IMR Press / CEOG / Volume 50 / Issue 3 / DOI: 10.31083/j.ceog5003057
Open Access Original Research
GRAP2: A Novel Immune-Related Prognosis Biomarker in Cervical Cancer
Shixin Lin1,2,3,4Jun Zhu1,2,3Xiaoling Mao3,4,5Gang Lin3,6Dan Yang1,2,3Yun Guan1,2,3Jun Gao2,3,*
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1 Department of Third Clinical Medical College of Nanchang University, The First Hospital of Nanchang, 330008 Nanchang, Jiangxi, China
2 Department of Gynecologic Oncology, Jiangxi Cancer Hospital, 330029 Nanchang, Jiangxi, China
3 Department of Nanchang Key Laboratory for Precision Therapy of Gynecological Tumor, The First Hospital of Nanchang, 330008 Nanchang, Jiangxi, China
4 Department of Jiangxi Key Laboratory of Cancer Metastasis and Precision Treatment, The First Hospital of Nanchang, 330008 Nanchang, Jiangxi, China
5 Department of Clinical Medicine College, Jiangxi University of Chinese Medicine, 330001 Nanchang, Jiangxi, China
6 Department of the First Clinical Medicine, Gannan Medical University, 341000 Ganzhou, Jiangxi, China
*Correspondence: (Jun Gao)
Clin. Exp. Obstet. Gynecol. 2023, 50(3), 57;
Submitted: 23 November 2022 | Revised: 27 December 2022 | Accepted: 3 January 2023 | Published: 13 March 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: Immune infiltration of the tumor microenvironment offers unlimited possibilities for therapeutic strategies in cervical cancer, where GRAP2 is an adaptor protein engaged in diverse signal activations. However, uncertainty exists regarding GRAP2’s prognostic significance and its relationship to immune infiltration. Methods: The data on cervical cancer cases were downloaded from The Cancer Genome Atlas (TCGA) database. The ESTIMATE computational technique was utilized to calculate the amount of immunological and stromal components, which helped us to identify the differential expression genes (DEGs). Among them, GRAP2 was considered to be related to overall survival based on a protein-protein interaction network and a univariate Cox regression analysis. Thus, based on the Gene Expression Omnibus (GEO) and TCGA databases, we evaluated GRAP2’s influence on clinical prognosis. Furthermore, GRAP2 expression was analyzed by Gene Set Enrichment Analysis (GSEA). Finally, we used CIBERSORTx analysis to assess the proportion of tumor-infiltrating immune cells (TICs) and the connection between GRAP2 and the tumor immune microenvironment. Results: ESTIMATEScore was associated with cervical cancer patient’s prognosis. There are 791 DEGs and 11 potential key genes were identified including GRAP2. In survival analyses with clinical information, We found that the GRAP2 high expression group exhibited a significantly longer overall survival (OS) than the low expression group and that the gene expression gradually declined as the Federation of International of Gynecologists and Obstetricians (FIGO) stage and M classification increased. GRAP2 was strongly linked with immunity and metabolism, according to GSEA. Finally, we discovered that 11 different TIC types and GRAP2 expressions were linked. Conclusions: GRAP2 may be a novel immune-related prognosis biomarker in cervical cancer.

cervical cancer
tumor microenvironment
prognostic biomarker
82060477/National Natural Science Foundation of China
2020BAB206054/Jiangxi Provincial Natural Science Foundation
202120073/Science and Technology Project of Health Commission of Jiangxi
Hongkezi2019-258-3/Nanchang Science and Technology Support Plan Key Project
2020NCZDSY-003/Nanchang Key Laboratory for Precision Therapy of Gynecological Tumors
Hongkezi 2021-156-29/2021 Nanchang High-level Science and Technology Innovation Talents “Double Hundred Plan” Project
2019-15-3/Nanchang Advantage Science and Technology Innovation Team Project
Fig. 1.
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