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5970 0004-8725

Biotechnology and Genetic Engineering Reviews

Biotechnology and Genetic Engineering Reviews

Taylor & Francis Taylor & Francis Group

ISSN: 0264-8725 (Print) 2046-5556 (Online) Journal homepage: www.tandfonline.com/journals/tbgr20

Bioinformatics analysis: relationship between adrenocortical carcinoma and KIFs

Xiao Li, Yanghao Tai, Shuying Liu, Yating Gao, Kaining Zhang, Jierong Yin, Huijuan Zhang, Xia Wang, Xiaofei Li & Dongfeng Zhang

To cite this article: Xiao Li, Yanghao Tai, Shuying Liu, Yating Gao, Kaining Zhang, Jierong Yin, Huijuan Zhang, Xia Wang, Xiaofei Li & Dongfeng Zhang (2023) Bioinformatics analysis: relationship between adrenocortical carcinoma and KIFs, Biotechnology and Genetic Engineering Reviews, 39:2, 575-585, DOI: 10.1080/02648725.2022.2160560

To link to this article: https://doi.org/10.1080/02648725.2022.2160560

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ARTICLE

Bioinformatics analysis: relationship between adrenocortical carcinoma and KIFs

Xiao Lia#, Yanghao Taib#, Shuying Liuª, Yating Gaoª, Kaining Zhangª, Jierong Yina, Huijuan Zhangª, Xia Wangª, Xiaofei Lia and Dongfeng Zhanga

ªDepartment of Thoracic Oncology, Linfen Central Hospital, Linfen, China; bDepartment of Clinical Medicine, Shanxi Medical University, Taiyuan, China

ABSTRACT

Adrenal cortical cancer has a relatively low incidence, but a dismal 5-year survival rate. Surgical intervention is the gold standard of care today. In spite of this progress, patients continue to have a dismal outlook. The results of this study demonstrate that kinin superfamily (KIF) has strong ties to many different types of cancers. However, their prognostic and immune cell infiltration of adrenocortical carcinoma (ACC) remain unclear. Multiple databases were searched for information on the transcription level of KIFs, its correlation with clinical data of ACC patients, patients’ overall survival (OS), first progression survival (FPS), and progression free interval (PFI). Its role and association with immune cells were also investigated. We observed an increase in the expression of KIF4A, KIF11, KIF20A, and KIF22. There was a strong correlation between them and the advancedness of ACC tumors. Parallel to this, KIFs are connected to the con- cepts of operating systems, distributed file systems, and partitioned file systems. Similarly, we found five key genes, PRC1, PLK1, KIF23, KIFC1, and KIF5A, through data analysis, all of which participate in multiple cellular pathways. Both KIF4A and KIF11 expression levels were marginally positively corre- lated with immune infiltration. Because KIF4A, KIF11, KIF20A, and KIF22 are involved in multiple ACC processes and can influence the onset and progression of ACC, they provide a mechanistically grounded framework for diagnosing and managing the disease.

ARTICLE HISTORY Received 9 November 2022 Accepted 15 December 2022

KEYWORDS Kifs; clinical data; prognosis; immune infiltration; ACC

1. Introduction

There are over a million new cases of adrenal cortical carcinoma (ACC) per year (Fassnacht et al., 2018), making it a relatively infrequent malignant tumor. Recurrence, poor prognosis, and high mortality are among character- istics that are often associated with ACC. Data show that the 5-year survival

3220060697@stu.cpu.edu.cn

Department of Thoracic Oncology, Linfen Central Hospital, Linfen 041000, China

Xiao Li and Yanghao Tai contributed equally to this work.

+ Supplemental data for this article can be accessed online at https://doi.org/10.1080/02648725.2022.2160560.

rate is much lower than 20%. A recurrence of ACC often occurs during the first two years after major surgery (Glenn et al., 2019). If you have ACC, you should know that surgical resection is the gold standard therapy. Surgery to remove adrenal tumors suspected of ACC should be comprehensive, includ- ing removal of peritumorous/periadrenal retroperitoneal fat, according to recent international recommendations (Fassnacht et al., 2018). Further, lymph node dissection should be conducted locally to decrease the recurrence rate and increase the survival time of patients (Mirallie et al., 2019). Recent research has shown PD-L1 expression in ACC malignancies. The high expression of the FATE1 gene, which is found in both male and female germ cells, in adult ACC tissue has also been linked to a bad prognosis Doghman et al. (2020). Patients diagnosed at stage I have a 5-year survival rate of over 80%, whereas those diagnosed at stage IV have a survival rate of approximately 13% (Fassnacht et al., 2009). Recent studies have shown that genetic and molecular features of ACC have a regulatory role in the invasion and proliferation of the pathogen (Wasserman et al., 2015). As a result, it is crucial to look for genes associated with acc prognosis and therapy.

Recent research has shown that members of the kinin superfamily (KIFs) are kinesins that operate on microtubules. Mainly, they use intracellular transporters to move things like organelles and messenger RNAs along microtubules in an ATP-dependent fashion (Hirokawa & Takemura, 2008; Hirokawa et al., 2009; Miki et al., 2005). They are present in both mitotic (engaged in cell division) and amitotic (involved in intracellular transport) eukaryotes (Rath & Kozielski, 2012; Vale et al., 1985). They’re crucial for cell morphogenesis and fundamental biological processes (like mitosis and meiosis), but they also take part in more complex living activities like memory and learning in the brain (Hirokawa & Takemura, 2008; Hirokawa et al., 2009; Miki et al., 2005). At present, there is no relevant research on the mechanism of KIFs in ACC.Multiple public databases were searched for information on KIFs belonging to ACC patients in order to determine the association between the two conditions, with the hopes of better informing treatment decisions and providing more insight into prognosis. This research shows that KIFs significantly influenced the onset and progression of adrenocortical carcinoma, which opens up new avenues for research into adrenocortical carcinoma, sheds light on its complex pathophysiology, and points toward potential therapeutic interventions.

2. Methodology

2.1. TCGA and GTEx

After obtaining gene expression profiles of adrenocortical carcinoma tissues and healthy adrenal cortex from TCGA (The Cancer Genome Atlas) and

GTEx (Genotype-Tissue Expression), we used R software (version 3.6.3) to determine whether or not there was a significant difference in the expres- sion of members of the kinesin family in these two groups. Specifically, version 3.3.3 of the ggplot2 software was used to generate the images. In addition, the TCGA database was queried for patient clinical data such age, gender, pathological stage, survival, and outcome.

2.2. Gene expression profiling interactive analysis (GEPIA) analysis

Differential gene expression analysis, gene-related survival analysis, correlation analysis, clinical tumor staging, and pathological tumor staging are all possible with the help of the GEPIA database’s adaptable tools. Information from the GTEx project and TCGA RNA-seq studies are included in GEPIA. An array of kinesin-related genes were analyzed for differential expression using GEPIA in this study. We utilized GEPIA to investigate the expression of kinesin family members throughout the spectrum of ACC disease progression, and we also used it to do a survival study connected to individual kinesin family members.

2.3. GeneMANIA analysis

GeneMANIA is a database that may be used to learn about the intercon- nectedness of genes of interest and to make educated guesses about their potential functions. GeneMANIA was consulted in order to learn more about the gene-gene interaction network of the kinesin family.

2.4. Search tool for the retrieval of interacting genes (STRING) analysis

Protein-protein interaction networks across species may be analyzed with the help of STRING, an online tool. We investigated the kinesin family’s protein-protein interaction network using the STRING database.

2.5. Functional enrichment and KEGG pathway analysis

Gene Ontology (GO) functional annotation was achieved by using biologi- cal processes (BP), cellular components (CC), and molecular functionalities (MF). All of the following R packages were utilized: We used the clusterProfiler (version 3.14.3) and ggplot2 (version 3.3.3) packages for our respective GO enrichment analyses and plotting, respectively.

2.6. Tumor immune estimation resource (TIMER) database

Direct immunological investigation of individual genes in tumors may be performed and seen in high detail using TIMER, which serves as a genetic

immunoassay platform. We analyzed the relationship between the expres- sion of members of the kinesin family and immunological infiltrates in tumors, including neutrophils, CD8+ T cells, CD4+ T cells, dendritic cells, B cells, and macrophages.

2.7. The relationship between kinesin family members and clinical characteristics

To prove the therapeutic value of kinesin family member prognostic evalua- tion, we compared expression patterns between malignancies and adjacent normal tissues. Prognostic kinesin family member expression was studied in relation to patient characteristics including Gleason score and TNM stage. This study used the t-test and one-way analysis of variance (ANOVA) to compare many groups. The cutoff for statistical significance was set at 0.05, or less.

3. Results and discussion

3.1. Differential expressions of kinesin family members in ACC

To determine the probable function of kinesin family members of adreno- cortical carcinoma, we sought GEPIA and observed that KIF4A, KIF11, KIF20A, and KIF22 were obviously up-regulated in ACC samples con- trasted with nontumor samples (Figure 1a). KIF1C, KIF5C, KIF7, KIF13A, KIF17, and KIFC2 indicate high levels of expression in normal adrenal cortex tissues.

3.2. The relation between the transcription level of the kinesin family member and tumor stage of adrenocortical carcinoma

After investigating the KIF gene family’s expression pattern in ACC, we speculated as to whether or not its transcriptional level was related to the stage of ACC. For this study, we used the GEPIA2 databases, which are built off of the TCGA database, to evaluate the data. As shown in Figure 2, KIF4A (P=4.1e-05), KIF11 (P=1.71e-05), KIF20A (P=9.37e-05) and KIF22 (P= 0.00567) were significantly associated with the tumor stage of adrenocortical carcinoma, whereas KIF1C, KIF5C, KIF7, KIF13A, KIF17 and KIFC2 groups did not significantly differ. Furthermore, univariate analysis using the Cox proportional hazards model indicated tumor stage and high mRNA expression of all four KIF family members were associated with poor survival prognosis (Table 1). Therefore, we regard these four genes as the key genes of ACC for further study.

Figure 1. KIF family expression in ACC as compared to controls. The KIF family gene expression was compared between ACC tissues (ACC; n = 77) and normal adrenal cortex tissues (n = 128) using the GEPIA database, yielding the following graphs: * p 0.05. Normal tissues are shown in gray, whereas those affected by cancer are depicted in red.

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ACC (num(T)=77; num(N)=128)

ACC (num(T)=77; num(N)=128)

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ACC

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(num(T)=77; num(N)=128)

Figure 2. Violin plots were used to depict the associations between the mRNA expression of KIFs and the clinical phases in ACC patients as determined by the GEPIA database. While the mRNA expressions of certain genes, such as KIF4A/11/20A/22, were strongly correlated with the clinical phases of their respective patients, the mRNA expressions of other genes were not.

1

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F value = 0.994

Pr[>F) = 0.401

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F value = 0.729 Pri>F]= 0.538

F value = 0.685

Pr(F) = 0.576

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Stage II

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Stage Ii

Stage III

Stage IV

Stage 1

Stage II

Stage III

Stage IV

KI

F value = 0.14 Pr(>F) = 0.935

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F value = 0.225 Pr(F) = 0.879

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F value = 8.19

Pr[>F)=9.37€-05

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F value = 4.55

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Stage l

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Stage II

Stage III

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3.3. Role of the key genes in the prognosis of adrenocortical carcinoma patients

The survminer package and survival package in R software were used to analyze and visualize the expression profile and clinical data of ACC patients in the database in order to gain a deeper understanding of the relationship between the expression level of the key genes and OS, disease specific survival (DFS), and

Table 1. Correlation between KIF expression and clinicopathologic characteristics of ACC patients.
Characteristics KIFsp-value
KIF4AKIF11KIF20AKIF22
Age0.9070.5710.5710.739
Gender0.5810.9280.081
T stage0.0030.0020.0080.002
N stage0.310.0140.310.31
M stage0.018< 0.0010.0180.075
Pathologic stage0.013< 0.0010.0280.006
Tumor status< 0.001< 0.001< 0.001< 0.001
New event0.003< 0.0010.0120.003
Radiation therapy0.2210.0760.2210.221
Primary therapy outcome< 0.001< 0.0010.002< 0.001
Residual tumor< 0.001< 0.0010.0020.009
Laterality0.8970.89710.559
Mitotane therapy0.2590.0060.1950.106

Differentials with a significance level of p < 0.05 are highlighted in bold.

progress free interval (PFI) in ACC patients. As shown in Figure 3, high expression of KIF4A (HR =7.54, P <0.001), KIF11 (HR =12.61, P<0.001), KIF20A (HR = 5.97, P < 0.001) and KIF22 (HR =4.66, P <0.001) were related to the poor OS of the patients with adrenocortical carcinoma. High expression of KIF4A (HR =7.25, P <0.001), KIF11 (HR=12.08, P<0.001), KIF20A (HR = 5.73, P < 0.001) and KIF22 (HR=4.40, P=0.001) were related with the poor DSS of the patients with adrenocortical carcinoma. Besides, high expression of KIF4A (HR =3.65, P<0.001), KIF11 (HR=5.96, P<0.001), KIF20A (HR= 3.02, P = 0.001) and KIF22 (HR = 3.46, P < 0.001) were connected with the poor FPI of the patients with adrenocortical carcinoma.

To confirm our observations, we used the online database GEPIA to assess the prognostic ability of significant genes in ACC patients. The GEPIA2 database yielded findings that were comparable to those found in the TCGA database (Figure 4). High expression of KIF4A (Log-rank p = 1.5e-06), KIF11 (Log-rank p = 3.3e-08), KIF20A (Log-rank p = 1.1e-05) and KIF22 (Log-rank p = 0.00014) was connected with the poor OS of the patients with adrenocortical carcinoma. Besides, high expression of KIF4A (Log-rank p = 0.0016), KIF11 (Log-rank p =2.8e-06), and KIF20A (Log- rank p = 0.004) were related to the poor DFS of the patients with adreno- cortical carcinoma. These results indicate that the mRNA levels of KIF4A, KIF11, KIF20A, and KIF22 are related to clinical prognosis and might be prognostic markers in patients with ACC.

3.4. Examining the roles of kinesin family members in ACC: a functional and pathway enrichment analysis

GeneMANIA was used to build the gene-gene interaction network of the essential kinesin family (Figure 5a). Physical interaction, co-expression,

Figure 3. Using TCGA data, researchers have determined the predictive relevance of gene expression in the KIF family in patients with ACC. Predictive value of the crucial genes is shown via curves created using R tools. Several metrics are evaluated, such as PFI, OS, and DSS. Red lines represent extreme expressiveness, whereas blue lines represent the opposite. In each graph's lower right corner, you'll see the log-rank test results.

1.0

KIF4A

1.0

KIF4A

1.0

KIF4A

Low

Low

Low

High

High

High

0.8

Survival probability

0.8

0.8

Survival probability

Survival probability

0.6

0.6

0.6

0.4

0.4

0.4

0.2

Overall Survival

0.2

Disease Specific Survival

0.2

Progress Free Interval

HR = 7.54 (2.85-19.95)

HR = 7.25 (2.72-19.38)

HR = 3.65 (1.86-7.16)

0.0

P < 0.001

0.0

P < 0.001

0.0

P < 0.001

0

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150

0

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150

Time (months)

Time (months)

Time (months)

1.0

KIF11

1.0

KIF11

1.0

KIF11

Low

Low

Low

High

High

High

Survival probability

0.8

Survival probability

0.8

Survival probability

0.8

0.6

0.6

0.6

0.4

0.4

0.4

0.2

Overall Survival

0.2

HR = 12.61 (4.16-38.18)

Disease Specific Survival HR = 12.08 (3.96-36.90)

0.2

Progress Free Interval

HR = 5.96 (2.84-12.51)

0.0

P < 0.001

0.0

P < 0.001

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P < 0.001

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Time (months)

Time (months)

Time (months)

1.0

KIF20A

1.0

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KIF20A

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High

Survival probability

0.8

Survival probability

0.8

Survival probability

0.8

0.6

0.6

0.6

0.4

0.4

0.4

0.2

Overall Survival

0.2

HR = 5.97 (2.40-14.90)

Disease Specific Survival

0.2

HR = 5.73 (2.27-14.44)

Progress Free Interval

HR = 3.02 (1.55-5.88)

0.0

P < 0.001

0.0

P < 0.001

0.0

P = 0.001

0

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0

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Time (months)

1.0

KIF22

1.0

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1.0

KIF22

Low

Low

Low

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High

High

Survival probability

0.8

Survival probability

0.8

Survival probability

0.8

0.6

0.6

0.6

0.4

0.4

0.4

0.2

Overall Survival HR = 4.66 (2.00-10.85)

0.2

Disease Specific Survival HR = 4.40 (1.86-10.39)

0.2

Progress Free Interval

HR = 3.46 (1.75-6.83)

0.0

P < 0.001

0.0

P = 0.001

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P < 0.001

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50

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Time (months)

Time (months)

Time (months)

Figure 4. The GEPIA database of ACC patients and the predictive importance of the mRNA expression of key KIF family members. Increased mRNA expression of individual KIF members was linked to shorter overall survival and disease-free survival in individuals with adrenocortical cancer. When comparing survival curves, the log-rank test was applied.

Overall Survival

Disease Free Survival

Overall Survival

Disease Free Survival

9

LOW KIF4A TPM

8

Low KIF4A TPM

9

High KIF4A TPM

High KIF4A TPM

LOW KIF11 TPM

9

Low KIF11 TPM

Logrank p=1.5e-06

High KIF11 TPM

High KIF11 TPM

0.8

HR(high)=7.8

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HR(high) 2,9

Logrank p=3.3e-08

Logrank p=2.8e-06

p(HR)=3.80-05

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8

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n(high)=38

n(low)=38

Percent survival

n(high)=38

n(low)=38

Percent survival

n(high)=38

Percent survival

n(high)=38

0.6

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low)=38

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Overall Survival

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Low KIF20A

1

High KIF20A TPM

Low KIF20A TPM

:

Low KIF22 TPM

2

High KIF20A

Low KIF22 TPM

Logrank p=1.1e-05

Logrank p=0.004

High KIF22

Logrank p=0.00014

High KIF22 TPM

Logrank p=0.079

0.8

HR(high)=6.4

P(HR)=9.4e-05

OB

HR(high)=2.7

p(HR)=0.0055

0

HR(high)=4.7

p(HR)=0.00043

30

HR(high)=1.8

p(HR)=0.083

Percent survival

nthigh)=38

n(low)=38

Percent survival

n[high)=38

0.6

0.6

n(low)=38

Percent survival

n(high)=38 [(Tow)=38

Percent survival

n(high)=38

0.6

0.6

nílow)=38

0.4

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anticipated, co-localization, genetic exchange, route, and common protein domains were only a few of the GeneMANIA network categories that encircled the essential kinesin family members. Protein regulator of cyto- kinesis 1 (PRC1), polo-like kinase 1 (PLK1), kinesin family member 23 (KIF23), kinesin family member C1 (KIFC1), and kinesin family member 5A (KIFC1) were the top 5 genes linked to the essential kinesin family members (KIF5A). PRC1 showed the strongest association with the genes involved in physical contact. It is possible that the kinesin family member interacts with the other four genes in the context of antigen processing and presentation of peptide antigen via MHC class II, antigen processing and presentation of peptide or polysaccharide antigen via MHC class II, the microtubule-associated complex, motor activity, tubulin binding, the spin- dle apparatus, and mitotic nuclear division. The STRING database was also used to build the protein-protein interaction network (version 11.5). Figure 5b displays the 10 proteins that were linked to the crucial genes. The aforementioned 20 genes and their linked essential genes were analyzed for GO functional enrichment and visualized using the R program. Figure 5c and Supplementary Table S1 both show the outcomes.

3.5. Immune infiltration analysis of kinesin family member in ACC

Tumor microenvironment features such as immune cell infiltration are indepen- dent indicators of prognosis and lymph node metastasis. Figure 6 displays the results of an examination of the TIMER2.0 database that compares KIF to other immune cells seen in AC. KIF4A and KIF11 expression in ACC was weakly

Figure 5. An overview of the KIF gene family's predicted activities and pathways. (a)schematic depicting the protein-protein interactions within the KIF gene family (GeneMANIA). (b) Twenty members of the KIF gene family that are highly expressed in ACC have been shown to interact with one another via protein-protein interactions (PPI), which is revealed. (STRING). (c) Analysis of biological processes, cellular components, and molecular activities associated with the KIF gene family using the GO functional enrichment tool.

a

Networks

Functions

Physical Interaction

Microtubule associated complex

Co-expression

KF11

Motor activity

Predicted

Tubulin binding

Co-localization

Antigen processing and presentation of peptide antigen via MHC class II

Pathway

Antigen processing and presentation of peptide or polysaccharide antigen via MHC class II

Genetic Interactions

Spindle

Shares protein domains

Mitotic nuclear division

b

PLK1

CDK1

KIF20A

c

tubulin binding

microtubule binding

motor activity

KIF11

p.adjust

DLGAP5

202856e-16

microtubule motor activity

3.152142e-16

microtubule

2.101428e-16

1.050714e-16

CDCAB

KIF4A

microtubule associated complex

1.8225480-28

kinesin complex

Counts

10

AURKB

KIF22

spindle

12

14

microtubule-based movement

16

Known Interactions

Others

antigen processing and presentation of peptide

From curated databases

Textmining

antigen via MHC class II

Experimentally determined

Co-expression

antigen processing and presentation of exogenous

Protein homology

peptide antigen via MHC class II

Predicted Interactions

retrograde vesicle-mediated transport, Golgi to ER

Gene neighborhood

Gene fusions

0.5

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Gene co-occurrence

GeneRatio

Figure 6. Correlation analysis between the essential KIF genes' mRnas and common immune cells. The cutoff for statistical significance was set at p <0.05.

KIF4A Expression Level (log2 TPM)

6

Purity

B Cel

CD8+ T Cell

CD4+ T Cell

Macrophage

Neutrophil

Dendritic Cell

cor = 0.262

p - 2.42e-02

partial.cor = 0.322

p = 5.44e-03

partial.cor = - 0.051

p - 6.66e-01

partial.cor = 0.022

p - 8.50e-01

partial.cor = - 0.02

P - 8.67e-01

partial.cor = 0.155

p = 1.91e-01

partial.cor = 0.326

p = 4.91e-03

F

KIF

4A

2

02

0.4

0.6

0.8

1.0

0.11

0.12

0.13

0.20

0.25

0.30

0.35 0.07

0.09

0.11

0.13

0.15

0.08

0.12

0.18

0.12

0.14

0.16

0.18

0.49

0.50

0.51

0.52

0.53

Infiltration Level

KIF11 Expression Level (log2 TPM)

Purity

B Cell

CD8+ T Cell

CD4+ T Cell

Macrophage

Neutrophil

Dendritic Cell

7.5

cor = 0.368

p = 1.24e-03

partial.cor = 0.37

p = 1.26e-03

partial.cor = - 0.077

p = 5.17e-01

partial.cor = 0.013

p = 9.15e-01

partial.cor = - 0.038

p = 7.50e-01

partial.cor = 0.125

P = 2.93e-01

partial.cor = 0.253

p = 3.06e-02

.0

KIF

AC

11

0.0

0.2

0.4

0.6

0.8

1.0

0.11

0.12

0.13

0.20

0.25

0.30

0.35 0.07

0.09

0.11

0.13

0.15

0.08

0.12

0.14

Infiltration Level

0.12

0.18

0.16

0.18

0.49

0.50

0.51

0.52

0.53

KIF20A Expression Level (log2 TPM)

Purity

B Cell

CD8+ T Cel

CD4+ T Cell

Macrophage

Neutrophil

Dendritic Cell

7.5

cor = 0.268

p = 2.11€-02

partial.cor = 0,192

p = 1.03e-01

partial.cor = - 0.152

p = 1.980-01

partial.cor = - 0.053

p = 6.54e-01

partial.cor = - 0.082

p = 4.91e-01

partial.cor = 0.066

p = 5.80e-01

partial.cor = 0.155

p = 1.89e-01

5.0

KIF2

2.5

ADO

0A

0.0

2.5

0.2

0.4

0.6

0.8

1.0

0.11

0.12

0.13

0.20

0.25

0.30

0.35 0.07

0.09

0.11

0.13

0.15

0.08

0.12

0.16

0.12

0.14

0.15

0.18

0.49

0.50

0.51

0.52

0.53

Infiltration Level

KIF22 Expression Level (log2 TPM)

Purity

B Coll

CDB- T Col

CD4+ T Col

Macrophago

Neutrophil

Dendritic Coll

cor - 0.219

partial.cor = 0.011

p = 6.07e-02

p - 9.26e-01

partial.cor = 0.11

p - 3.540-01

partial.cor = 0.101

P- 3.93e-01

partial.cor - - 0.074

p = 5.34e-01

partial.cor - 0.039

partial.cor - - 0.01

p = 7.43e-01

p = 9.36e-01

5

KIF2

ACC

2

9

0.2

0.4

0.6

0.8

1.0

0.11

0.12

0.13

0.20

0.25

0.30

0.35 0.07

0.09

0,11

0.13

0.15

0.08

0.12

0.16

0.12

0.14

0.16

0.18

0.49

0.50

0.51

0.52

0.53

Infiltration Level

correlated with immune infiltration characteristics such as purity of infiltration, B cell count, and dendritic cell count (Figure 4a). However, there was no relationship between KIF20A and KIF22 expression and immune cell count.

4. Conclusion

Using a variety of sources, we uncovered the following about KIF: 1. KIF1C, KIF5C, KIF7, KIF13A, Kif17, and KIFC2 were considerably expressed in normal adrenal cortex, whereas KIF4A, KIF11, KIF20A, and KIF22 were highly up- regulated in ACC samples. Among the KIFs, KIF4A (P=4.1e-05), KIF11, KIF20A, and KIF22 were substantially linked to ACC tumor stage, but KIF1C, KIF5C, KIF7, KIF13A, KIF17, and KIFC2 were not. The genes KIF4A, KIF11, KIF20A, and KIF22 are linked to ocular surface disease, fibrosis, and ischemia. There is a negative association between OS, DFS, and PFI and the expression of KIF4A, KIF11, KIF20A, and KIF22. There is some speculation that they can be used as prognostic indicators in ACC patients. By querying the database, we were able to identify five key genes - PRC1, PLK1, KIF23, KIFC1, and KIF5A - in the process of building a gene interaction network. Microtubule-related complex, motility, microtubule-binding spindle, and mitosis play major roles, as do MHC II antigen processing and presentation of peptide antigen and MHC II antigen processing and presentation of polysaccharide antigen 5. Weak immune infiltration, including purity, B cell, and dendritic cell infiltration, was favorably linked with KIF4A and KIF11 expression levels. There was no correlation between the total number of immune cells and the KIF20A and KIF22 expression levels. Last but not least, we think that KIF4A, KIF11, KIF20A, and KIF22 all play a role in various ACC processes, have an impact on the onset and progression of ACC, and provide a unique foundation upon which to build a prognosis and treatment plan for the disease.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Data sharing agreement

The datasets used and/or analyzed during the current study are available from the corre- sponding author on reasonable request.

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