Clinical prognosis

临床预后
  • 文章类型: Journal Article
    肾透明细胞癌(KIRC)是严重威胁人类健康的恶性肿瘤。RhoGTPase激活蛋白4(ARHGAP4)在肿瘤的发生发展中起着重要作用。
    本研究的目的是探讨ARHGAP4在KIRC进展中的作用及其诊断和预后价值。
    使用多种分析方法和体外细胞测定来探索ARHGAP4的表达及其在进展中的价值,KIRC的诊断和预后。通过GO分析和KEGG通路分析研究ARHGAP4的生物学功能,然后分析ARHGAP4与免疫浸润的关系。
    ARHGAP4的表达在KIRC中显著上调。我们发现ARHGAP4的高表达与KIRC的进展有关,并提示预后不良。与正常组织相比,ARHGAP4在KIRC中具有较好的诊断价值。ARHGAP4的生物学功能与免疫有关,其表达也与肿瘤免疫浸润和免疫检查点密切相关。
    我们的研究表明ARHGAP4可能是一种生物标志物,这与进展有关,KIRC的诊断和预后。其生物学功能与肿瘤免疫浸润有关。
    UNASSIGNED: Kidney Renal Clear Cell Carcinoma (KIRC) is a malignant tumor that seriously threatens human health. Rho GTPase-activating protein 4 (ARHGAP4) plays an important role in the occurrence and development of tumors.
    UNASSIGNED: The purpose of this study was to explore the role of ARHGAP4 in the progression of KIRC and its diagnostic and prognostic value.
    UNASSIGNED: Multiple analytical methods and in vitro cell assays were used to explore the expression of ARHGAP4 and its value in the progression, diagnosis and prognosis of KIRC. The biological function of ARHGAP4 was studied by GO analysis and KEGG pathway analysis, and then the relationship between ARHGAP4 and immune infiltration was analyzed.
    UNASSIGNED: The expression of ARHGAP4 was significantly up-regulated in KIRC. We found that the high expression of ARHGAP4 was related to the progression of KIRC and suggested a poor prognosis. Compared with normal tissues, ARHGAP4 had a better diagnostic value in KIRC. The biological function of ARHGAP4 was related to immunity, and its expression was also closely related to tumor immune infiltration and immune checkpoints.
    UNASSIGNED: Our study demonstrated that ARHGAP4 may be a biomarker, which is related to the progression, diagnosis and prognosis of KIRC. Its biological functions are related to tumor immune infiltration.
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  • 文章类型: Journal Article
    背景:在急性冠脉综合征(ACS)患者中,症状解释与预后之间的关系尚未得到很好的研究。因此,本研究评估了ACS患者对心脏病认知对院内死亡率的影响.方法和结果:我们对2014年至2018年间入院时确认症状解释的1,979例连续ASC患者进行了事后分析,重点关注患者特征,再通时间,和临床结果。一被录取,1,264名患者将其病情解释为心脏病,而715没有将他们的病情解释为心脏病。尽管两组之间的门至球囊时间没有显着差异。在那些将自己的病情解释为心脏病的人中,从气球开始的时间明显较短(254vs.345分钟;P<0.001)。此外,根据已确定的危险因素校正后的Cox回归模型,未将病情解释为心脏病的患者的院内死亡率风险比(HR1.73;95%置信区间1.08~2.76;P=0.022)显著更高.
    结论:这项研究表明,院前症状的解释与ACS患者的院内临床结局显著相关。此外,观察到的临床预后差异与门到球囊时间无关,但可能与球囊发作时间有关。
    BACKGROUND: The association between symptom interpretation and prognosis has not been investigated well among patients with acute coronary syndrome (ACS). As such, the present study evaluated the effect of heart disease awareness among patients with ACS on in-hospital mortality.Methods and Results: We performed a post hoc analysis of 1,979 consecutive patients with ASC with confirmed symptom interpretation on admission between 2014 and 2018, focusing on patient characteristics, recanalization time, and clinical outcomes. Upon admission, 1,264 patients interpreted their condition as cardiac disease, whereas 715 did not interpret their condition as cardiac disease. Although no significant difference was observed in door-to-balloon time between the 2 groups, onset-to-balloon time was significantly shorter among those who interpreted their condition as cardiac disease (254 vs. 345 min; P<0.001). Moreover, the hazard ratio (HR) for in-hospital mortality was significantly higher among those who did not interpret their condition as cardiac disease based on the Cox regression model adjusted for established risk factors (HR 1.73; 95% confidence interval 1.08-2.76; P=0.022).
    CONCLUSIONS: This study demonstrated that prehospital symptom interpretation was significantly associated with in-hospital clinical outcomes among patients with ACS. Moreover, the observed differences in clinical prognosis were not related to door-to-balloon time, but may be related to onset-to-balloon time.
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  • 文章类型: Journal Article
    背景:本文试图阐明空泡蛋白分选相关蛋白72同源物(VPS72)在前列腺癌(PCa)进展中的作用和机制。
    方法:前列腺癌患者的临床信息和基因表达谱来自癌症基因组图谱(TCGA)。研究了VPS72在PCa中的表达和VPS72影响PCa进展的潜在机制。接下来,我们进行了COX回归分析,以确定PCa的独立预后因素,并构造了一个列线图。使用“pRophetic”可以预期化疗药物的敏感性。随后,体外试验验证VPS72对PCa细胞增殖的影响,迁移和抗雄激素治疗的敏感性。
    结果:与正常组织相比,PCa组织中VPS72的表达明显更高。VPS72高表达与不良预后和不良临床病理因素之间存在显着相关性。基于VPS72表达式构建的列线图模型具有良好的预测性能。根据GSEA,VPS72相关基因在NF-kB通路中富集,PCa中细胞因子-细胞因子受体相互作用和趋化因子信号通路。尽管低VPS72表达的PCa更适合化疗药物,我们的体外实验表明,VPS72敲低显著降低了PCa细胞的迁移,扩散,以及对抗雄激素治疗的抗性。
    结论:总之,我们的研究结果表明,VPS72可能在PCa的恶性进展中起关键作用,其表达水平可作为PCa预后的可能生物标志物。
    BACKGROUND: This paper attempted to clarify the role and mechanism of vacuolar protein sorting-associated protein 72 homolog (VPS72) in the progression of prostate cancer (PCa).
    METHODS: Clinical information and gene expression profiles of patients with prostate cancer were obtained from The Cancer Genome Atlas (TCGA). VPS72 expression in PCa and the potential mechanism by which VPS72 affects PCa progression was investigated. Next, we performed COX regression analysis to identify the independent prognostic factors of PCa, and constructed a nomogram. The sensitivity of chemotherapeutic medications was anticipated using \"pRRophetic\". Subsequently, in vitro assays to validate the effect of VPS72 on PCa cell proliferation, migration and susceptibility to anti-androgen therapy.
    RESULTS: The expression of VPS72 was considerably higher in PCa tissues compared to normal tissues. Significant correlations were found between high VPS72 expression and a poor prognosis and adverse clinicopathological factors. The nomogram model constructed based on VPS72 expression has good predictive performance. According to GSEA, VPS72-related genes were enriched in the NF-kB pathways, cytokine-cytokine receptor interaction and chemokine signaling pathway in PCa. Although PCa with low VPS72 expression was more adaptable to chemotherapeutic medications, our in vitro experiment showed that VPS72 knockdown significantly decreased the PCa cell migration, proliferation, and resistance to anti-androgen therapy.
    CONCLUSIONS: In summary our findings suggests that VPS72 could play a crucial role in the malignant progression of PCa, and its expression level can be employed as a possible biomarker of PCa prognosis.
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  • 文章类型: Journal Article
    背景:共济失调毛细血管扩张症突变(ATM),顶端DNA损伤反应基因,是肿瘤中常见的突变基因,其突变可以增强肿瘤的免疫原性并改变PD-L1的表达,这可能有助于免疫检查点抑制剂(ICIs)的治疗。
    方法:本文综合分析了ATM突变的特点及其与ICIs治疗临床预后的关系。在癌症基因组图谱(TCGA)队列中,已发现ATM突变的总频率为4%(554/10953)。
    结果:有ATM突变的患者的TMB和MSI水平均明显高于无突变的患者(P<0.0001)。TMB中位数与ATM突变频率呈正相关(r=0.54,P=0.003)。在TCGA队列中,具有ATM突变的患者在总生存期方面具有更好的临床益处(OS,危险比(HR)=0.736,95%CI=0.623-0.869),无进展生存期(PFS,HR=0.761,95%CI=0.652-0.889),和无病生存率(DFS,HR=0.686,95%CI=0.512-0.919)]比无ATM突变的患者。随后,验证结果显示,在ICIs治疗的患者中,ATM突变与较长的OS显著相关(HR=0.710,95%CI=0.544~0.928).进一步研究表明,ATM突变与抗肿瘤免疫调节显著相关(P<0.05)。
    结论:我们的研究结果强调了ATM突变作为预测多种肿瘤ICIs治疗的一个有前景的生物标志物的价值。
    Ataxia telangiectasia mutated (ATM), an apical DNA damage response gene, is a commonly mutated gene in tumors, and its mutation could strengthen tumor immunogenicity and alter the expression of PD-L1, which potentially contributes to immune checkpoint inhibitors (ICIs) therapy.
    The characteristics of ATM mutation and its relationship with the ICIs-treated clinical prognosis have been analyzed comprehensively in this paper. The overall frequency of ATM mutations has been found to be 4% (554/10953) in the cancer genome atlas (TCGA) cohort.
    Both the TMB and MSI levels in patients with ATM mutations were significantly higher than those in patients without mutations (P < 0.0001). The median TMB was positively correlated with the frequency of ATM mutations (r = 0.54, P = 0.003). In the TCGA cohort, patients with ATM mutations had better clinical benefits in terms of overall survival (OS, hazard ratio (HR) = 0.736, 95% CI = 0.623 - 0.869), progression-free survival (PFS, HR = 0.761, 95% CI = 0.652 - 0.889), and disease-free survival (DFS, HR = 0.686, 95% CI = 0.512 - 0.919)] than patients without ATM mutations. Subsequently, the verification results showed ATM mutations to be significantly correlated with longer OS in ICIs-treated patients (HR = 0.710, 95% CI = 0.544 - 0.928). Further exploration indicated ATM mutation to be significantly associated with regulated anti-tumor immunity (P < 0.05).
    Our findings highlight the value of ATM mutation as a promising biomarker to predict ICIs therapy in multiple tumors.
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  • 文章类型: Journal Article
    治疗急性缺血性中风(AIS)的关键是迅速重新开放闭塞的血管,恢复血流,拯救缺血半暗带。治疗方法主要包括溶栓、血管内介入,等。然而,这些治疗方法受到严格的时间窗口和技术条件的限制。更简单、更可行的改善脑血流量的方法是目前临床研究的热点。近年来,多项研究表明,体位的改变可以有效改善患者的脑血流量。然而,AIS对神经功能预后的影响尚无定论。本文综述了体位变化对AIS临床预后的影响。结合相关指南和最新研究。该研究提供了改善AIS临床预后的证据。
    The key to treating Acute Ischemic Stroke (AIS) is to rapidly reopen occluded blood vessels, restore blood flow, and rescue the ischemic penumbra. Treatment methods mainly include thrombolysis, endovascular intervention, etc. However, these treatments are limited by strict time windows and technical conditions. Simpler and more feasible methods to improve cerebral blood flow are currently a hot topic in clinical research. In recent years, several studies have shown that changes in body position can effectively improve cerebral blood flow in patients. However, the effect on the neurological functional prognosis of AIS remains inconclusive. This review has examined the effects of changes in body position on the clinical prognosis of AIS, combining relevant guidelines and the latest research. The study has provided evidence of an improvement in the clinical prognosis of AIS.
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  • 文章类型: Journal Article
    焦虑症的共病对进化有深远的不利影响,抑郁症的预后和治疗反应性,它将延长抑郁发作缓解所需的时间,与抑郁症患者相比,接受治疗的患者往往会更快地退出治疗方案,但没有焦虑的合并症。这项研究的目的是评估临床的重要性,病因,抑郁症中精神病合并症的存在给预后和特别是治疗的内涵。使用PubMed,Medline,Scopus,谷歌学术和WoS数据库。要选择文章,我们用关键词:精神病合并症,抑郁症和焦虑症,抑郁症和心境恶劣,精神活性物质抑郁症,抑郁症与人格障碍。从精神病学的角度来看,精神障碍的合并症可以分为精神病合并症,当两个或更多不同的精神病存在于同一个人,和医学合并症,当医疗外科疾病与精神障碍有关时。重度抑郁症的存在本身就是广泛性焦虑症后期发作的预测因素。药物滥用或成瘾患者的抑郁症合并症对其临床预后具有深远的影响。人格障碍的关联对重度抑郁症患者的自杀行为有显著影响。
    The comorbidity with anxiety disorders has profound adverse implications on the evolution, prognosis and therapeutic responsiveness of depression, it will prolong the time required to achieve remission of the depressive episode, and patients under treatment will tend to drop out of their therapeutic regimens faster than those with depression but without anxious comorbidity. The purpose of this study is to evaluate the importance of the clinical, etiopathogenetic, prognostic and especially therapeutic connotations given by the presence of psychiatric comorbidities in depression. Articles evaluating the presence of psychiatric comorbidities in depression were analyzed using PubMed, Medline, Scopus, Google Academics and WoS databases. To select the articles, we used keywords: psychiatric comorbidity, depression with anxiety disorders, depression with dysthymia, depression with psychoactive substances, depression with personality disorders. From a psychiatric perspective, the comorbidity of mental disorders can be divided into psychiatric comorbidity, when two or more distinct psychiatric conditions are present in the same individual, and medical comorbidity, when a medical-surgical illness is associated with a mental disorder. The presence of major depression is in itself a predictive factor for a later onset of generalized anxiety disorder. The comorbidity of depression in those with substance abuse or addiction has profound implications on their clinical prognosis. The association of personality disorder has a significant impact on the suicidal behavior of patients with major depression.
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  • 文章类型: Journal Article
    目的:转归成功率(CSR)对转归治疗后最初不可切除的结直肠癌肝转移(CRLM)的临床结局具有重要意义。本研究旨在开发一种简单的预测评分模型,用于根据基线磁共振成像(MRI)特征识别CSR。并确认其在验证队列中的表现和预后意义。
    方法:本研究对155例最初不可切除的CRLM患者进行了回顾性分析。通过使用多变量逻辑回归分析,在发展队列(n=104)中开发了一个简单的基于MRI的预测评分模型,用于识别CSR。评估预测评分的诊断性能。此后,验证队列中的患者(n=51)根据评分分为预测高CSR或低CSR组.采用对数秩检验比较两组患者的无进展生存期(PFS)和总生存期(OS)。
    结果:CSR的预测得分,名叫mrNISE,纳入CRLM的数量≥10,最大尺寸≥50mm,肿瘤-肝脏界面,和肿瘤周围增强。mrNISE评分的AUC为开发队列的0.845和验证队列的0.776。根据分数,在开发和验证队列中,预测高CSR患者的PFS和OS均优于低CSR患者.
    结论:预测评分在识别最初不可切除的CRLM的CSR方面表现良好。根据评分对患者进行分层,转化治疗前可制定个性化治疗目标,以改善临床预后,减少治疗无效引起的不良事件。
    OBJECTIVE: The conversion success rate (CSR) has crucial implication for clinical outcomes of initially unresectable colorectal liver metastases (CRLM) following conversion therapy. This study aimed to develop a simple predictive scoring model for identifying CSR according to baseline magnetic resonance imaging (MRI) features, and confirm its performance and prognostic significance in a validation cohort.
    METHODS: A total of 155 consecutive patients with initially unresectable CRLM were retrospectively reviewed in the study. A simple MRI-based predictive scoring model for identifying CSR was developed in the development cohort (n = 104) by using multivariable logistic regression analyzes. The diagnostic performance was evaluated for the predictive score. Thereafter, patients in the validation cohort (n = 51) were stratified into groups with predicted high CSR or low CSR according to the score. The progression-free survival (PFS) and overall survival (OS) were compared between two groups using the log-rank test.
    RESULTS: The predictive score of CSR, named mrNISE, incorporated the number of CRLM ≥ 10, the largest size ≥ 50 mm, poorly defined tumor-liver interface, and peritumoral enhancement. The AUC of the mrNISE score was 0.845 for the development cohort and 0.776 for the validation cohort. According to the score, patients with predicted high CSR had better PFS and OS than those with low CSR in both development and validation cohorts.
    CONCLUSIONS: The predictive score demonstrated great performance for identifying CSR of initially unresectable CRLM. Stratifying patients by the score, personalized treatment goals can be formulated before conversion therapy to improve clinical prognosis and reduce adverse events caused by ineffective treatment.
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  • 文章类型: Journal Article
    背景:氯吡格雷抵抗(CR)与急性缺血性卒中或短暂性脑缺血发作(TIA)患者的不良临床结局相关。然而,CR是否影响长期临床预后尚待澄清.ABCD-GENE评分是一种新的风险模型,可识别心血管疾病患者的CR;其诊断能力和在缺血性卒中或TIA中的应用仍有待研究。本研究旨在探讨ABCD-GENE评分对缺血性卒中或TIA患者CR的诊断能力,并分析CR与长期临床预后的关系。
    方法:从2018年1月至2021年1月,纳入251例缺血性卒中或TIA患者,发病后使用氯吡格雷治疗超过3个月并维持药物治疗直至随访时间,血小板反应性通过血栓弹力图检测。进行CYP2C19基因分析。从发病后3个月开始记录不良临床结果。中位随访时间为878天。
    结果:CR的患病率为33.9%。CYP2C19功能丧失携带者比例为62.2%。ABCD-GENE评分≥10与CR独立相关(OR=1.82,95%CI:1.02~3.24,P=0.041),CR评分的C统计值(作为二进制和整数变量)分别为0.58和0.63.CR和氯吡格雷敏感组之间的长期不良临床结局的风险没有显着差异(12.94%vs.11.44%,HR=1.22,95%CI:0.57-2.62,P=0.603)。在ABCD-GENE评分≥10组和ABCD-GENE评分<10组之间观察到类似的结果(10.38%vs.12.64%,HR=1.19,95%CI:0.55-2.60,P=0.666)。
    结论:在缺血性卒中或TIA患者中,ABCD-GENE评分可以识别CR的风险。CR与长期不良临床结局无关。
    BACKGROUND: Clopidogrel resistance (CR) is associated with adverse clinical outcomes in acute ischemic stroke or transient ischemic attack (TIA) patients. However, whether CR affects the long-term clinical prognosis remains to be clarified. The ABCD-GENE score is a novel risk model that identifies CR in cardiovascular disease patients; its diagnostic ability and application in ischemic stroke or TIA remain to be studied. This study aimed to investigate the diagnostic ability of the ABCD-GENE score for CR and analyze the relationship between CR and long-term clinical prognosis in patients with ischemic stroke or TIA.
    METHODS: From January 2018 to January 2021, 251 ischemic stroke or TIA patients who were treated with clopidogrel for more than three months after onset and maintained the medication until the follow-up time were enrolled, and platelet reactivity was detected by thromboelastography. CYP2C19 gene analysis was performed. Adverse clinical outcomes were recorded from 3months after onset. The median follow-up time was 878days.
    RESULTS: The prevalence of CR was 33.9%. The proportion of CYP2C19 loss-of-function carriers was 62.2%. The ABCD-GENE score≥10 was independently associated with CR (OR=1.82, 95% CI: 1.02-3.24, P=0.041), and the C-statistic value of the score (as a binary and integer variable) on CR was 0.58 and 0.63, respectively. The risk of long-term adverse clinical outcomes was not significantly different between CR and clopidogrel sensitive groups (12.94% vs. 11.44%, HR=1.22, 95% CI: 0.57-2.62, P=0.603). A similar result was observed between ABCD-GENE score≥10 and ABCD-GENE score<10 groups (10.38% vs. 12.64%, HR=1.19, 95% CI: 0.55-2.60, P=0.666).
    CONCLUSIONS: In ischemic stroke or TIA patients, the ABCD-GENE score could identify the risk of CR. CR was not associated with long-term adverse clinical outcomes.
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  • 文章类型: Journal Article
    背景:Tie1孤儿受体已成为研究的重点,Tie1可以与Tie2形成聚合物,调节Ang/Tie2通路,在病理血管生成和肿瘤进展中发挥重要作用,Tie1在宫颈癌(CC)进展中的功能仍不确定。这里,我们研究了Tie1过表达对CC的体外和体内功能影响。
    方法:我们使用免疫组织化学(IHC)分析来检测Tie1在CC中的相对表达,我们分析了其与CC患者的总生存期(OS)和无进展生存期(PFS)的关系。为了证明Tie1在细胞增殖和转移中的作用,慢病毒上调了CC细胞系中的Tie1表达。
    结果:宫颈癌组织肿瘤细胞中Tie1的高表达与FIGO分期显著相关,分化肿瘤,有直径的肿瘤,深层基质侵入。我们发现Tie1过表达CC细胞系在体内和体外均可促进细胞进展。Tie1可能对与上皮-间质转化(EMT)和PI3K/AKT信号通路相关的标志物的表达产生决定性影响。
    结论:我们的研究表明,Tie1与CC进展高度相关,因为它可能通过PI3K/AKT信号通路在EMT过程中发挥作用。
    BACKGROUND: Tie1 orphan receptor has become a focus of research, Tie1 can form a polymer with Tie2, regulate the Ang/Tie2 pathway and play a vital role in pathological angiogenesis and tumor progression, the function of Tie1 has remained uncertain in the progression of cervical cancer (CC). Here, we investigated the functional influences of Tie1 overexpress on CC in vitro and in vivo.
    METHODS: We used Immunohistochemistry (IHC) analysis to detect the relative expression of Tie1 in CC, and we analyzed its connection with the overall survival (OS) and progression free survival (PFS)of CC patients. To prove the role of Tie1 in cell proliferation and metastatic, Tie1 expression in CC cell lines was upregulated by lentivirus.
    RESULTS: The high expression of Tie1 in tumor cells of cervical cancer tissues is significantly correlated with FIGO stage, differentiated tumors, tumors with diameters, deep stromal invasion. We found that cell progression was promoted in Tie1-overexpress CC cell lines in vivo and in vitro. Tie1 potentially exerts a commanding influence on the expression of markers associated with epithelial-mesenchymal transition (EMT) and the PI3K/AKT signaling pathway.
    CONCLUSIONS: Our research indicates that Tie1 is highly connected to CC progression as it may play a role in the EMT process through the PI3K/AKT signaling pathway.
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  • 文章类型: Journal Article
    低级别胶质瘤(GBMLGG)很常见,致命的,和难以治疗的癌症。目前的治疗选择具有令人印象深刻的疗效限制。因此,迫切需要开发有效的治疗方法和确定新的治疗靶点。二硫化物代谢是非凋亡性程序性细胞死亡的原因,称为二硫化物凋亡,这是最近才发现的。本研究使用从公共数据库下载的GBMLGG患者的mRNA表达数据和相关临床信息来研究参与二硫化物沉积的基因的预后意义。在癌症基因组图谱(TCGA)和基因表达综合(GEO)队列中,我们的发现表明,许多与二硫键凋亡相关的基因在正常和GBMLGG组织中表达不同。发现含有IQ基序的GTP酶激活蛋白1(IQGAP1)是影响GBMLGG结果的关键基因。此外,建立了一个列线图模型来预测GBMLGG患者的可视化。此外,对IQGAP1的促癌功能进行了体内和体外验证。总之,我们发现了一个与二硫键沉积相关的基因标签,它可以有效预测GBMLGG患者的OS.因此,治疗二硫键下垂可能是GBMLGG患者的可行替代方案。
    Lower-grade gliomas (GBMLGG) are common, fatal, and difficult-to-treat cancers. The current treatment choices have impressive efficacy constraints. As a result, the development of effective treatments and the identification of new therapeutic targets are urgent requirements. Disulfide metabolism is the cause of the non-apoptotic programmed cell death known as disulfideptosis, which was only recently discovered. The mRNA expression data and related clinical information of GBMLGG patients downloaded from public databases were used in this study to investigate the prognostic significance of genes involved in disulfideptosis. In the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) cohort, our findings showed that many disulfidptosis-related genes were expressed differently in normal and GBMLGG tissues. It was discovered that IQ motif-containing GTPase-activating protein 1 (IQGAP1) is a key gene that influences the outcome of GBMLGG. Besides, a nomogram model was built to foresee the visualization of GBMLGG patients. In addition, in vivo and in vitro validation of IQGAP1\'s cancer-promoting function was done. In conclusion, we discovered a gene signature associated with disulfideptosis that can effectively predict OS in GBMLGG patients. As a result, treating disulfideptosis may be a viable alternative for GBMLGG patients.
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