO1) is a membrane protein found in mitochondria that is important for regulating mitochondrial ROS production and redox sensing [69]. Romo1 is capable of triggering and exacerbating cancer through extracellular signal-regulated kinases (ERKs) and nuclear factor-kB (NF-kB)-induced reactive oxygen species (ROS) [70]. ROS can trigger and exacerbate cancer in a variety of malignancies [71, 72]. It can also influence cancer cell invasion by affecting the epithelial-mesenchymal transition (EMT) pathway [73, 74]. This protein affects signaling pathways and ROS homeostasis, affects the G2/M phase cell cycle, and leads to cell overgrowth through increased expression levels[75]. Studies have shown that ROMO1 is overexpressed in hepatocellular carcinoma, colorectal cancer, and glioma [76–78] but has not been reported in PCa. In the present study, we selected the Wilcoxon test and found that ROMO1 was highly expressed in tumor tissue and significantly different from normal tissue; we also found that the four identified tumor subtypes were significantly different. The expression of ROMO1 was also found to be associated with tumor-infiltrating immune cells, leading to changes in the tumor microenvironment and further increasing tumor heterogeneity; drug sensitivity analysis revealed that nutlin-3 and fluorouracil could be used as potential therapeutic agents for ROMO1.
In general, tumor pathogenesis involves many interacting signaling pathways, including tumor cell proliferation, cell immortalization, invasion, and migration, etc[79]. The complexity of cancer can be reflected through the tumor microenvironment, while protein interactions can further increase heterogeneity between tumors [80, 81]. In the present study, we have used weighted gene co-expression network analysis (WGCNA), which classifies the gene co-expression network of PCa into 10 highly correlated signature modules. The modules were then correlated with specific clinical features to identify genes that are key to tumorigenesis and transformation, to help identify potential mechanisms involved, and to explore candidate biomarkers. However, WGCNA has the limitation of not being able to coexist at different levels of clustering within a single network, thus not reflecting the multi-scale hierarchical nature of complex networks. Multi-scale embedded gene co-expression network analysis (MEGENA), on the other hand, allows the construction and analysis of large-scale planar filtered co-expression networks to the greatest extent possible [43]. Parallelization of embedded network construction and the identification of multiscale clustering structures are two key components of MEGENA, which is an essential complement to existing co-expression network analysis methods by identifying multiscale modular systems and co-expression networks with varying degrees of sparse and tight connectivity. Here, by using WGCNA in conjunction with MEGENA to construct a gene co-expression network for PCa, we identified more meaningful clusters of co-expressed genes and identified key biomarkers associated with prostate carcinogenesis in transformation.
In this study, we combined various bioinformatic analysis methods, especially the introduction of weighted gene co-expression network analysis and multi-scale chimeric network analysis, to reveal that ROMO1 may serve as a new key prognostic marker for PCa. However, the article still has some limitations. Firstly, the role of ROMO1 has not been validated experimentally in vivo and in vitro, and secondly, the fact that the number of cancer samples and normal samples are not identical to each other has led to some preference in our data. We believe that if we had direct access to a larger sample of clinical sequencing data and sample information, we would obtain better and more accurate results.