Analysis Of Differentially Expressed Genes Based On TCGA And GEO Databases And Risk Factor Analysis Based On Clinical Real-world Databases In Adenocarcinoma Of Esophagogastric Junction

Background: In recent decades,the incidence of Adenocarcinoma of Esophagogastric Junction(AEG)and its proportion in the upper digestive tract tumors have been on the rise,which has caused a heavy burden to the health in the world and our country.Tumor genesis and progression is a complex regulatory process in which the expression of a variety of molecules will be altered.The variation in gene expression can serve as markers for the clinical diagnosis or treatment of tumors patients.Exploring the clinical application of biomolecular changes and the clinical risk factors in the diagnosis and treatment of cancers is of great significance for AEG.Method: In this study,with the analysis of transcriptome data of AEG in TCGA and GEO database,bioinformatics was used to analyze the differentially expressed genes.And combined with the prediction of using relevant databases and literature reviewing,the molecules that may be clinically relevant in AEG were dug out.The real-world clinical database of AEG was constructed and utilized to analyze the clinical expression and influence of these clinically relevant molecules,and the clinical risk factors were identified by using real-world research statistical methods.Result: In the first part,transcriptome data analysing found that the gene expression of AEG was highly similar to esophageal adenocarcinoma,and the differences in gene expression of AEG with different Sierwert types gradually decreased with the increasing distance from the distal stomach.The expression of H19 and CD44 is up-regulated in AEG,and the expression of H19 is correlated with the clinical poor prognosis in AEG patients.A competiting endogenous RNA network involving H19 has been constructed in this study.In the second part,expression of CD44 s protein,the translated product of CD44,was found that was a risk factor for lymph node ratio > 25% in AEG,and that lymph node ratio > 25% was associated with poorer overall survival in AEG.In the third part,lymphovascular invasion was be found as a prognostic risk factor for specific survival and overall survival for AEG,and lymphovascular invasion had a greater impact on the prognosis of Siewert III AEG than Siewert I/II.Conclusion: In this study,we described the profile of genes expression in AEG,and found that patients with up-regulated expression of H19 will suffer from a worse prognosis,and the positive expression of CD44 s was a risk factor for lymph node ratio > 25% in AEG.Lymph node ratio > 25% and lymphovascular invasion were lead to a worse long-term prognosis in AEG patients.Fingdings of this study will benefit to provide evidences for the diagnosis and treatment of AEG.