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Volume 23, Issue 3 (May 2021) 23, 259–265; 10.4103/aja.aja_30_20

Characterization of progression-related alternative splicing events in testicular germ cell tumors

Chuan-Jie Zhang1, Zong-Tai Li2, Kan-Jie Shen3, Lu Chen1, Dan-Feng Xu1, Yi Gao1

1 Department of Urinary Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
2 Department of Medical Oncology, Gaozhou People's Hospital, Gaozhou 525200, China
3 First Clinical Medical College of Nanjing Medical University, Nanjing 210000, China

Correspondence: Dr. L Chen (cl12063@rjh.com.cn) or Dr. DF Xu (xdf12036@163.com)

Date of Submission 15-Aug-2019 Date of Acceptance 26-Apr-2020 Date of Web Publication 02-Oct-2020


Accumulating evidence supports the significance of aberrant alternative splicing (AS) events in cancer; however, genome-wide profiling of progression-free survival (PFS)-related AS events in testicular germ cell tumors (TGCT) has not been reported. Here, we analyzed high-throughput RNA-sequencing data and percent-spliced-in values for 150 patients with TGCT. Using univariate and multivariate Cox regression analysis and a least absolute shrinkage and selection operator method, we identified the top 15 AS events most closely associated with disease progression. A risk-associated AS score (ASS) for the 15 AS events was calculated for each patient. ASS, pathological stage, and T stage were significantly associated with disease progression by univariate analysis, but only ASS and pathological stage remained significant by multivariate analysis. The ability of these variables to predict 5-year progression was assessed using receiver operating characteristic curve analysis. ASS had stronger predictive value than a combination of age, pathological stage, and T stage (area under the curve = 0.899 and 0.715, respectively). Furthermore, Kaplan–Meier analysis of patients with low and high ASS demonstrated that high ASS was associated with significantly worse PFS than low ASS (P = 1.46 × 10−7). We also analyzed the biological functions of the PFS-related AS-related genes and found enrichment in pathways associated with DNA repair and modification. Finally, we identified a regulatory network of splicing factors with expression levels that correlated significantly with AS events in TGCT. Collectively, this study identifies a novel method for risk stratification of patients and provides insight into the molecular events underlying TGCT.

Keywords: alternative splicing events; network; progression-free survival-related model; testicular germ cell tumor

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