Pathway Genes in Ovarian Cancer: Clinical Significance and Associations with Immune Cell Infiltration.

Background: Activation of the signaling pathway is associated with tumorigenesis. The aim of this study was to investigate pathway gene functions and regulatory mechanisms in ovarian cancer (OC).

Methods: We conducted a bioinformatics analysis of publicly available datasets in order to identify potential -related mechanisms, associated genes, biological pathways, and their relation to immune function.

Results: Significant differential expression of the pathway genes , , , , , , , , and was observed between OC samples and normal controls. Low expression of DLL4 and of in OC patients was associated with International Federation of Gynecology and Obstetrics (FIGO) stage (0.001 and = 0.036, respectively), while high expression of was associated with race ( = 0.039) and age ( = 0.044). JAG2 and expression were significantly associated with progression-free interval (PFI) ( = 0.011 and = 0.039, respectively). (Hazard Ratio (HR): 2.096; 95% CI: 1.522-2.886, 0.001) and (HR: 0.711; 95% CI: 0.514-0.983, = 0.039) expression were independently associated with PFI in multivariate analysis. , , , , and expression could significantly differentiate OC from non-cancer samples. Genes associated with the pathway were mainly enriched in five signaling pathways: the signaling pathway, breast cancer, endocrine resistance, Th1 and Th2 cell differentiation, and oxidative phosphorylation. The expression of pathway genes was significantly associated with immune cell infiltration.

Conclusions: pathway genes appear to play an important role in the progression of OC by regulating immune cells, endocrine resistance, Th1 and Th2 cell differentiation, and oxidative phosphorylation. and are potential biomarkers and therapeutic targets for the treatment of OC.