Pan-cancer analysis of the prognostic and immunotherapeutic values of exostosin-1

Background: Exostosin-1 ( EXT1 ) is associated with the spread and metastasis of cancer cells. In this study, we investigate the prognostic value and immunological relevance of EXT1 in various cancers. Methods: The expression profiles and clinical data of 33 different cancers were collected. The differences of EXT1 expression between tumor and normal tissues were analyzed using a t -test and paired t -test. Univariate Cox regression analysis was performed, and survival curves were plotted to evaluate the prognostic value of EXT1 . The molecular mechanisms of EXT1 were determined, and a drug sensitivity analysis was conducted. Finally, the expression and function of EXT1 was verified in endocervical adenocarcinoma (CESC) cells. Results: The Cancer Genome Atlas and Genotype-Tissue Expression databases showed that EXT1 expression was higher in CESC, cholangiocarcinoma, head and neck squamous cell carcinoma, esophageal carcinoma, kidney renal papillary cell carcinoma, liver hepatocellular carcinoma, lung squamous cell carcinoma, and stomach adenocarcinoma specimens than in normal specimens. Additionally, EXT1 expression correlated with survival time, including overall survival, disease-specific survival, disease-free interval, and progression-free interval, in multiple cancers. Functional enrichment analysis revealed that EXT1 is associated with immunity-, tumorigenesis-, and development-related pathways. Immunocorrelation analysis showed that EXT1 is related to the immune response, tumor microenvironment, and immunotherapeutic response in various cancers. Drug sensitivity analysis revealed that 152 drugs exhibited remarkably different sensitivities between the high- and low- EXT1 expression groups. Cell experiments showed that EXT1 expression was related to the proliferation, migration, and invasion of CESC tumor cells. Conclusion: EXT1 is a potential target gene for immune infiltration and has prognostic value in multiple cancers; thus, it may provide new insights into cancer treatment.