Yangyang Lu’s research while affiliated with First Affiliated Hospital of China Medical University and other places

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Publications (9)


Study workflow.
Identification of core prognostic genes and enrichment analysis. (A) Venn diagram illustrating the intersection of 685 genes associated with autophagy, senescence, and STAD. (B) Volcano plot of DEASRGs based on intersected genes. (C) GO functional annotation of DEASRGs. (D) KEGG enrichment analysis of DEASRGs. (E) Univariate Cox regression analysis identifying 29 genes. (F) Frequencies of CNV gain and loss among 29 prognostic genes. (G) Circular plots visualizing chromosome distributions of core prognostic genes.
Development and verification the ASRGs signature. (A) LASSO regression model selection curve with log(λ) on the x-axis and partial likelihood deviance on the y-axis. (B) Coefficients of the LASSO regression model. (C, D) KM survival curves of OS. (E, G) Survival curves of patients with GC. (F, H) Distribution of survival status based on risk score. (I, J) Heatmaps of gene expression for the prognostic model genes. (K, M) Comparison of ROC curves. (L, N) ROC curve using temporal information (time-dependent ROC curves).
Association of the prognostic signature with gene clusters and immunological features. (A) The heat map display of consensus clustering is categorized into three cluster (C1 = 277; C2 = 63; C3 = 26). (B) PCA showing the perfect separation of C1, C2 and C3. (C) KM survival curves with three distinct clusters. (D) A Sankey diagram illustrating the link between gene clusters, risk group, and survival status. (E) Variations in risk score among the three gene subtypes. (F-H) ESTIMATE algorithm results for three gene clusters. (I) Expression of immune checkpoints related genes. (J) The heat map depicting variations in immune cell infiltration as determined using TIMER, CIERSORT, quanTIseq, MCPcounter, xCell, and EPIC algorithms.
Establishment and validation of the nomogram. (A, E) A nomogram was established to forecast the 1-year, 3-year, and 5-year OS. (B, F) Calibration plots illustrating the agreement of predicted survival rates compared to the actual observed survival rates. (C, G) A DCA was carried out to compare the net benefits of the nomogram incorporating the prognostic signature, the nomogram excluding the prognostic signature, and other factors. (D, H) The AUC was employed to compare the predictive accuracy of the nomogram with other prognostic markers.

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A prognostic model based on autophagy-and senescence-related genes for gastric cancer: implications for immunotherapy and personalized treatment
  • Article
  • Full-text available

March 2025

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15 Reads

Shuming Chen

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Xiaoxi Han

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Yangyang Lu

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[...]

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Weiwei Qi

Background The process of human aging is accompanied by an increased susceptibility to various cancers, including gastric cancer. This heightened susceptibility is linked to the shared molecular characteristics between aging and tumorigenesis. Autophagy is considered a critical mediator connecting aging and cancer, exerting a dynamic regulatory effect in conjunction with cellular senescence during tumor progression. In this study, a combined analysis of autophagy- and senescence-related genes was employed to comprehensively capture tumor heterogeneity. Methods The gene expression profiles and clinical data for GC samples were acquired from TCGA and GEO databases. Differentially expressed autophagy- and senescence-related genes (DEASRGs) were identified between tumor and normal tissues. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were carried out to provide insights into biological significance. A prognostic signature was established using univariate Cox and LASSO regression analyses. Furthermore, consensus clustering analyses and nomograms were employed for survival prediction. TME and drug sensitivity analyses were conducted to compare differences between the groups. To predict immunotherapy efficacy, the correlations between risk score and immune checkpoints, MSI, TMB, and TIDE scores were investigated. Results A fourteen-gene prognostic signature with superior accuracy was constructed. GC patients were stratified into three distinct clusters, each exhibiting significant variations in their prognosis and immune microenvironments. Drug sensitivity analysis revealed that the low-risk group demonstrated greater responsiveness to several commonly used chemotherapeutic agents for gastric cancer, including oxaliplatin. TME analysis further indicated that the high-risk group exhibited increased immune cell infiltration, upregulated expression of ICs, and a higher stromal score, suggesting a greater capacity for immune evasion. In contrast, the low-risk group was characterized by a higher proportion of microsatellite instability-high (MSI-H) cases, an elevated TIDE score, and a greater TMB, indicating a higher likelihood of benefiting from immunotherapy. In addition, Single-cell sequencing demonstrated that TXNIP was expressed in epithelial cells. Cellular experiments preliminarily verified that TXNIP could promote the proliferation and migration of gastric cancer cells. Conclusion This study presents a robust predictive model for GC prognosis using autophagy- and senescence-related genes, demonstrating its ability to predict immune infiltration, immunotherapy effectiveness, and guide personalized treatment.

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Nrf2 depletion enhanced curcumin therapy effect in gastric cancer by inducing the excessive accumulation of ROS

December 2024

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8 Reads

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1 Citation

Gastric cancer (GC) is the most common malignant tumor of the gastrointestinal tract and currently has a poor clinical outcome. Turmeric’s rhizome contains a polyphenolic component called curcumin (Cur), which has been demonstrated to inhibit a variety of tumor cells, such as pancreatic, colon, lung and gastric cancers. However, it remains to be elucidated how Cur functions in GC and what molecular processes underlie it. Here, Cur showed a stronger inhibitory effect on GC cells AGS and HGC27. In addition, Cur’s inhibition of GC cells growth was accompanied by increased ROS production, triggering of the Keap1-Nrf2 signaling pathway, and increased transcription of its downstream antioxidant genes HO-1, GCLM, and NQO1. However, when a ROS scavenger NAC was used, the inhibitory effect of Cur on GC cells was reversed. Nuclear factor erythroid 2-related factor 2 (Nrf2) is overexpressed or activated in cancers to shield cancer cells from oxidative damage by responding to oxidative stress (OS). Cur has been found to act as an activator of Nrf2. Notably, compared with Nrf2 knockdown and Cur alone, the combination of the two dramatically increased Cur-induced ROS overaccumulation and inhibition of GC cells proliferation, migration, and invasive abilities. Consistent with in vitro experiments, Cur combined with Nrf2 knockdown significantly inhibited tumor growth in nude mice transplanted with AGS cells. Therefore, we concluded that Nrf2 depletion enhanced Cur therapy effect in GC by inducing the excessive accumulation of ROS, indicating that this is a promising treatment strategy. Supplementary Information The online version contains supplementary material available at 10.1038/s41598-024-81375-1.


An investigation of the molecular characterization of the tripartite motif (TRIM) family and primary validation of TRIM31 in gastric cancer

July 2024

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10 Reads

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2 Citations

Human Genomics

Most TRIM family members characterized by the E3-ubiquitin ligases, participate in ubiquitination and tumorigenesis. While there is a dearth of a comprehensive investigation for the entire family in gastric cancer (GC). By combining the TCGA and GEO databases, common TRIM family members (TRIMs) were obtained to investigate gene expression, gene mutations, and clinical prognosis. On the basis of TRIMs, a consensus clustering analysis was conducted, and a risk assessment system and prognostic model were developed. Particularly, TRIM31 with clinical prognostic and diagnostic value was chosen for single-gene bioinformatics analysis, in vitro experimental validation, and immunohistochemical analysis of clinical tissue microarrays. The combined dataset consisted of 66 TRIMs, of which 52 were differentially expressed and 43 were differentially prognostic. Significant survival differences existed between the gene clusters obtained by consensus clustering analysis. Using 4 differentially expressed genes identified by multivariate Cox regression and LASSO regression, a risk scoring system was developed. Higher risk scores were associated with a poorer prognosis, suppressive immune cell infiltration, and drug resistance. Transcriptomic data and clinical sample tissue microarrays confirmed that TRIM31 was highly expressed in GC and associated with a poor prognosis. Pathway enrichment analysis, cell migration and colony formation assay, EdU assay, reactive oxygen species (ROS) assay, and mitochondrial membrane potential assay revealed that TRIM31 may be implicated in cell cycle regulation and oxidative stress-related pathways, contribute to gastric carcinogenesis. This study investigated the whole functional and expression profile and a risk score system based on the TRIM family in GC. Further investigation centered around TRIM31 offers insight into the underlying mechanisms of action exhibited by other members of its family in the context of GC. Supplementary Information The online version contains supplementary material available at 10.1186/s40246-024-00631-7.


Development and verification of a manganese metabolism- and immune-related genes signature for prediction of prognosis and immune landscape in gastric cancer

May 2024

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16 Reads

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2 Citations

Background Gastric cancer (GC) poses a global health challenge due to its widespread prevalence and unfavorable prognosis. Although immunotherapy has shown promise in clinical settings, its efficacy remains limited to a minority of GC patients. Manganese, recognized for its role in the body’s anti-tumor immune response, has the potential to enhance the effectiveness of tumor treatment when combined with immune checkpoint inhibitors. Methods Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) databases was utilized to obtain transcriptome information and clinical data for GC. Unsupervised clustering was employed to stratify samples into distinct subtypes. Manganese metabolism- and immune-related genes (MIRGs) were identified in GC by univariate Cox regression and least absolute shrinkage and selection operator (LASSO) regression analysis. We conducted gene set variation analysis, and assessed the immune landscape, drug sensitivity, immunotherapy efficacy, and somatic mutations. The underlying role of NPR3 in GC was further analyzed in the single-cell RNA sequencing data and cellular experiments. Results GC patients were classified into four subtypes characterized by significantly different prognoses and tumor microenvironments. Thirteen genes were identified and established as MIRGs, demonstrating exceptional predictive effectiveness in GC patients. Distinct enrichment patterns of molecular functions and pathways were observed among various risk subgroups. Immune infiltration analysis revealed a significantly greater abundance of macrophages and monocytes in the high-risk group. Drug sensitivity analysis identified effective drugs for patients, while patients in the low-risk group could potentially benefit from immunotherapy. NPR3 expression was significantly downregulated in GC tissues. Single-cell RNA sequencing analysis indicated that the expression of NPR3 was distributed in endothelial cells. Cellular experiments demonstrated that NPR3 facilitated the proliferation of GC cells. Conclusion This is the first study to utilize manganese metabolism- and immune-related genes to identify the prognostic MIRGs for GC. The MIRGs not only reliably predicted the clinical outcome of GC patients but also hold the potential to guide future immunotherapy interventions for these patients.


Constructing and validating a risk model based on neutrophil-related genes for evaluating prognosis and guiding immunotherapy in colon cancer

April 2024

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11 Reads

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2 Citations

The Journal of Gene Medicine

Background Colon cancer is one of the most common digestive tract malignancies. Although immunotherapy has brought new hope to colon cancer patients, there is still a large proportion of patients who do not benefit from immunotherapy. Studies have shown that neutrophils can interact with immune cells and immune factors to affect the prognosis of patients. Methods We first determined the infiltration level of neutrophils in tumors using the CIBERSORT algorithm and identified key genes in the final risk model by Spearman correlation analysis and subsequent Cox analysis. The risk score of each patient was obtained by multiplying the Cox regression coefficient and the gene expression level, and patients were divided into two groups based on the median of risk score. Differences in overall survival (OS) and progression‐free survival (PFS) were assessed by Kaplan–Meier survival analysis, and model accuracy was validated in independent dataset. Differences in immune infiltration and immunotherapy were evaluated by immunoassay. Finally, immunohistochemistry and western blotting were performed to verify the expression of the three genes in the colon normal and tumor tissues. Results We established and validated a risk scoring model based on neutrophil‐related genes in two independent datasets, The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) database, with SLC11A1 and SLC2A3 as risk factors and MMP3 as a protective factor. A new nomogram was constructed and validated by combining clinical characteristics and the risk score model to better predict patients OS and PFS. Immune analysis showed that patients in the high‐risk group had immune cell infiltration level, immune checkpoint level and tumor mutational burden, and were more likely to benefit from immunotherapy. Conclusions The low‐risk group showed better OS and PFS than the high‐risk group in the neutrophil‐related gene‐based risk model. Patients in the high‐risk group presented higher immune infiltration levels and tumor mutational burden and thus may be more responsive to immunotherapy.


Nortriptyline hydrochloride, a potential candidate for drug repurposing, inhibits gastric cancer by inducing oxidative stress by triggering the Keap1-Nrf2 pathway

March 2024

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59 Reads

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3 Citations

Effective drugs for the treatment of gastric cancer (GC) are still lacking. Nortriptyline Hydrochloride (NTP), a commonly used antidepressant medication, has been demonstrated by numerous studies to have antitumor effects. This study first validated the ability of NTP to inhibit GC and preliminarily explored its underlying mechanism. To begin with, NTP inhibits the activity of AGS and HGC27 cells (Human-derived GC cells) in a dose-dependent manner, as well as proliferation, cell cycle, and migration. Moreover, NTP induces cell apoptosis by upregulating BAX, BAD, and c-PARP and downregulating PARP and Bcl-2 expression. Furthermore, the mechanism of cell death caused by NTP is closely related to oxidative stress. NTP increases intracellular reactive oxygen species (ROS) and malondialdehyde (MDA) levels, decreasing the mitochondrial membrane potential (MMP) and inducing glucose (GSH) consumption. While the death of GC cells can be partially rescued by ROS inhibitor N-acetylcysteine (NAC). Mechanistically, NTP activates the Kelch-like ECH-associated protein (Keap1)—NF-E2-related factor 2 (Nrf2) pathway, which is an important pathway involved in oxidative stress. RNA sequencing and proteomics analysis further revealed molecular changes at the mRNA and protein levels and provided potential targets and pathways through differential gene expression analysis. In addition, NTP can inhibited tumor growth in nude mouse subcutaneous tumor models constructed respectively using AGS and MFC (mouse-derived GC cells), providing preliminary evidence of its effectiveness in vivo. In conclusion, our study demonstrated that NTP exhibits significant anti-GC activity and is anticipated to be a candidate for drug repurposing.


Role of Kinetochore Scaffold 1 (KNL1) in Tumorigenesis and Tumor Immune Microenvironment in Pan-Cancer: Bioinformatics Analyses and Validation of Expression

October 2023

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23 Reads

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2 Citations

Purpose Kinetochore scaffold 1 (KNL1), a crucial protein during cell mitosis participating in cell division, was widely expressed in multiple kinds of cancers. However, the expression profile, the effect on cell biological function, tumor immune microenvironment, and predictive value of clinical prognosis in pan-cancer of KNL1 still require a comprehensive inquiry. Methods The mRNA and protein expression profile of KNL1 was validated in pan-cancer using different databases. Six algorithms were used to explore the correlation between KNL1 and immune infiltration and the relationship between KNL1 and tumor mutation burden (TMB), microsatellite instability (MSI), and TIDE score were calculated. The diagnostic and clinical prognostic predictive ability of KNL1 was assessed. Differentially expressed genes (DEGs) of KNL1 were screened out and function enrichment analyses were performed in pancreatic adenocarcinoma (PAAD), stomach adenocarcinoma (STAD), and bladder urothelial carcinoma (BLCA). Finally, 8 cases of pancreatic adenocarcinoma tissues and paired adjacent tissues were collected for immunohistochemical (IHC) staining and the histological score (H-score) was calculated. Real-time PCR was performed in gastric cancer and bladder cancer cell lines. Results KNL1 was abnormally upregulated in more than half of cancers across different databases. IHC and real-time PCR verified the up-regulated expression in cancer tissues in PAAD, gastric cancer, and BLCA. The satisfactory diagnostic value of KNL1 was indicated in 30 cancers and high KNL1 expression was associated with poorer overall survival (OS) in 12 cancers. The prognostic role of KNL1 as a predictive biomarker of PAAD was clarified. KNL1 played an active part in the cell cycle and cell proliferation. Moreover, KNL1 was likely to mold the Th2-dominant suppressive tumor immune microenvironment and was associated with TMB, MSI, and immune checkpoint-related genes in pan-cancer. Conclusion Our study elucidated the anomalous expression of KNL1 and revealed that KNL1 was a promising prognostic biomarker in pan-cancer.


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Construction and validation of neutrophil-related gene based risk models for assessing colon cancer prognosis and guiding immunotherapy

July 2023

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33 Reads

Purpose Colon cancer is one of the most common digestive tract malignancies. Studies have shown that neutrophils can interact with immune cells and immune factors to affect the prognosis of patients. Methods We first determined the infiltration level of neutrophils in tumors using CIBERSORT and identified key genes in the final risk model by Spearman correlation analysis and subsequent Cox analysis. The risk score of each patient was obtained by multiplying the Cox regression coefficient by the gene expression level, and patients were divided into two groups according to the median. Differences in OS and PFS were assessed by KM survival analysis, and model accuracy was validated in another independent dataset. Finally, the differences in immune infiltration and immunotherapy were evaluated by immunoassay. Results We established and validated a risk scoring model based on neutrophil-related genes in two independent datasets; the patients in the high-risk group had a poorer prognosis than those in the low-risk group. A new nomogram was constructed and validated by combining clinical characteristics and the risk score model to better predict patient OS and PFS. Immune analysis showed that patients in the high-risk group had immune cell infiltration level, immune checkpoint levels, and tumor mutational burden and were more likely to benefit from immunotherapy. Conclusion The low-risk group had relatively better OS and PFS than the high-risk group in the neutrophil-related gene-based risk model. Patients in the high-risk group presented higher immune infiltration levels and tumor mutational burden and thus may be more responsive to immunotherapy.


Cepharanthine, a regulator of keap1-Nrf2, inhibits gastric cancer growth through oxidative stress and energy metabolism pathway

May 2023

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61 Reads

Cephalanthine (CEP), a bioactive compound derived from Stephania Cephalantha Hayata , is cytotoxic to various malignancies. However, the underlying mechanism of gastric cancer is unknown. CEP inhibited the cellular activity of gastric cancer AGS and HGC27 cell lines in this study. CEP induced apoptosis, reduced Bcl-2 expression, and increased cleaved caspase 3, cleaved caspase 9, Bax, and Bad expression. CEP caused a G2 cell cycle arrest and reduced cyclin D1 and cyclin-dependent kinases 2 (CDK2) expression. Meanwhile, it increased oxidative stress, decreased mitochondrial membrane potential, and enhanced reactive oxygen species (ROS) accumulation in AGS and HGC27 cells. Mechanistically, CEP inhibited Kelch-like ECH-associated protein (Keap1) expression while activating NF-E2 related factor 2 (Nrf2) expression, increasing transcription of Nrf2 target genes quinone oxidoreductase 1 (NQO1), heme oxygenase 1 (HMOX1), and glutamate-cysteine ligase modifier subunit (GCLM). Furthermore, a combined analysis of targeted energy metabolism and RNA sequencing revealed that CEP could alter the levels of metabolic substances such as D (+) - Glucose, D-Fructose 6-phosphate, citric acid, succinic acid, and pyruvic acid, thereby altering energy metabolism in AGS cells. In addition, CEP significantly inhibited tumor growth in MFC BALB/c nude mice in vivo , consistent with the in vitro findings. Overall, CEP can induce oxidative stress by regulating Nrf2/Keap1 and alter energy metabolism, resulting in anti-ovarian tumor effects. Our findings suggest a potential application of CEP in gastric cancer treatment.

Citations (6)


... It currently plays a vital role in cancer and cardiovascular disease prevention (4), liver protection with increased bile secretion, and inhibition of bacterial propagation (5), as well as suppression of inflammatory response diffusion in the human body (6,7). Curcumin can regulate multiple immune cells (including B lymphocytes, T lymphocytes, dendritic cells, monocytesmacrophages, natural killer cells, and neutrophils) (8,9)and cytokines (10), participating in various immune response processes (such as humoral immunity, cellular immunity, and autoimmunity) to reduce inflammatory responses while enhancing immune cell recognition, presentation, and killing of tumor cells (11,12). Modern studies have applied curcumin in treating autoimmune diseases (13), various types of tumors, HIV, hepatitis B-related liver cirrhosis, and even the novel coronavirus (14), achieving promising progress (15). ...

Reference:

Research trajectory and future trends in curcumin related to immunity: a bibliometric analysis of publications from last two decades
Nrf2 depletion enhanced curcumin therapy effect in gastric cancer by inducing the excessive accumulation of ROS

... Additionally, several TRIM proteins, including TRIM15, TRIM47, and TRIM55, have been implicated in EMT. These proteins facilitate EMT by modulating key molecular markers such as E-cadherin, N-cadherin, and Vimentin, contributing to increased cancer cell invasiveness and metastatic potential [74][75][76]145,[151][152][153][154][155][156][157][158][159]. ...

An investigation of the molecular characterization of the tripartite motif (TRIM) family and primary validation of TRIM31 in gastric cancer

Human Genomics

... In a univariate analysis, the risk score and TNM stage emerged as significant predictors of survival in gastric cancer patients (P < 0.001) (Fig. 6F); furthermore, multivariate analysis indicated a statistically significant correlation (P < 0.001) between the risk score, age, and survival, even after controlling for other variables (Fig. 6G). We compared our own model to 14 other published GC models to better highlight its predictive capability [18][19][20][21][22][23][24][25][26][27][28][29][30][31]. When compared to other models, ours has a higher C-index (Fig. 6H). ...

Development and verification of a manganese metabolism- and immune-related genes signature for prediction of prognosis and immune landscape in gastric cancer

... Although pathology played an important role in evaluating the prognosis of diseases such as tumors, its predictive accuracy was still limited. Clinical pathological evaluation usually only focuses on changes at the tissue or cellular level and may not fully consider the overall condition of the patient [27]. Cancer cells originate from normal tissue cells and may be the result of genetic factors leading to certain gene changes [28]. ...

Constructing and validating a risk model based on neutrophil-related genes for evaluating prognosis and guiding immunotherapy in colon cancer
  • Citing Article
  • April 2024

The Journal of Gene Medicine

... Among them, cisplatin is widely used in clinical practice but faces challenges, including drug resistance, side effects, and the lack of optimized drug delivery systems [34]. Meanwhile, other drugs targeting oxidative stress are still in preclinical studies (nortriptyline, histone deacetylase (HDAC) inhibitors, topotecan, etc.) [35][36][37], or clinical trial stages (multivitamins, etc.) [38]. Hence, gaining a deeper understanding of redox-related biological events and exploring their applications in the precision treatment of gastric cancer may provide more effective therapeutic strategies. ...

Nortriptyline hydrochloride, a potential candidate for drug repurposing, inhibits gastric cancer by inducing oxidative stress by triggering the Keap1-Nrf2 pathway

... Machine learning and deep learning have demonstrated strong performance in predictive tasks, enabling the inference of a wide range of gene mutations, molecular tumor subtypes, gene expression signatures, and traditional pathological biomarkers directly from conventional histology ( Figure 4, Table 2) [36]. These technologies play important roles in investigating the prognostic ability and the relationship between biological substances and pan-cancer, thus facilitating the discovery of potential biomarkers [37][38][39][40]. Al-Fatlawi et al. [41] predicted features with strong pan-cancer commonality and ranked them according to applicability, improving the versatility of the predicted biomarkers. ...

Role of Kinetochore Scaffold 1 (KNL1) in Tumorigenesis and Tumor Immune Microenvironment in Pan-Cancer: Bioinformatics Analyses and Validation of Expression