Clinical and Translational Research
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jun 15, 2023; 15(6): 1019-1035
Published online Jun 15, 2023. doi: 10.4251/wjgo.v15.i6.1019
Comprehensive analysis of distal-less homeobox family gene expression in colon cancer
Yong-Cheng Chen, Dong-Bing Li, Dong-Liang Wang, Hui Peng
Yong-Cheng Chen, Department of General Surgery (Endoscopic Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China
Yong-Cheng Chen, Hui Peng, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China
Yong-Cheng Chen, Hui Peng, Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China
Dong-Bing Li, Dong-Liang Wang, Department of Medicine, ChosenMed Technology (Beijing) Co., Ltd., Beijing 100176, China
Hui Peng, Department of General Surgery (Anorectal Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, Guangdong Province, China
Author contributions: Chen YC and Peng H participated in study design, and data collection and analysis; Chen YC, Li DB, and Wang DL performed the data analysis; Chen YC and Peng H drafted the manuscript; Chen YC and Peng H revised the manuscript; All authors read and approved the final manuscript.
Institutional review board statement: The current study does not require approval from an ethics committee.
Clinical trial registration statement: This study did not involve a clinical trial registration statement.
Informed consent statement: The data that support the findings of this study are publicly available. The current study does not require signed informed consent documents.
Conflict-of-interest statement: All the authors report having no relevant conflicts of interest for this article.
Data sharing statement: All data and material are public.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hui Peng, MD, Chief Doctor, Department of General Surgery (Anorectal Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, No. 26 Yuancun Erheng Road, Tianhe District, Guangzhou 510655, Guangdong Province, China. phui@mail.sysu.edu.cn
Received: January 6, 2023
Peer-review started: January 6, 2023
First decision: January 23, 2023
Revised: February 6, 2023
Accepted: April 27, 2023
Article in press: April 27, 2023
Published online: June 15, 2023
ARTICLE HIGHLIGHTS
Research background

The distal-less homeobox (DLX) gene family plays an important role in several tumors. However, the role of DLX gene family in colon cancer is not yet clear.

Research motivation

The aim of this study was to investigate the role of the DLX gene family in colon cancer and to establish a sound scientific basis for clinical decision making and risk management.

Research objectives

In this study, we aimed to comprehensively analyze the biological role of the DLX gene family in colon cancer.

Research methods

Colon cancer and normal colon tissue samples were collected from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus databases. We used Wilcoxon rank sum test and t-test to assess DLX gene family expression between colon cancer tissue samples and unpaired normal colon tissue samples, cBioPortal to analyze DLX gene family variants, R software (version 3.6.3) to analyze DLX gene expression in colon cancer and the relationship between DLX gene family expression and clinical features and correlation heat map, the survival package [version 3.2-10] and Cox regression module to assess the prognostic value of the DLX gene family, the pROC package [version 1.17.0.1] to analyze the diagnostic value of the DLX gene family, R software (version 3.6.3) to analyze the possible regulatory mechanisms of DLX gene family members and related genes, the GSVA package [version 1.34.0] to analyze the relationship between the DLX gene family and immune infiltration, and the ggplot2 [version 3.3.3], the survminer package [version 0.4.9], and the clusterProfiler package [version 3.14.3] for visualization.

Research results

Expression levels of DLX1/2/3/4/5 were significantly abnormal in tissue from patients with colon cancer. DLX gene family expression in colon cancer was significantly associated with clinical characteristics, including M stage, pathological stage, primary treatment outcome, residual tumor, lymphatic invasion, T stage, N stage, age, peripheral invasion, and history of colonic polyps. Results of the multivariate Cox analysis showed DLX5 to be an independent prognostic factor in patients with colon cancer. DLX1/2/3/4/5/6 may be involved in the development and progression of colon cancer through mediation of multiple pathways, including the Hippo signaling pathway, the Wnt signaling pathway, and signaling pathways regulating the pluripotency of stem cells. DLX1/2/3/4/5/6 are associated with immune infiltration.

Research conclusions

DLX family genes may function as potential diagnostic or prognostic biomarkers and therapeutic targets for colon cancer.

Research perspectives

It may be possible to use DLX family genes as a diagnostic or prognostic biomarkers or therapeutic targets for colon cancer.