Expression of EMC6，C-myc and BCL-2 in Cervical Cancer Tissues and Prognosis Analysis
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摘要:
目的 通过生信分析，评估EMC6基因在泛癌及宫颈癌中的表达、免疫相关性及诊断价值，并探究EMC6、C-myc、BCL-2蛋白与宫颈癌的相关性及预后。 方法 分析TCGA和GTEx数据库中EMC6在泛癌和宫颈癌的表达，并利用SangerBox和Timer数据库评估EMC6与免疫相关性，以及ROC评估诊断潜力。通过免疫组化在68例宫颈癌及癌旁组织中检测EMC6、C-myc、BCL-2蛋白表达，分析其与临床病理特征的联系。使用Phi系数法分析相关性，并利用Kaplan-Meier法评估这些蛋白对预后的影响。 结果 宫颈癌中EMC6表达降低，对免疫浸润有显著影响，且诊断准确性较高（AUC = 0.819）。免疫组化显示，与宫颈癌旁组织相比，EMC6蛋白表达下降、而C-myc和BCL-2蛋白表达上调，差异均有统计学意义（P < 0.05）。EMC6表达与临床病理特征无相关性（P > 0.05），而C-myc与病理类型相关（P < 0.05），BCL-2与年龄、病理类型、肿瘤大小、分化程度相关（P < 0.05）。EMC6与C-myc、BCL-2表达在宫颈癌中呈负相关（Phi = -0.367 ，P = 0.002； Phi = -0.284 ，P = 0.019），且三者与患者总生存期显著相关（P < 0.05）。 结论 宫颈癌中EMC6蛋白表达下降，与C-myc、BCL-2蛋白表达呈负相关，且这些蛋白的表达水平与患者的总生存期之间存在显著的相关性，提示它们可能作为宫颈癌治疗和预后评估的潜在生物标志物。 Abstract:Objective This study employs bioinformatics analysis to evaluate the expression, immune correlation, and diagnostic value of EMC6 gene in pan-cancer and cervical cancer, and investigate the associations of EMC6, C-myc, and BCL-2 proteins with cervical cancer and patient prognosis. Methods This study analyzed the expression of EMC6 across pan-cancer and cervical cancer datasets from TCGA and GTEx, utilizing SangerBox and Timer databases to assess its correlation with immune response and employing ROC analysis to evaluate its diagnostic potential. EMC6, C-myc, and BCL-2 protein expressions were detected in 68 cases of cervical cancer and adjacent tissues using immunohistochemistry, and their associations with clinicopathological characteristics were analyzed. The Phi coefficient method was employed to assess correlations, and the Kaplan-Meier method was used to evaluate the impact of these proteins on prognosis. Results In cervical cancer, the expression of EMC6 decreased, which significantly affected immune infiltration and had a high diagnostic accuracy （AUC = 0.819）. Immunohistochemistry revealed that compared to the adjacent tissues of cervical cancer, the expression of EMC6 protein decreased, while the expressions of C-myc and BCL-2 proteins were upregulated, with statistically significant differences （P < 0.05）. EMC6 expression showed no correlation with clinicopathological features （P > 0.05）, while C-myc was associated with pathological type （P < 0.05）, and BCL-2 was associated with age, pathological type, tumor size, and degree of differentiation （ P < 0.05）. In cervical cancer, the expression of EMC6 was negatively correlated with C-myc and BCL-2 （Phi = -0.367, P = 0.002; Phi = -0.284, P = 0.019）, and all three were significantly associated with overall patient survival （ P < 0.05）. Conclusions The expression of EMC6 protein decreases in cervical cancer and is negatively correlated with the expression of C-myc and BCL-2 proteins. There is a significant correlation between the expression levels of these proteins and the overall survival of patients, suggesting that they may be used as treatments for cervical cancer and Potential biomarkers for prognostic assessment. -
Key words:
- EMC6 /
- C-myc /
- BCL-2 /
- Cervical cancer /
- Apoptosis
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图 1 EMC6在泛癌及宫颈癌中的表达
A：EMC6在多种肿瘤组织和癌旁组织中的差异表达分析；B：EMC6在宫颈癌样本及正常宫颈样本中的表达差异。*P < 0.05，**P < 0.01，***P < 0.001。
Figure 1. Expression of EMC6 in pan-cancer and cervical cancer
图 2 宫颈癌中EMC6表达与免疫浸润之间的关系及ROC诊断
A：EMC6表达与免疫浸润的相关性；B：EMC6的表达与肿瘤纯度及免疫细胞之间的相关性；C：EMC6作为宫颈癌生物标志物的ROC曲线分析。
Figure 2. The relationship between EMC6 expression and immune invasion in cervical cancer and the diagnosis of ROC
图 3 2组中EMC6与C-myc、BCL-2的表达（IHC染色，×400）
A、B：EMC6在宫颈癌组织和宫颈癌旁组织中的表达；C、D：C-myc在宫颈癌组织和宫颈癌旁组织中的表达；E、F：BCL-2在宫颈癌组织和宫颈癌旁组织中的表达。
Figure 3. Expression of EMC6，C-myc and BCL-2 in the two groups（IHC staining，×400）
图 4 宫颈癌中EMC6与C-myc、BCL-2的总体生存K-M曲线
A：EMC6总体生存K-M曲线；B：C-myc总体生存K-M曲线；C：BCL-2总体生存K-M曲线。
Figure 4. K-M curves of EMC6 vs. C-myc and BCL-2 in cervical cancer
表 1 EMC6与C-myc、BCL-2在宫颈组织中的比较（n）
Table 1. Comparison of EMC6 with C-myc and BCL-2 in cervical tissues （n）
组别 n EMC6阳性 C-myc阳性 Bcl-2阳性 宫颈癌组 68 30 43 38 宫颈癌旁组 68 49 27 3 χ2 10.903 7.536 42.773 P 0.001* 0.006* <0.001* *P < 0.05。 
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表 2 EMC6与C-myc、BCL-2的蛋白表达与宫颈癌临床病理特征的关系[n（%）]
Table 2. Relationship between the protein expression of EMC6，C-myc and BCL-2 and the clinicopathological features of cervical cancer[n（%）]
变量 n EMC6 C-myc Bcl-2 阳性 χ2 P 阳性 χ2 P 阳性 χ2 P 年龄（岁） 0.299 0.584 0.148 0.700 8.961 0.003* <50岁 36 17（47.2） 22（61.1） 14（38.9） ≥50岁 32 13（40.6） 21（65.6） 24（75.0） 病理类型 2.867 0.090 13.238 <0.001* 5.049 0.025* 鳞癌 50 19（38.0） 38（76.0） 32（64.0） 腺癌 18 11（61.1） 5（27.8） 6（33.3） 分期 0.141 0.707 2.264 0.132 0.753 0.385 I期 30 14（46.7） 16（53.3） 15（50.0） II期 38 16（42.1） 27（71.1） 23（60.5） 淋巴结转移 0.044 0.833 0.921 0.337 0.090 0.764 有 24 11（45.8） 17（70.8） 14（58.3） 无 44 19（43.2） 26（59.1） 24（54.5） 浸润深度 1.849 0.174 2.264 0.132 1.849 0.174 ≤1/2 30 16（53.3） 16（53.3） 14（46.7） >1/2 38 14（36.8） 27（71.1） 24（63.2） 肿瘤大小（cm） 0.001 0.973 0.274 0.601 8.484 0.004* <4 52 23（44.2） 32（61.5） 24（46.2） ≥4 16 7（43.8） 11（68.8） 14（87.5） 分化程度 1.074 0.300 0.014 0.906 6.271 0.012* 中分化 36 18（50.0） 23（63.9） 15（41.7） 低分化 32 12（37.5） 20（62.5） 23（71.9） *P < 0.05。
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表 3 EMC6与C-myc、BCL-2在宫颈癌中表达的关系
Table 3. Relationship between EMC6 and C-myc and BCL-2 expression in cervical cancer
EMC6 C-myc 合计 Phi P Bcl-2 合计 Phi P + − + − + 13 17 30 −0.367 0.002* 12 18 30 −0.284 0.019* − 30 8 38 26 12 38 合计 43 25 68 38 30 68 *P < 0.05。
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