The High Expression of RRM2 Can Predict the Malignant Transformation of Endometriosis

Introduction A large number of epidemiological studies have revealed that women with endometriosis (EMS) have a higher risk of developing endometriosis-associated ovarian cancer (EAOC). At present, there are few studies on predicting the malignant transformation of ovarian endometriosis (OE). The purpose of this study is to identify and verify the molecules that may be able to predict the malignant transformation of OE.

The gene expression profiles of ovarian cancer and OE were downloaded from Gene Expression Omnibus (GEO), and a common hub gene ribonucleotide reductase M2 (RRM2) was identified. A total of 44 patients with EAOC and 44 with OE were enrolled in this study. Immunohistochemistry (IHC) and quantitative reverse transcription polymerase chain reaction (RT-qPCR) were used to detect the expression of RRM2, while the relationship between RRM2 and Ki-67 was analyzed by IHC co-localization.

Bioinformatics analysis showed that the expression of RRM2 was low in EMS and high in ovarian cancer. RRM2 was obviously positively expressed in eutopic endometrium (EU), ectopic endometrium (EC), and cancer tissues of EAOC patients. The IHC signal and mRNA levels of RRM2 were higher in the EC of EAOC patients compared with OE patients (P < 0.01). In addition, there was a correlation between the expression of RRM2 and Ki-67 in EC of EAOC patients (P < 0.01).

The upregulated expression of RRM2 in the EC of OE patients may indicate malignant transformation. High expression of RRM2 promotes abnormal proliferation of histiocytes. RRM2 can be used as a potential marker of malignant transformation of OE. Similar content being viewed by others

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Funding This work was supported by the Major Science and Technology Projects in Tianjin, grant number 17ZXMFSY00160 and National Natural Science Foundation of China, grant number 81802605. The Rapid Service Fees was funded by the Tianjin Central Hospital of Gynecology Obsterics. Authorship All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. Author Contributions Yuanjing Hu contributed to the study conception and design. Material preparation, data collection and analysis were performed by Binkai Yang. TianWang, NaLi, and Wenwen Zhang contributed to revisions. All authors read and approved the final manuscript. Disclosures Yuanjing Hu, Tian Wang, Na Li, Wenwen Zhang and Binkai have nothing to disclosures. Compliance with Ethics Guidelines All procedures performed in those studies involving human participants were in accordance with the ethical standards of the local Institutional Review Boards for each site and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Data Availability The datasets generated during and analyzed during the current study are available from the corresponding author on reasonable request. Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Yang, B., Wang, T., Li, N. et al. The High Expression of RRM2 Can Predict the Malignant Transformation of Endometriosis. Adv Ther 38, 5178–5190 (2021). https://doi.org/10.1007/s12325-021-01888-3 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s12325-021-01888-3