<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" "journalpublishing.dtd">
<article article-type="research-article" dtd-version="2.3" xml:lang="EN" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">
<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Cell Dev. Biol.</journal-id>
<journal-title>Frontiers in Cell and Developmental Biology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Cell Dev. Biol.</abbrev-journal-title>
<issn pub-type="epub">2296-634X</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="publisher-id">1211843</article-id>
<article-id pub-id-type="doi">10.3389/fcell.2023.1211843</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Cell and Developmental Biology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Identification of CHMP7 as a promising immunobiomarker for immunotherapy and chemotherapy and impact on prognosis of colorectal cancer patients</article-title>
<alt-title alt-title-type="left-running-head">Guo et al.</alt-title>
<alt-title alt-title-type="right-running-head">
<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fcell.2023.1211843">10.3389/fcell.2023.1211843</ext-link>
</alt-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Guo</surname>
<given-names>Yu</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="fn" rid="fn1">
<sup>&#x2020;</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/2395883/overview"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Wang</surname>
<given-names>Shu</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<xref ref-type="fn" rid="fn1">
<sup>&#x2020;</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Liang</surname>
<given-names>Feng</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Wang</surname>
<given-names>Min</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="corresp" rid="c001">&#x2a;</xref>
<uri xlink:href="https://loop.frontiersin.org/people/2292549/overview"/>
</contrib>
</contrib-group>
<aff id="aff1">
<sup>1</sup>
<institution>Department of the General Surgery</institution>, <institution>The Second Hospital of Jilin University</institution>, <addr-line>Changchun</addr-line>, <country>China</country>
</aff>
<aff id="aff2">
<sup>2</sup>
<institution>Department of the Ridiotherapy</institution>, <institution>The Second Hospital of Jilin University</institution>, <addr-line>Changchun</addr-line>, <country>China</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>
<bold>Edited by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1643386/overview">Subhadip Mukhopadhyay</ext-link>, New York University, United States</p>
</fn>
<fn fn-type="edited-by">
<p>
<bold>Reviewed by:</bold> <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1590846/overview">Jindong Xie</ext-link>, Sun Yat-sen University Cancer Center (SYSUCC), China</p>
<p>
<ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1117253/overview">Suprabhat Mukherjee</ext-link>, Kazi Nazrul University, India</p>
</fn>
<corresp id="c001">&#x2a;Correspondence: Min Wang, <email>jdeywangmin@163.com</email>
</corresp>
<fn fn-type="equal" id="fn1">
<label>
<sup>&#x2020;</sup>
</label>
<p>These authors have contributed equally to this work</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>30</day>
<month>08</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="collection">
<year>2023</year>
</pub-date>
<volume>11</volume>
<elocation-id>1211843</elocation-id>
<history>
<date date-type="received">
<day>05</day>
<month>05</month>
<year>2023</year>
</date>
<date date-type="accepted">
<day>09</day>
<month>08</month>
<year>2023</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2023 Guo, Wang, Liang and Wang.</copyright-statement>
<copyright-year>2023</copyright-year>
<copyright-holder>Guo, Wang, Liang and Wang</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<p>
<bold>Introduction:</bold> ESCRT is a molecular machine involved in various important physiological processes, such as the formation of multivesicular bodies, cellular autophagy, and cellular membrane repair. <italic>CHMP7</italic> is a regulatory subunit of ESCRT-III and is necessary for the proper functioning of ESCRT. In this study, public databases were exploited to explore the role of <italic>CHMP7</italic> in tumors.</p>
<p>
<bold>Methods:</bold> The research on <italic>CHMP7</italic> in oncology is rather limited. In this study, the differential expression of <italic>CHMP7</italic> in multiple tumor tissues was analyzed with information from public databases and clinically collected colorectal cancer tissue samples. Subsequently, the mutational landscape of <italic>CHMP7</italic>, methylation levels, and the relationship between its expression levels and genomic instability were resolved. The immune microenvironment is a compelling emerging star in tumor research. The correlation of <italic>CHMP7</italic> with various infiltrating immune cell types in TME was analyzed by online datasets and single-cell sequencing. In terms of clinical treatment, the impact of <italic>CHMP7</italic> expression levels on chemotherapy and immunotherapy and the evaluation of small molecule drugs related to <italic>CHMP7</italic> were assessed.</p>
<p>
<bold>Results:</bold> <italic>CHMP7</italic> has a predictive value for the prognosis of patients with tumors and is highly involved in tumor immunity. The downregulation of <italic>CHMP7</italic> may lead to genomic instability. A strong correlation between <italic>CHMP7</italic> and TME immune cell infiltration has been observed, participating in the formation of suppressive TME and promoting tumor progression. The expression level of <italic>CHMP7</italic> is significantly lower in the non-responder group of multiple chemotherapeutic agents. <italic>CHMP7</italic> can potentially serve as a new biomarker for predicting the efficacy of tumor chemotherapy and immunotherapy.</p>
<p>
<bold>Conclusion:</bold> As a gene of interest, <italic>CHMP7</italic> is expected to provide novel and promising targets for further treatment of patients with tumor.</p>
</abstract>
<abstract abstract-type="graphical">
<title>Graphical Abstract</title>
<p>
<fig>
<caption>
<p>The main points of this study. The role of CHMP7 in COAD was analyzed in terms of differential expression, mutational analysis, functional enrichment analysis, and immune infiltration.</p>
</caption>
<graphic xlink:href="FCELL_fcell-2023-1211843_wc_abs.tif" position="anchor"/>
</fig>
</p>
</abstract>
<kwd-group>
<kwd>pan-cancer</kwd>
<kwd>CHMP7</kwd>
<kwd>endosomal sorting complex required for transport</kwd>
<kwd>immunosuppression</kwd>
<kwd>CTL dysfunction</kwd>
<kwd>M2 macrophages infiltration</kwd>
</kwd-group>
<custom-meta-wrap>
<custom-meta>
<meta-name>section-at-acceptance</meta-name>
<meta-value>Cancer Cell Biology</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
<body>
<sec id="s1">
<title>Introduction</title>
<p>The formation of malignant tumors is an extremely complicated process that typically takes decades. Tissue cells in normal individuals evolve and progressively develop into tumor cells with a malignant phenotype, a process called tumor progression, usually accompanied by multiple genetic alterations (<xref ref-type="bibr" rid="B11">Hausman, 2019</xref>). Tumor progression is attributed to the accumulation of random mutations and epigenetic alterations in DNA sequences that affect the proliferation of malignant cells associated with gene regulatory networks and other traits associated with the malignant phenotype (<xref ref-type="bibr" rid="B39">Vogelstein et al., 2013</xref>; <xref ref-type="bibr" rid="B12">Iranzo et al., 2018</xref>). Tumorigenesis is usually the result of the synergistic effect of multiple risk factors, including environmental chemical factors (e.g., atmospheric pollutants), physical factors (e.g., ionizing radiation), viral infections, adverse dietary habits, and pharmaceutical effects (<xref ref-type="bibr" rid="B20">Lewandowska et al., 2019</xref>; <xref ref-type="bibr" rid="B35">Sun et al., 2020</xref>). Current treatment modalities for malignancies include surgery, chemotherapy, targeted drug therapy, radiation therapy, hormone therapy, stem cell transplantation, and tumor immunotherapy. However, various genomic mutations and epigenetic modifications occur in tumor cell DNA during progression, leading to the emergence of malignant phenotypes, including abnormal metabolism, treatment resistance, unrestricted division, and weakened intercellular adhesion, subsequently limiting the effectiveness of various therapeutic modalities and affecting the prognosis of patient survival. Tumor heterogeneity affects the sensitivity of different patients with the same tumor to chemotherapeutic agents, radiation therapy, and targeted drugs (<xref ref-type="bibr" rid="B24">Lim and Ma, 2019</xref>). In addition to tumor cells, there are several kinds of infiltrating cells in tumor tissue, such as cancer-associated fibroblasts (CAFs), B cells, T cells, macrophages, and other immune cells, adipocytes, and endothelial cells of blood vessels, which together with the tumor extracellular matrix (ECM) constitute the tumor microenvironment (TME). Different immune cells may perform different roles in tumorigenesis by inhibiting or promoting tumorigenesis (<xref ref-type="bibr" rid="B18">Lee and Cheah, 2019</xref>; <xref ref-type="bibr" rid="B2">Bilotta et al., 2022</xref>). The tumor progression is frequently characterized by mutations in multiple genes, and the development of high-throughput sequencing technology has become a practical approach to unraveling the mystery of cancer genes.</p>
<p>
<italic>CHMP7</italic> (Charged multivesicular body protein 7) is essential in properly regulating the ESCRT (endosomal sorting complex required for transport). The ESCRT system is an integral molecular mechanism responsible for membrane protein sorting and membrane repair in eukaryotic cells, and it participates in several physiological processes, such as cell division and autophagy. Ubiquitin-tagged membrane proteins are primarily transported to the endosomal membrane through cytokinesis and then invaginated by the ESCRT system, which releases membrane components containing these proteins into the endosomal lumen to form intraluminal vesicles (ILVs). Subsequently, the ILVs and their membrane proteins are degraded through fusion with lysosomes, and the protein-bound ESCRT complex proteins are degraded and recycled (<xref ref-type="bibr" rid="B16">Korbei, 2022</xref>). For example, the epidermal growth factor receptor (EGFR) is degraded by this pathway. In addition to its involvement in the degradation of ubiquitinated proteins, the ESCRT system is also involved in the sorting and delivery of extracellular vehicles (EVs) (<xref ref-type="bibr" rid="B40">Wei et al., 2021</xref>) and in the repair of cell membranes to maintain cell integrity and normal function. It is also a vital component of membrane proteins in cellular life activities such as cell division and autophagy (<xref ref-type="bibr" rid="B38">Vietri et al., 2020</xref>; <xref ref-type="bibr" rid="B32">Ritter et al., 2022</xref>). All these physiological processes are involved in topological membrane remodeling. ESCRT-III is the key player in completing the critical step of the shearing of the budding body (<xref ref-type="bibr" rid="B8">Gatta and Carlton, 2019</xref>; <xref ref-type="bibr" rid="B13">Isono, 2021</xref>). The dysregulation of ESCRT function is highly related to tumor development, and CHMP7, an important regulatory subunit of ESCRT-III, has attracted our attention.</p>
<p>Aberrant expression of <italic>CHMP7</italic> may lead to nuclear pore complex damage and TDP-43 dysfunction in amyotrophic lateral sclerosis/frontotemporal dementia (<xref ref-type="bibr" rid="B6">Coyne et al., 2021</xref>). Neurodegenerative diseases, such as Huntington&#x2019;s disease and Parkinson&#x2019;s disease, are often associated with the accumulation of intracellular ubiquitinated protein aggregates, with lesions that may be associated with the loss of ESCRT function (<xref ref-type="bibr" rid="B7">Coyne and Rothstein, 2022</xref>). Regarding oncology research, Ritter <italic>et al.</italic> discovered that ESCRT-mediated cell membrane repair mechanisms contribute to the immune escape of cancer cells from lethal attacks by cytotoxic T lymphocytes (CTL). Furthermore, inhibiting the ESCRT pathway significantly improves the killing efficiency of CTL (<xref ref-type="bibr" rid="B32">Ritter et al., 2022</xref>). Abnormal expression of several genes in the ESCRT system is also assumed to be associated with tumors. <italic>VPS4A</italic> is significantly overexpressed in liver cancer tissues and can promote tumor growth and invasion by affecting the sorting and delivery of exosomes (<xref ref-type="bibr" rid="B10">Han et al., 2019</xref>). However, conclusive studies on the role of <italic>CHMP7</italic> in tumors are limited.</p>
<p>In this study, the differential expression of <italic>CHMP7</italic> in tumor tissues and its prognostic impact were systematically analyzed with information from public databases such as TCGA, CCLE, and GTEX. Immunohistochemical (IHC) validation was performed on clinically collected colorectal cancer tissue samples. Subsequently, the mutational landscape of <italic>CHMP7</italic>, methylation levels, and the relationship between its expression levels and genomic instability were resolved. The co-expression of <italic>CHMP7</italic> in various infiltrating immune cell types in TME was verified by an online dataset and single-cell sequencing analysis. The influence of <italic>CHMP7</italic> on chemotherapy and immunotherapy was evaluated to predict the effect of immunotherapy and sensitive drugs against <italic>CHMP7</italic> in these cancers (<xref ref-type="fig" rid="F1">Figure 1</xref>).</p>
<fig id="F1" position="float">
<label>FIGURE 1</label>
<caption>
<p>The flow chart of this study.</p>
</caption>
<graphic xlink:href="fcell-11-1211843-g001.tif"/>
</fig>
</sec>
<sec sec-type="methods" id="s2">
<title>Methods</title>
<sec id="s2-1">
<title>Data source</title>
<p>The unified and standardized pan-cancer dataset was downloaded from the UCSC (<ext-link ext-link-type="uri" xlink:href="https://xenabrowser.net/">https://xenabrowser.net/</ext-link>) database, Therapeutically Applicable Research to Generate Effective Treatments (TARGET; includes 7 pediatric cancers), and Genotype-Tissue Expression (GTEx; covers 54 normal tissues). Those samples with fewer than three tumor types were excluded from the analysis. Single-cell sequencing datasets were obtained from the Gene Expression Omnibus (GEO) database. They included breast invasive carcinoma (BRCA, GSE114727), colon adenocarcinoma (COAD, GSE146771), skin cutaneous melanoma (SKCM, GSE48190), liver hepatocellular carcinoma (LIHC, GSE98638), nasopharyngeal carcinoma (NPC, GSE150430), and kidney renal clear cell carcinoma (KIRC, GSE 111360).</p>
</sec>
<sec id="s2-2">
<title>Differential expression and prognostic analysis</title>
<p>Diseases associated with <italic>CHMP7</italic> were analyzed with the Open Target website (<ext-link ext-link-type="uri" xlink:href="https://www.opentargets.org/">https://www.opentargets.org/</ext-link>) and represented in bubble charts. The sample information obtained from UCSC was analyzed with R software (version 3.6.4) to calculate the difference in <italic>CHMP7</italic> expression between normal and tumor samples in each tumor, and the significance of differences was performed using the unpaired Wilcoxon rank sum and signed rank tests. Protein level data were obtained from the UALCAN database (<ext-link ext-link-type="uri" xlink:href="http://ualcan.path.uab.edu/">http://ualcan.path.uab.edu/</ext-link>) and further utilized to reveal the differential expression of <italic>CHMP7</italic> in normal and tumors (<xref ref-type="bibr" rid="B31">Patra et al., 2021</xref>). The UALCAN database also facilitated further analysis of the correlation between <italic>CHMP7</italic> expression levels and tumor stage (<xref ref-type="bibr" rid="B30">Patra et al., 2023</xref>). The SURVIVAL package from the R software was applied to analyze the association between <italic>CHMP7</italic> expression and pan-cancer survival with risk tables.</p>
</sec>
<sec id="s2-3">
<title>IHC validation</title>
<p>IHC staining analysis was performed on fifty specimens of postoperative paraffin slides that underwent surgical treatment at the Department of Colorectal Surgery, Second Hospital of Jilin University, from January 2017 to December 2017, and whose postoperative pathology was confirmed as colorectal cancer. The experiment was approved by the ethics committee. The antibody was obtained from Proteintech under item number 16424-1-AP for IHC staining. Paraffin slides were stained by the Servicebio company. The slides were dried and observed with a light microscope, and two professional pathologists were invited to determine the intensity of the staining. Relevant clinical information of patients was collected and followed up to determine whether there was any significant difference in the effect of different <italic>CHMP7</italic> expression intensities on the prognosis of patients.</p>
</sec>
<sec id="s2-4">
<title>Mutational analysis of <italic>CHMP7</italic> and correlation with genomic instability</title>
<p>cBioPortal (<ext-link ext-link-type="uri" xlink:href="https://www.cbioportal.org/">https://www.cbioportal.org/</ext-link>) is a website that enables researchers to explore, visualize, and analyze multidimensional cancer genomic data. Using this website, we can easily explore genetic alterations in different tumor types, genes, and pathways. We queried the mutation characteristics of <italic>CHMP7</italic> in different tumor types and further explored the mutation types of the genes. The prognostic impact of <italic>CHMP7</italic> mutations on patients with tumors was evaluated through the &#x201c;Comparison&#x201d; module of the website.</p>
<p>To further analyze the correlation between <italic>CHMP7</italic> and genomic stability, the R software was used to compute the correlation between tumor mutation burden (TMB), microsatellite instability (MSI), homologous recombination deficiency (HRD), and neoantigen (NEO) data for each tumor and <italic>CHMP7</italic> expression levels. A heat map demonstrated the correlation between <italic>CHMP7</italic> expression levels and five mismatch repair genes (<italic>MLH1</italic>, <italic>MSH2</italic>, <italic>MSH6</italic>, <italic>PMS2</italic>, and <italic>EPCAM</italic>) in each tumor type (<xref ref-type="bibr" rid="B19">Levy et al., 2017</xref>).</p>
</sec>
<sec id="s2-5">
<title>Analyses of tumor stemness and epigenetic modifications</title>
<p>The Stemness index is an indicator to assess the similarity of tumor cells to stem cells, which is associated with active biological processes in stem cells and a more advanced degree of tumor dedifferentiation. Wiznerowicz et al. constructed predictive models for multipotential stem cell samples from the PCBC dataset with the one-class logistic regression (OCLR) machine learning algorithm. The predictive model was subsequently applied to a training set such as TCGA to calculate the stemness score for each sample (<xref ref-type="bibr" rid="B25">Malta et al., 2018</xref>). The tumor stemness index calculated by mRNA expression and methylation signature was obtained from previous studies, and the stemness index and gene expression data of the samples and their correlation performed were further integrated (<xref ref-type="bibr" rid="B15">Kocaturk et al., 2019</xref>).</p>
<p>Homologous recombination repair (HRR), as one of the core DNA damage repair methods, is a DNA repair mechanism that maintains genome integrity to ensure high-fidelity transmission of genetic information. Mutation of related HRR genes or methylation of gene promoters can trigger HRR dysfunction, leading to genomic instability. Tumor cells tend to exploit HRR to save cells from apoptosis. HRR is a complex signaling pathway involving multiple steps, in which the most critical genes are <italic>BRCA1</italic> and <italic>BRCA2</italic>, and other related genes include <italic>MLH1</italic>, <italic>MSH2</italic>, <italic>ATM</italic>, and <italic>TP53</italic>. The HRR-related genes analyzed in the present study were cited in the research of Liang et al. (<xref ref-type="bibr" rid="B23">Liang et al., 2022</xref>). The correlation between <italic>CHMP7</italic> and HRR signature can be analyzed by applying the GEPIA2.0 online website (<xref ref-type="bibr" rid="B17">Ledermann et al., 2016</xref>). Heat maps were applied to visualize the correlation between <italic>CHMP7</italic> and 44 RNA-modified genes.</p>
</sec>
<sec id="s2-6">
<title>Alternative splicing (AS) analysis</title>
<p>AS refers to the process of mRNA precursor to mature mRNA, in which various splicing methods can allow the same gene to produce multiple different mature mRNAs, resulting in the translation of different proteins (<xref ref-type="bibr" rid="B37">Ule and Blencowe, 2019</xref>). AS is a major mechanism for maintaining protein diversity (<xref ref-type="bibr" rid="B21">Li et al., 2017</xref>). It produces specific shear isoforms in certain tissues or conditions at different stages of development. The OncoSplicing website (<ext-link ext-link-type="uri" xlink:href="http://www.oncosplicing.com/">http://www.oncosplicing.com/</ext-link>) was employed to explore SplAdder and SliceSeq projects that contain AS events for <italic>CHMP7</italic>. Differences in percent spliced-in (PSI) and AS events were further compared between TCGA tumor tissues and GTEx normal tissues. We also explored the impact of AS events of <italic>CHMP7</italic> on patient prognosis in diverse tumors and confirmed shear isoforms of <italic>CHMP7</italic> in pan-cancer.</p>
</sec>
<sec id="s2-7">
<title>Functional enrichment analysis</title>
<p>The protein-protein interaction (PPI) network of <italic>CHMP7</italic> was explored using the STRING website (<ext-link ext-link-type="uri" xlink:href="https://www.string-db.org/">https://www.string-db.org/</ext-link>). Tumor development involves the aberrant activation of multiple critical pathways. Genes in the corresponding pathways were collected from TCGA and analyzed using the GSVA package of R software. The correlation between <italic>CHMP7</italic> and pathway scores was analyzed using Spearman correlation analysis. The similar gene detection function in the GEPIA2.0 website helped us obtain genes that were the top 100 co-expressed with <italic>CHMP7</italic> in tumor tissues and performed gene ontology (GO) functional analysis of the top 100 genes with the clusterProfiler package. Gene set enrichment analysis (GSEA) further explored the functional enrichment-related pathways <italic>CHMP7</italic> may affect.</p>
</sec>
<sec id="s2-8">
<title>Immune infiltration analysis</title>
<p>The role of immune cells in TME has attracted much attention in recent years (<xref ref-type="bibr" rid="B29">Padma et al., 2023</xref>). Different immune cells perform various roles in tumorigenesis. The immune cells of tumor types are frequently quantified in studies of tumorigenesis, treatment, and other mechanisms. The correlation scores between <italic>CHMP7</italic> and tumor tissue immune infiltration levels were calculated with the ESTIMATE package of R software, and the bar graphs present the stromal, immune, and ESTIMATE scores for each tumor (<xref ref-type="bibr" rid="B43">Yoshihara et al., 2013</xref>). The correlation between <italic>CHMP7</italic> and immune checkpoints is also shown in a heat map.</p>
<p>The TISDB online website (<ext-link ext-link-type="uri" xlink:href="http://cis.hku.hk/TISIDB/">http://cis.hku.hk/TISIDB/</ext-link>) was utilized to analyze the differential expression of <italic>CHMP7</italic> in distinct immune subtypes of pan-cancerous tissues (<xref ref-type="bibr" rid="B36">Thorsson et al., 2018</xref>). The site was also exploited to construct heat maps exhibiting the correlation between <italic>CHMP7</italic> and chemokines, chemokine receptors, immunostimulatory factors, and immunoinhibitory factors.</p>
<p>M2 macrophages are regarded to serve in pathogen clearance, anti-inflammatory response, and tumor progression (<xref ref-type="bibr" rid="B3">Biswas and Mantovani, 2010</xref>). The TIMER2.0 website was applied to analyze the relationship between <italic>CHMP7</italic> and M2 macrophages according to different algorithms. Additionally, spatial transcripts in SpatialDB (<ext-link ext-link-type="uri" xlink:href="https://www.spatialomics.org/SpatialDB/">https://www.spatialomics.org/SpatialDB/</ext-link>) were subjected to analysis of the overlapping levels of <italic>CHMP7</italic> expression and spatial expression of M2 macrophage markers (CD68 and CD163). As for the TISCH website (<ext-link ext-link-type="uri" xlink:href="http://tisch.comp-genomics.org/">http://tisch.comp-genomics.org/</ext-link>), single-cell data from multiple tumors were presented to compare the expression of <italic>CHMP7</italic> in various cell subtypes of tumor tissues.</p>
<p>CTLs are one of the critical immune surveillance cells. A high abundance of CTL with a killing function in tumor tissues is a promising prognostic indicator, and increasing the proportion of CTL in patients&#x2019; tumor tissues can help inhibit tumor progression and eventual elimination (<xref ref-type="bibr" rid="B26">Mami-Chouaib et al., 2018</xref>). Multiple algorithms are available on the TIMER2.0 website to analyze the correlation between <italic>CHMP7</italic> and CTL and the impact of <italic>CHMP7</italic> expression levels and CTL infiltration levels on patient prognosis. Tumor immune dysfunction and exclusion (TIDE, a web tool) also enabled us to investigate the role of <italic>CHMP7</italic> in T cell dysfunction and CTL-related prognosis in tumor tissues.</p>
</sec>
<sec id="s2-9">
<title>Drug sensitivity analysis</title>
<p>To elucidate the predictive value of <italic>CHMP7</italic> in tumor immunotherapy, we explored it from public databases. The predictive role of <italic>CHMP7</italic> as a new biomarker was compared with classical markers such as TMB at the TIDE website to calculate the predictive role of <italic>CHMP7</italic>. The TIDE website further enabled us to predict the therapeutic response of <italic>CHMP7</italic> in the core dataset, immunotherapy dataset, CRISPR screening dataset, and mechanistic follow-up experiments of immunosuppressive cell types. And the differential expression of <italic>CHMP7</italic> was compared between the responding and non-responding groups in 30 immunotherapy cohorts such as IMvigor210.</p>
<p>The ROC Plotter dataset (<ext-link ext-link-type="uri" xlink:href="http://www.rocplot.org/site/index">http://www.rocplot.org/site/index</ext-link>) was adopted to analyze the gene expression levels in the response and non-response groups of multiple chemotherapeutic agents. The RNAactDrug database (<ext-link ext-link-type="uri" xlink:href="https://links.jianshu.com/go?to=http%3A%2F%2Fbio-bigdata.hrbmu.edu.cn%2FRNAactDrug%2Findex.jsp">hrbmu.edu.cn</ext-link>) can facilitate our queries on the association between <italic>CHMP7</italic> and drug sensitivity (<xref ref-type="bibr" rid="B42">Xie et al., 2022</xref>).</p>
</sec>
<sec id="s2-10">
<title>Statistical analysis</title>
<p>The overall survival (OS) differences between the high and low gene expression groups were explored using the log-rank test. The correlation coefficients were quantified using Spearman or Pearson. All data analyses included in this article, such as differential expression, gene interaction, immune infiltration, and drug sensitivity analyses, were considered significant only at <italic>p</italic> &#x3c; 0.05.</p>
</sec>
</sec>
<sec sec-type="results" id="s3">
<title>Results</title>
<sec id="s3-1">
<title>
<italic>CHMP7</italic> is aberrantly expressed in multiple tumor tissues and correlates with patient prognosis</title>
<p>The Open Target website presents diseases associated with <italic>CHMP7</italic>, and the bubble chart illustrates that <italic>CHMP7</italic> may be associated with multiple tumors (<xref ref-type="fig" rid="F2">Figure 2A</xref>). The differential expression of <italic>CHMP7</italic> in tumor tissues and corresponding normal tissues were analyzed with TCGA, TARGET, and GTEx databases. The results indicated that <italic>CHMP7</italic> expression levels were significantly upregulated in GBM, LGG, BRCA, KIPAN, STAD, HNSC, SKCM, PAAD, LAML, and CHOL tumor tissues, while markedly downregulated in ESCA, STES, KIRP, COAD, PRAD, LUSC, BLCA, THCA, READ, OV, TGCT, UCS, ACC, and KICH tumor tissues (<xref ref-type="fig" rid="F2">Figure 2B</xref>). The UALCAN website analyzed the differences in <italic>CHMP7</italic> protein levels, revealing that <italic>CHMP7</italic> protein was downregulated in BRCA, COAD, and UCEC tumor tissues and upregulated in LUAD tumor tissues (<xref ref-type="fig" rid="F2">Figure 2C</xref>). The expression level of <italic>CHMP7</italic> is related to the stage of many tumors. For example, the more advanced the stage in COAD, the lower the <italic>CHMP7</italic> expression level (<xref ref-type="fig" rid="F2">Figure 2D</xref>). The TCGA data were employed to analyze the predictive value of <italic>CHMP7</italic> on prognosis and demonstrated that low <italic>CHMP7</italic> expression was associated with poorer OS in BRCA, ESCA, HNSC, KIRC, SARC, and SKCM, while in LAML, patients in the high <italic>CHMP7</italic> expression group had a worse prognosis (<xref ref-type="fig" rid="F2">Figure 2E</xref>).</p>
<fig id="F2" position="float">
<label>FIGURE 2</label>
<caption>
<p>Differential expression and prognostic analysis. <bold>(A)</bold> Diseases associated with <italic>CHMP7</italic> were analyzed with the openTarget website. And tumors that may be associated with <italic>CHMP7</italic> are marked with red dotted lines. <bold>(B)</bold> Analysis of the TCGA, TARGET and GTEx databases for differential expression of <italic>CHMP7</italic> in tumor tissues and corresponding normal tissues. <bold>(C)</bold> The UALCAN website facilitates the analysis of differential expression of <italic>CHMP7</italic> in different tumor stages. <bold>(D)</bold> <italic>CHMP7</italic> expression levels of multiple tumors at different stages were further analyzed on UALCAN. <bold>(E)</bold> Kaplan-Meier curves were plotted for the analysis of <italic>CHMP7</italic> expression in relation to patient prognosis. <bold>(F)</bold> IHC staining maps of COAD tissues. F<sub>1</sub>-F<sub>3</sub> is the low <italic>CHMP7</italic> expression group and F<sub>4</sub>-F<sub>6</sub> is the high group with a magnification of &#xd7;40. <bold>(G)</bold> The OS of COAD patients that performed IHC staining. (&#x2a;: <italic>p</italic> &#x3c; 0.05, &#x2a;&#x2a;: <italic>p</italic> &#x3c; 0.01 and &#x2a;&#x2a;&#x2a;: <italic>p</italic> &#x3c; 0.001).</p>
</caption>
<graphic xlink:href="fcell-11-1211843-g002.tif"/>
</fig>
<p>The IHC staining was performed on the collected 50 colorectal cancer paraffin slides. According to the staining intensity, specimens were divided into <italic>CHMP7</italic> low expression group (<xref ref-type="fig" rid="F2">Figures 2F1&#x2013;3</xref>) and <italic>CHMP7</italic> high expression group (<xref ref-type="fig" rid="F2">Figures 2F4&#x2013;6</xref>). The relevant information was collected into a baseline clinical information table (<xref ref-type="table" rid="T1">Table 1</xref>), and the collected data were processed and analyzed using R software. The results indicated that <italic>CHMP7</italic> expression level was not significantly correlated with patients&#x2019; age, weight, gender, concomitant disease status (hypertension and diabetes), and T-stage, and the group with low <italic>CHMP7</italic> expression had advanced N-stage and TNM-stage. The prognostic impact of <italic>CHMP7</italic> on patients was analyzed by Kaplan-Meier survival analysis, which revealed that patients with low <italic>CHMP7</italic> expression had a relatively poor prognosis (<xref ref-type="fig" rid="F2">Figure 2G</xref>).</p>
<table-wrap id="T1" position="float">
<label>TABLE 1</label>
<caption>
<p>Baseline table of clinical information of COAD patients who performed IHC staining.</p>
</caption>
<table>
<thead valign="top">
<tr>
<th rowspan="2" align="center">Characteristics</th>
<th align="center">High expression of CHMP7</th>
<th align="center">Low expression of CHMP7</th>
<th rowspan="2" align="center">Total (<italic>N</italic> &#x3d; 50)</th>
<th rowspan="2" align="center">
<italic>p</italic> value</th>
<th rowspan="2" align="center">FDR</th>
</tr>
<tr>
<th align="center">(<italic>N</italic> &#x3d; 25)</th>
<th align="center">(<italic>N</italic> &#x3d; 25)</th>
</tr>
</thead>
<tbody valign="top">
<tr>
<td align="left">Age</td>
<td align="left"/>
<td align="left"/>
<td align="left"/>
<td align="right">
</td>
<td align="right">
</td>
</tr>
<tr>
<td align="left">Mean &#xb1; SD</td>
<td align="left">62.36 &#xb1; 11.85</td>
<td align="left">61.32 &#xb1; 10.97</td>
<td align="left">61.84 &#xb1; 11.31</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">Median [min-max]</td>
<td align="left">62.00 [37.00,85.00]</td>
<td align="left">62.00 [42.00,84.00]</td>
<td align="left">62.00 [37.00,85.00]</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">Weight</td>
<td align="left"/>
<td align="left"/>
<td align="left"/>
<td align="right">
</td>
<td align="right">
</td>
</tr>
<tr>
<td align="left">Mean &#xb1; SD</td>
<td align="left">68.88 &#xb1; 13.16</td>
<td align="left">66.82 &#xb1; 13.06</td>
<td align="left">67.85 &#xb1; 13.02</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">Median [min-max]</td>
<td align="left">70.00 [40.00,94.00]</td>
<td align="left">67.00 [43.00,100.00]</td>
<td align="left">69.50 [40.00,100.00]</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">Sex</td>
<td align="left"/>
<td align="left"/>
<td align="left"/>
<td align="right">1</td>
<td align="right">1</td>
</tr>
<tr>
<td align="left">Female</td>
<td align="left">6 (12.00%)</td>
<td align="left">5 (10.00%)</td>
<td align="left">11 (22.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">Male</td>
<td align="left">19 (38.00%)</td>
<td align="left">20 (40.00%)</td>
<td align="left">39 (78.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">T.stage</td>
<td align="left"/>
<td align="left"/>
<td align="left"/>
<td align="right">0.11</td>
<td align="right">0.76</td>
</tr>
<tr>
<td align="left">T1</td>
<td align="left">3 (6.00%)</td>
<td align="left">0 (0.0e&#x2b;0%)</td>
<td align="left">3 (6.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">T2</td>
<td align="left">6 (12.00%)</td>
<td align="left">3 (6.00%)</td>
<td align="left">9 (18.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">T3</td>
<td align="left">16 (32.00%)</td>
<td align="left">17 (34.00%)</td>
<td align="left">33 (66.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">T4</td>
<td align="left">0 (0.0e&#x2b;0%)</td>
<td align="left">1 (2.00%)</td>
<td align="left">1 (2.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">T4a</td>
<td align="left">0 (0.0e&#x2b;0%)</td>
<td align="left">3 (6.00%)</td>
<td align="left">3 (6.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">T4b</td>
<td align="left">0 (0.0e&#x2b;0%)</td>
<td align="left">1 (2.00%)</td>
<td align="left">1 (2.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">N.stage</td>
<td align="left"/>
<td align="left"/>
<td align="left"/>
<td align="right">0.07</td>
<td align="right">0.52</td>
</tr>
<tr>
<td align="left">N0</td>
<td align="left">19 (38.00%)</td>
<td align="left">9 (18.00%)</td>
<td align="left">28 (56.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">N1</td>
<td align="left">1 (2.00%)</td>
<td align="left">1 (2.00%)</td>
<td align="left">2 (4.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">N1a</td>
<td align="left">0 (0.0e&#x2b;0%)</td>
<td align="left">2 (4.00%)</td>
<td align="left">2 (4.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">N1b</td>
<td align="left">1 (2.00%)</td>
<td align="left">5 (10.00%)</td>
<td align="left">6 (12.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">N1c</td>
<td align="left">0 (0.0e&#x2b;0%)</td>
<td align="left">2 (4.00%)</td>
<td align="left">2 (4.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">N2a</td>
<td align="left">2 (4.00%)</td>
<td align="left">5 (10.00%)</td>
<td align="left">7 (14.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">N2b</td>
<td align="left">2 (4.00%)</td>
<td align="left">1 (2.00%)</td>
<td align="left">3 (6.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">M.stage</td>
<td align="left"/>
<td align="left"/>
<td align="left"/>
<td align="right">0.23</td>
<td align="right">1</td>
</tr>
<tr>
<td align="left">M0</td>
<td align="left">25 (50.00%)</td>
<td align="left">22 (44.00%)</td>
<td align="left">47 (94.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">M1</td>
<td align="left">0 (0.0e&#x2b;0%)</td>
<td align="left">3 (6.00%)</td>
<td align="left">3 (6.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">TNM.stage</td>
<td align="left"/>
<td align="left"/>
<td align="left"/>
<td align="right">4.40E-03</td>
<td align="right">0.04</td>
</tr>
<tr>
<td align="right">1</td>
<td align="left">9 (18.00%)</td>
<td align="left">1 (2.00%)</td>
<td align="left">10 (20.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="right">2</td>
<td align="left">10 (20.00%)</td>
<td align="left">7 (14.00%)</td>
<td align="left">17 (34.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="right">3</td>
<td align="left">6 (12.00%)</td>
<td align="left">14 (28.00%)</td>
<td align="left">20 (40.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="right">4</td>
<td align="left">0 (0.0e&#x2b;0%)</td>
<td align="left">3 (6.00%)</td>
<td align="left">3 (6.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">Hypertension</td>
<td align="left"/>
<td align="left"/>
<td align="left"/>
<td align="right">1</td>
<td align="right">1</td>
</tr>
<tr>
<td align="left">No</td>
<td align="left">20 (40.00%)</td>
<td align="left">21 (42.00%)</td>
<td align="left">41 (82.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">Yes</td>
<td align="left">5 (10.00%)</td>
<td align="left">4 (8.00%)</td>
<td align="left">9 (18.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">Diabetes mellitus</td>
<td align="left"/>
<td align="left"/>
<td align="left"/>
<td align="right">1</td>
<td align="right">1</td>
</tr>
<tr>
<td align="left">No</td>
<td align="left">21 (42.00%)</td>
<td align="left">20 (40.00%)</td>
<td align="left">41 (82.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">Yes</td>
<td align="left">4 (8.00%)</td>
<td align="left">5 (10.00%)</td>
<td align="left">9 (18.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">Vascular invasion</td>
<td align="left"/>
<td align="left"/>
<td align="left"/>
<td align="right">0.12</td>
<td align="right">0.76</td>
</tr>
<tr>
<td align="left">No</td>
<td align="left">21 (42.00%)</td>
<td align="left">15 (30.00%)</td>
<td align="left">36 (72.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">Yes</td>
<td align="left">4 (8.00%)</td>
<td align="left">10 (20.00%)</td>
<td align="left">14 (28.00%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">CEA</td>
<td align="left"/>
<td align="left"/>
<td align="left"/>
<td align="right">
</td>
<td align="right">
</td>
</tr>
<tr>
<td align="left">Mean &#xb1; SD</td>
<td align="left">9.71 &#xb1; 16.19</td>
<td align="left">9.43 &#xb1; 13.14</td>
<td align="left">9.57 &#xb1; 14.59</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">Median [min-max]</td>
<td align="left">3.52 [0.35,63.79]</td>
<td align="left">4.14 [0.71,46.33]</td>
<td align="left">3.89 [0.35,63.79]</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">EGFR status</td>
<td align="left"/>
<td align="left"/>
<td align="left"/>
<td align="right">0.77</td>
<td align="right">1</td>
</tr>
<tr>
<td align="left">negative</td>
<td align="left">8 (16.33%)</td>
<td align="left">6 (12.24%)</td>
<td align="left">14 (28.57%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">positive</td>
<td align="left">12 (24.49%)</td>
<td align="left">14 (28.57%)</td>
<td align="left">26 (53.06%)</td>
<td align="left"/>
<td align="left"/>
</tr>
<tr>
<td align="left">weakly positive</td>
<td align="left">5 (10.20%)</td>
<td align="left">4 (8.16%)</td>
<td align="left">9 (18.37%)</td>
<td align="left"/>
<td align="left"/>
</tr>
</tbody>
</table>
</table-wrap>
</sec>
<sec id="s3-2">
<title>
<italic>CHMP7</italic> is associated with various pathways, such as angiogenesis and apoptosis</title>
<p>To explore the possible role of <italic>CHMP7</italic> in tumor development in detail, the enrichment pathways of <italic>CHMP7</italic> and its related genes were analyzed. The PPI network for <italic>CHMP7</italic> was constructed with the STRING website (<xref ref-type="fig" rid="F3">Figure 3A</xref>). The tumor data from the TCGA database were exploited to analyze the correlations between <italic>CHMP7</italic> and multiple pathways, and the results were represented as scatter plots. <italic>CHMP7</italic> and angiogenesis, apoptosis, inflammatory response, EMT markers, tumor proliferation signature, and tumor inflammation signature all demonstrated a significant positive correlation (<xref ref-type="fig" rid="F3">Figure 3B</xref>).</p>
<fig id="F3" position="float">
<label>FIGURE 3</label>
<caption>
<p>
<italic>CHMP7</italic> functional enrichment analysis. <bold>(A)</bold> The String site reveals proteins interacting with <italic>CHMP7</italic>. <bold>(B)</bold> <italic>CHMP7</italic> expression levels correlate with the angiogenesis, apoptosis, inflammatory response, EMT markers, tumor proliferation signature, and tumor inflammation signature pathway. <bold>(C)</bold> The correlation between <italic>CHMP7</italic> and the top 5 co-expressed genes identified on GEPIA2.0. Each cancer type is shown on the left, and all cancer samples are on the right. <bold>(D)</bold> GO enrichment analysis circle plot of the top 100 <italic>CHMP7</italic> co-expressed genes identified on GEPIA2.0. <bold>(E)</bold> Enrichment plot of GSEA analysis of <italic>CHMP7</italic> and its associated genes KEGG and HALLMARK terms.</p>
</caption>
<graphic xlink:href="fcell-11-1211843-g003.tif"/>
</fig>
<p>The top 100 genes tightly associated with <italic>CHMP7</italic> were explored via the GEPIA website, and heat maps were drawn to present the top 5 genes of relevance (<xref ref-type="fig" rid="F3">Figure 3C</xref>; <xref ref-type="sec" rid="s12">Supplementary Material S1</xref>). The genes of <italic>CHMP7</italic> and its related top hundred were subjected to GO and KEGG enrichment analysis, revealing a strong association with RNA splicing, ESCRT complex, and DNA damage checkpoint (<xref ref-type="fig" rid="F3">Figures 3D, E</xref>).</p>
</sec>
<sec id="s3-3">
<title>
<italic>CHMP7</italic> is altered in multiple tumor tissues and associated with genomic instability</title>
<p>Mutation analysis of <italic>CHMP7</italic> in the TCGA database was performed on the cBioPortal website. The results reveal that the top five tumors with alterations are PRAD, OV, LIHC, BLCA, and COAD, with the main mutation type being deletion. The main loci of mutations are shown in <xref ref-type="fig" rid="F4">Figure 4A</xref>. To further analyze the effect of <italic>CHMP7</italic> mutations on patient prognosis, COAD and LUSC patients in the <italic>CHMP7</italic>-altered group had poorer disease-free survival (DFS; <xref ref-type="fig" rid="F4">Figure 4B</xref>).</p>
<fig id="F4" position="float">
<label>FIGURE 4</label>
<caption>
<p>
<italic>CHMP7</italic> is correlated with genomic instability in tumor tissues. <bold>(A)</bold> Genomic alterations of <italic>CHMP7</italic> in TCGA pan-cancer and the loci at which missense mutations, frameshift deletions and splicing occur. <bold>(B)</bold> Impact of <italic>CHMP7</italic> mutations on patient prognosis, with poorer prognosis in the mutated group of COAD and LUSC patients. <bold>(C)</bold> Radar plot showing the association between <italic>CHMP7</italic> expression levels and TMB (top) and MSI (bottom) in pan-cancer; correlation coefficients of 0 are indicated by dashed circles, points inside the dashed circles indicate negative correlation coefficients, those outside the circles indicate positive correlation coefficients, and &#x2a; indicates the significance of the difference. <bold>(D)</bold> Correlation coefficients between <italic>CHMP7</italic> expression levels and Ploidy or HRD. <bold>(E)</bold> Association between <italic>CHMP7</italic> expression and neoantigen counts. The waves at the top and right side represent the distribution density of <italic>CHMP7</italic> and neoantigen counts. (&#x2a;: <italic>p</italic> &#x3c; 0.05, &#x2a;&#x2a;: <italic>p</italic> &#x3c; 0.01 and &#x2a;&#x2a;&#x2a;: <italic>p</italic> &#x3c; 0.001).</p>
</caption>
<graphic xlink:href="fcell-11-1211843-g004.tif"/>
</fig>
<p>TMB and MSI are important clinical biomarkers that can be effectively predicted for tumor treatment (<xref ref-type="bibr" rid="B1">Baretti and Le, 2018</xref>; <xref ref-type="bibr" rid="B44">Zhang et al., 2022</xref>). Radar plots present the correlation between <italic>CHMP7</italic> and TMB, and MSI in different tumor tissues (<xref ref-type="fig" rid="F4">Figure 4C</xref>). <italic>CHMP7</italic> is positively correlated with TMB in five tumors (LGG, COAD, STES, STAD, and UCEC) and significantly negatively correlated with TMB in three tumors (LUAD, KIRP, and THCA). As for MSI, <italic>CHMP7</italic> is significantly positively correlated in CESC, COAD, ESCA, STES, STAD, UCEC, READ, and UVM and negatively correlated in PRAD, THCA, and DLBC.</p>
<p>Ploidy is tightly associated with chromosomal instability in tumor development (<xref ref-type="bibr" rid="B27">M&#xfc;ller et al., 2021</xref>). The bar chart demonstrates the correlation of <italic>CHMP7</italic> with ploidy, which is significantly negatively correlated in nine types of tumors (BRCA, STES, KIPAN, PRAD, UCEC, KIRC, LUSC, THYM, and BLCA). <italic>CHMP7</italic> is significantly negatively correlated with HRD in CESC, LUAD, COAD, BRCA, ESCA, STES, KIPAN, STAD, UCEC, KIRC, LUSC, READ, TGCT, SKCM, UCS, BLCA, and CHOL. It presents a positive correlation in LGG (<xref ref-type="fig" rid="F4">Figure 4D</xref>). NEO is abundantly expressed in tumor cells with strong immunogenicity and tumor heterogeneity, making it an attractive target for tumor immunotherapy (<xref ref-type="bibr" rid="B4">Blass and Ott, 2021</xref>). Scatter plots indicate a significant positive correlation between <italic>CHMP7</italic> and NEO in COAD, LGG, UCEC, and CESC, while a negative correlation in BLCA and PCPG (<xref ref-type="fig" rid="F4">Figure 4E</xref>). All analyses suggest that <italic>CHMP7</italic> is altered in various tumor tissues and associated with genomic instability.</p>
</sec>
<sec id="s3-4">
<title>
<italic>CHMP7</italic> is associated with gene repair in pan-cancerous tissues</title>
<p>The stability of the genome relies on the combined action of multiple repair mechanisms, such as MMR and HRR. The diagonal heat map demonstrates the correlation between <italic>CHMP7</italic> and MMR-related genes (<italic>MLH1, MSH2, MSH6, PMS2</italic>, and <italic>EPCAM</italic>), exhibiting positive correlation in various tumor tissues, including ACC, BRCA, and KIRC (<xref ref-type="fig" rid="F5">Figure 5A</xref>). The correlation between <italic>CHMP7</italic> and cancer stemness was analyzed based on six tumor stemness indices calculated by mRNA expression and methylation signature, which were significantly positively correlated in HNSC and negatively correlated in LUAD, COAD, COADREAD, BRCA, THYM, PCPG, and BLCA (<xref ref-type="fig" rid="F5">Figure 5B</xref>; <xref ref-type="sec" rid="s12">Supplementary Material S2</xref>). A positive correlation between <italic>CHMP7</italic> and HRR was found in multiple tumor tissues, indicating that <italic>CHMP7</italic> may be associated with DNA repair (<xref ref-type="fig" rid="F5">Figure 5C</xref>).</p>
<fig id="F5" position="float">
<label>FIGURE 5</label>
<caption>
<p>
<italic>CHMP7</italic> is involved in DNA mismatch repair, cancer stemness and epigenetic regulation. <bold>(A)</bold> Heat map demonstrating the correlation between <italic>CHMP7</italic> and 5 MMR genes (<italic>MLH1, MSH2, MSH6, PMS2, EPCAM</italic>) in pan-cancer. <bold>(B)</bold> Lollipop plot reveals the association between <italic>CHMP7</italic> expression levels and cancer stemness. The dot size indicates the number of samples and the color indicates the <italic>p</italic>-value. <bold>(C)</bold> Scatter plot depicting the correlation between <italic>CHMP7</italic> expression levels and HRR characteristics. <bold>(D)</bold> <italic>CHMP7</italic> DNA methylation was significantly negatively correlated with probe cg00140501 in ACC, BRCA, BLCA, COAD, LIHC and LUAD. <bold>(E)</bold> The correlation between <italic>CHMP7</italic> expression levels and RNA regulation. (&#x2a;: <italic>p</italic> &#x3c; 0.05, &#x2a;&#x2a;: <italic>p</italic> &#x3c; 0.01 and &#x2a;&#x2a;&#x2a;: <italic>p</italic> &#x3c; 0.001).</p>
</caption>
<graphic xlink:href="fcell-11-1211843-g005.tif"/>
</fig>
<p>DNAss is a cancer stemness score based on the methylation profile calculated for each tumor and further analyzed for <italic>CHMP7</italic> DNA methylation in the TCGA database (<xref ref-type="bibr" rid="B25">Malta et al., 2018</xref>). A significant negative correlation was observed between <italic>CHMP7</italic> and DNA methylation probe cg00140501 in several tumor tissues of TCGA, including ACC, BRCA, BLCA, COAD, LIHC, and LUAD (<xref ref-type="fig" rid="F5">Figure 5D</xref>). In addition to methylation analysis, the correlation between <italic>CHMP7</italic> and RNA-modified genes was analyzed, revealing a heat map showing a positive correlation between <italic>CHMP7</italic> and major RNA-modified genes (<xref ref-type="fig" rid="F5">Figure 5E</xref>).</p>
</sec>
<sec id="s3-5">
<title>AS events in <italic>CHMP7</italic> can contribute to predicting patient prognosis</title>
<p>AS is an essential mechanism for regulating gene expression and generating proteomic diversity, which has the potential to serve as a new biomarker in oncology and provide many new targets for drug development (<xref ref-type="bibr" rid="B5">Blencowe, 2006</xref>). The AS events for <italic>CHMP7</italic> were evaluated at the OncoSplicing website, and alt_5prime_195490 is presented in <xref ref-type="fig" rid="F6">Figure 6A</xref> and the rest in <xref ref-type="sec" rid="s12">Supplementary Material S3</xref>. A higher PSI was observed in BRCA, CHOL, KIRP, and READ tumors. The difference in PSI between tumor tissues and adjacent/normal tissues was compared, and <italic>CHMP7</italic>_alt_5prime_195490 exhibited higher PSI in various tumor tissues, such as BRCA and STAD (<xref ref-type="fig" rid="F6">Figure 6B</xref>). The predictive value of PSI values on the prognosis of patients with tumors was analyzed. The results suggested that high PSI values were associated with poorer OS in ESCA, COAD, HNSC, and UVM and poorer DFI in LIHC, SKCM, and TGCT (<xref ref-type="fig" rid="F6">Figure 6C</xref>). Shear isoforms of <italic>CHMP7</italic> in pan-cancer were also demonstrated (<xref ref-type="fig" rid="F6">Figure 6D</xref>). All these results indicate that AS events of <italic>CHMP7</italic> are critical in tumor research.</p>
<fig id="F6" position="float">
<label>FIGURE 6</label>
<caption>
<p>Alternative splicing analysis of <italic>CHMP7</italic>. <bold>(A)</bold> The read-in, read-out, and PSI values of <italic>CHMP7</italic> _alt_5prime in tumor and normal tissues. <bold>(B)</bold> Differences in PSI value between tumor and adjacent normal tissue (top), and tumor and GTEx normal tissue (bottom); red dashed line refers to FDR of 0.05. <bold>(C)</bold> Kaplan-Meier curves present the effect of PSI values of <italic>CHMP7</italic> _alt_5prime on patient OS, DSS, DFI, and PFI. <bold>(D)</bold> Isoform switch events of the <italic>CHMP7</italic> gene in pan-cancer.</p>
</caption>
<graphic xlink:href="fcell-11-1211843-g006.tif"/>
</fig>
</sec>
<sec id="s3-6">
<title>
<italic>CHMP7</italic> is engaged in tumor immune infiltration and regulation</title>
<p>To investigate the relationship between <italic>CHMP7</italic> and immune infiltration in the tumor TME, we calculated the stromal and immune scores of tumor samples based on <italic>CHMP7</italic> expression data using the ESTIMATE package of R software. The two scores were summed to obtain the ESTIMATE score, which can be used to estimate tumor purity. Significant correlation between <italic>CHMP7</italic> expression and immune infiltration was observed in 20 cancer species, 12 of which were significantly positively correlated, including TCGA-BRCA, TCGA-STES, TCGA-KIPAN, TCGA-COAD, TCGA-COADREAD, TCGA-PRAD, TCGA-STAD, TCGA-HNSC, TCGA -KIRC, TCGA-BLCA, TCGA-PAAD, and TCGA-LAML. There were eight significant negative correlations, such as TCGA-GBM, TCGA-GBMLGG, TCGA-LGG, TCGA-SARC, TARGET-WT, TCGA-THCA, TARGET-NB, and TCGA-ACC (<xref ref-type="fig" rid="F7">Figure 7A</xref>). <italic>CHMP7</italic> was significantly positively correlated with most immune checkpoints and immunoregulatory genes in pan-cancerous tissues. Notably, <italic>CHMP7</italic> was negatively correlated with most immune checkpoints and immunoregulatory genes in THYM (<xref ref-type="fig" rid="F7">Figure 7B</xref>; <xref ref-type="sec" rid="s12">Supplementary Material S4</xref>).</p>
<fig id="F7" position="float">
<label>FIGURE 7</label>
<caption>
<p>
<italic>CHMP7</italic> is correlated with immune infiltrates and immune checkpoints. <bold>(A)</bold> Bar graph displaying the correlation between <italic>CHMP7</italic> and ESTIMATEScore, ImmuneScore and StromalScore immune infiltration scores, and scatter plot presenting the top 6 correlated cancers for each immune infiltration score. <bold>(B)</bold> Heat map of the association between immune checkpoint and <italic>CHMP7</italic> expression levels. <bold>(C)</bold> The association between <italic>CHMP7</italic> and immune subtypes was obtained by TSIDB online tool. <bold>(D)</bold> <italic>CHMP7</italic> expression levels were correlated with immune subtypes. <bold>(E)</bold> Heat map of correlation between <italic>CHMP7</italic> expression and receptors (top left), chemokines (bottom left), immunostimulatory factors (top right) immunosuppressive factors (bottom right). <bold>(F)</bold> Box line plot of changes in <italic>CHMP7</italic> expression levels in tumor cell lines before and after cytokine treatment. (&#x2a;: <italic>p</italic> &#x3c; 0.05, &#x2a;&#x2a;: <italic>p</italic> &#x3c; 0.01 and &#x2a;&#x2a;&#x2a;: <italic>p</italic> &#x3c; 0.001).</p>
</caption>
<graphic xlink:href="fcell-11-1211843-g007.tif"/>
</fig>
<p>The TISIDB enabled us to investigate the differential expression of <italic>CHMP7</italic> in different immune subtypes. The results revealed that <italic>CHMP7</italic> expression was significantly elevated in the C4 subtype in BRCA, KIRP, and LGG, indicating that <italic>CHMP7</italic> may be associated with lymphocyte function (<xref ref-type="fig" rid="F7">Figures 7C, D</xref>). Heat maps demonstrate the correlation of <italic>CHMP7</italic> with cytokines, cytokine receptors, immunostimulatory factors, and immunosuppressive factors (<xref ref-type="fig" rid="F7">Figure 7E</xref>). The TISMO website was utilized to compare the changes in <italic>CHMP7</italic> expression levels in tumor cell lines in both pre- and post-cytokine treatment (<xref ref-type="fig" rid="F7">Figure 7F</xref>). <italic>CHMP7</italic> expression levels increased in several cell lines after IFN-&#x3b2; treatment, and the same was observed in several cell lines treated with IFN-&#x3b3;. The results suggest that the downregulation of our <italic>CHMP7</italic> expression levels may lead to the suppression of immune checkpoint function, which is associated with suppressive TME.</p>
</sec>
<sec id="s3-7">
<title>
<italic>CHMP7</italic> is associated with M2 macrophage infiltration</title>
<p>The relationship between <italic>CHMP7</italic> and immune cell infiltration in TME was analyzed using the EPIC algorithm (<xref ref-type="bibr" rid="B34">Sturm et al., 2019</xref>), and seven immune cells associated with <italic>CHMP7</italic> expression were obtained (<xref ref-type="fig" rid="F8">Figure 8A</xref>). The results indicate that <italic>CHMP7</italic> negatively correlates with CD8<sup>&#x2b;</sup> T cells in CESC, KICH, KIRC, PRAD, THCA, THYM, and UVM. The negative correlation of <italic>CHMP7</italic> with tumor-associated macrophages has been observed in BLCA, COAD, HNSC, LAML, PAAD, and PRAD, while the opposite has been observed in CHOL, GBM, KIRP, LIHC, and THYM. The relationship between <italic>CHMP7</italic> and immune cells in COAD is shown in scatter plots (<xref ref-type="fig" rid="F8">Figure 8B</xref>).</p>
<fig id="F8" position="float">
<label>FIGURE 8</label>
<caption>
<p>
<italic>CHMP7</italic> is associated with tumor tissue infiltration of immune cells. <bold>(A)</bold> EPIC algorithm for calculating <italic>CHMP7</italic> correlation with immune cell infiltration. <bold>(B)</bold> Scatter plots representing <italic>CHMP7</italic> correlation with B cell, CD4<sup>&#x2b;</sup> T cell, CD8<sup>&#x2b;</sup> T cell, uncharacterized cell, macrophage and NK cell infiltration. <bold>(C)</bold> Correlation of <italic>CHMP7</italic> with M2 macrophage infiltration was calculated by TIMER2.0 with several algorithms. <bold>(D)</bold> Spatial transcriptional sections illustrated the spatial expression of <italic>CHMP7</italic> in BRCA and PRCA tissues and CD68 and CD163 markers. <bold>(E)</bold> Expression of <italic>CHMP7</italic> in cancer monocyte clusters correlates with immune cell infiltration. <bold>(F)</bold> Expression of <italic>CHMP7</italic> in different immune cells in single cell clusters of multiple tumor cells. (&#x2a;: <italic>p</italic> &#x3c; 0.05, &#x2a;&#x2a;: <italic>p</italic> &#x3c; 0.01 and &#x2a;&#x2a;&#x2a;: <italic>p</italic> &#x3c; 0.001).</p>
</caption>
<graphic xlink:href="fcell-11-1211843-g008.tif"/>
</fig>
<p>M2 macrophages can secrete suppressive cytokines such as TGF-&#x3b2; and IL-10, producing an immunosuppressive TME that promotes tumor progression (<xref ref-type="bibr" rid="B9">Genin et al., 2015</xref>). The TIMER2.0 website facilitated us to analyze the correlation between <italic>CHMP7</italic> and M2 macrophage infiltration levels with multiple algorithms, and consistent correlations were observed in KIRP, THYM, and UCEC, suggesting that downregulation of <italic>CHMP7</italic> expression may be associated with M2 macrophage infiltration (<xref ref-type="fig" rid="F8">Figure 8C</xref>). The correlation between <italic>CHMP7</italic> and M2 macrophage markers (CD68, CD163) was analyzed at the spatial transcriptional level utilizing the SpatialDB, and <italic>CHMP7</italic> and M2 macrophage biomarkers presented a similar spatial distribution (<xref ref-type="fig" rid="F8">Figure 8D</xref>).</p>
<p>Subsequently, we investigated the correlation between <italic>CHMP7</italic> and immune cell infiltration from the single-cell level. The relationship between <italic>CHMP7</italic> and immune cell infiltration was investigated with the help of the TISCH (<xref ref-type="fig" rid="F8">Figure 8E</xref>). The correlation between <italic>CHMP7</italic> expression and immune cells in BRCA, COAD, SKCM, NPC, LIHC, and KIRC was analyzed, and there were differences in the expression levels of <italic>CHMP7</italic> in various infiltrating immune cells (<xref ref-type="fig" rid="F8">Figure 8F</xref>).</p>
</sec>
<sec id="s3-8">
<title>
<italic>CHMP7</italic> is associated with CTL dysfunction</title>
<p>In addition to M2 macrophages, the relevance of <italic>CHMP7</italic> to CTL has also attracted our attention. Similar to M2 macrophages, we analyzed the correlation between <italic>CHMP7</italic> and CTL with multiple immune infiltration algorithms in TIMER2.0 and expressed consistent significant positive correlations in BLCA, BRCA-Basal, BRCA-LumA, PAAD, PRAD, SARC, SKCM, STAD, THCA, and UVM (<xref ref-type="fig" rid="F9">Figure 9A</xref>). Combined <italic>CHMP7</italic> expression and CTL infiltration levels were analyzed for their predictive value for patient prognosis. The results reveal a poorer prognosis in the <italic>CHMP7</italic> low expression and CTL low infiltration groups in BRCA, CSC, HNSC, LIHC, KIRC, and SKCM (<xref ref-type="fig" rid="F9">Figure 9B</xref>).</p>
<fig id="F9" position="float">
<label>FIGURE 9</label>
<caption>
<p>
<italic>CHMP7</italic> has been positively correlated with CD8<sup>&#x2b;</sup> T-cell infiltration. <bold>(A)</bold> Heat map of association between <italic>CHMP7</italic> levels and CD8<sup>&#x2b;</sup> T-cell infiltration calculated by multiple algorithms. <bold>(B)</bold> Impact of <italic>CHMP7</italic> expression levels and CD8<sup>&#x2b;</sup> T-cell infiltration levels on prognosis of tumor patients. <bold>(C)</bold> Table depicting the correlation between <italic>CHMP7</italic> expression and CTL, CTL dysfunction and risk.</p>
</caption>
<graphic xlink:href="fcell-11-1211843-g009.tif"/>
</fig>
<p>The correlation between <italic>CHMP7</italic> and CTL dysfunction was observed in SKCM, UCEC, BRCA, and LAML through the TIDE website. A significant positive correlation between <italic>CHMP7</italic> and CTL was demonstrated in SKCM and LAML (<xref ref-type="fig" rid="F9">Figure 9C</xref>). The results suggest that <italic>CHMP7</italic> is associated with many immune cells, with the possible involvement of killing tumor cells by targeting CTLs.</p>
</sec>
<sec id="s3-9">
<title>
<italic>CHMP7</italic> may assist in predicting the efficacy of chemotherapy and immunotherapy</title>
<p>To investigate the possible role of <italic>CHMP7</italic> in tumor therapy, we investigated the predictive value of <italic>CHMP7</italic> compared to classical biomarkers for immunotherapeutic response through the TIDE website (<xref ref-type="fig" rid="F10">Figure 10A</xref>). The bar chart indicates that <italic>CHMP7</italic> presents an AUC above 0.5 in 11 of the 25 immunotherapy cohorts, suggesting a predictive significance. In 11 cohorts, the predictive value of <italic>CHMP7</italic> was superior to the MSI score of <italic>CHMP7</italic>. Higher predictive value of <italic>CHMP7</italic> was observed in 14, seven, 18, 18, 16, nine, and six immunotherapy cohorts compared with TIDE, TMB, CD274, CD8, IFN, T. Clonality, T. Clonality, and Merck18, respectively. It was observed in the antiPD-L1 treatment group of the EMT6 mouse breast cancer cell line that <italic>CHMP7</italic> expression was higher in the response group (<xref ref-type="fig" rid="F10">Figure 10B</xref>). The TIDE website also assisted us in predicting the therapeutic response of <italic>CHMP7</italic> in the core dataset, immunotherapy dataset, CRISPR screening dataset, and mechanistic follow-up experiments with immunosuppressive cell types (<xref ref-type="fig" rid="F10">Figure 10C</xref>).</p>
<fig id="F10" position="float">
<label>FIGURE 10</label>
<caption>
<p>
<italic>CHMP7</italic> may predict immunotherapy and chemotherapy drug sensitivity. <bold>(A)</bold> <italic>CHMP7</italic> correlates with immunotherapy response and <bold>(B)</bold> biomarkers in the immunotherapy cohort. <bold>(C)</bold> Therapeutic response of <italic>CHMP7</italic> in mechanistic follow-up experiments. <bold>(D)</bold> Prediction of <italic>CHMP7</italic> level-sensitive small compounds by CTRP and GDSC sites. <bold>(E)</bold> GDSC data-based analysis of differential <italic>CHMP7</italic> expression in multiple chemotherapy drug response and non-response groups. (&#x2a;: <italic>p</italic> &#x3c; 0.05, &#x2a;&#x2a;: <italic>p</italic> &#x3c; 0.01 and &#x2a;&#x2a;&#x2a;: <italic>p</italic> &#x3c; 0.001).</p>
</caption>
<graphic xlink:href="fcell-11-1211843-g010.tif"/>
</fig>
<p>In addition to the predictive value of <italic>CHMP7</italic> for immunotherapy efficacy, <italic>CHMP7</italic>-sensitive small molecule drugs were also analyzed using the CTRP and GDSC datasets (<xref ref-type="fig" rid="F10">Figure 10D</xref>). It was further compared that <italic>CHMP7</italic> was differentially expressed in the responding and non-responding groups of multiple immunotherapy cohorts. The results revealed that <italic>CHMP7</italic> was differentially expressed in response and non-response groups in multiple immunotherapy cohorts including SRP094781, GSE67501, SRP230414, and IMvigor210 (<xref ref-type="sec" rid="s12">Supplementary Material S5</xref>). The RNAact Drug website also facilitated our predictions (<xref ref-type="sec" rid="s12">Supplementary Material S6</xref>). The results suggest that the top 5 sensitive drugs associated with CHMP7 expression based on the GDSC dataset are GSK429286A, KU-55933, BX-912, CCT007093, and Tretinoin (<italic>p</italic> &#x3c; 0.05). Performing further exploration of the differential expression of <italic>CHMP7</italic> in the response and non-response groups of multiple chemotherapeutic agents, we discovered that high <italic>CHMP7</italic> expression may be associated with drug sensitivity to chemotherapeutic agents such as paclitaxel, oxaliplatin, gemcitabine, and methotrexate, which are now commonly recommended (<xref ref-type="fig" rid="F10">Figure 10E</xref>).</p>
</sec>
</sec>
<sec sec-type="discussion" id="s4">
<title>Discussion</title>
<p>Tumor progression is attributed to the accumulation of random mutations and epigenetic alterations in DNA sequences that affect the proliferation of malignant cells associated with gene regulatory networks and other traits associated with the malignant phenotype (<xref ref-type="bibr" rid="B28">Nakagawa and Fujita, 2018</xref>). ESCRT is a molecular machine that participates in various essential physiological processes, such as the formation of multivesicular bodies, involvement in cellular autophagy, and repair of cellular membranes. The dysregulation of ESCRT function is highly related to tumor development, and <italic>CHMP7,</italic> an important regulatory subunit of ESCRT-III, has attracted our attention. The dysregulated function of ESCRT may affect the proliferation and migration capacity of tumor cells through the sorting and delivery of exosomes (<xref ref-type="bibr" rid="B41">Wei et al., 2015</xref>). In this study, <italic>CHMP7</italic> has been comprehensively described with the help of public databases of tumor tissues. The differential expression of <italic>CHMP7</italic> in tumor and normal tissues was first compared, and the predictive value of <italic>CHMP7</italic> for patient OS was assessed further. The role of <italic>CHMP7</italic> in tumor immunity is a central focus of our study and excels as a biomarker for predicting the efficacy of tumor immunotherapy and chemotherapy. The low <italic>CHMP7</italic> expression group was associated with poor prognosis in BRCA, COAD, HNSC, and KIRC, and the level of <italic>CHMP7</italic> expression decreased with a more advanced tumor stage. The results suggest that normal <italic>CHMP7</italic> expression may be crucial for maintaining normal cellular function.</p>
<p>DNA integrity affected the accuracy of genetic information transmission in organisms, and the ESCRT system is thought to be related to cell division, where we further explored the correlation between <italic>CHMP7</italic> and the DNA damage repair response. To maintain genome integrity, complex DNA repair systems are employed to counteract various forms of DNA damage, and these mechanisms are known as the DNA damage response (<xref ref-type="bibr" rid="B14">Jackson and Bartek, 2009</xref>). Cellular DNA damage can be classified into single-strand break (SSB) and double-strand break (DSB). SSBs mainly rely on poly ADP-ribose polymerase (PARP) for nucleotide excision repair (NER), base excision repair (BER), and MMR; while DSBs are repaired by HRR, non-homologous end joining (NHEJ), and microhomology-mediated end joining (MMEJ) pathways (<xref ref-type="bibr" rid="B22">Li et al., 2016</xref>). The inhibitor targeting PARP can promote the recruitment of DNA repair effector molecules and structural remodeling of chromatin around DNA damage sites, which can selectively kill tumor cells with HRD. Therefore, it is a promising therapeutic strategy for BRCA-mutated tumors (<xref ref-type="bibr" rid="B33">Slade, 2020</xref>). In this study, <italic>CHMP7</italic> was significantly and positively correlated with MMR and HRR-related gene signatures in various tumor tissues. The results indicate that normal expression of <italic>CHMP7</italic> is essential for cells to complete DNA repair through MMR and HRR pathways. Furthermore, <italic>CHMP7</italic> was significantly and negatively correlated with Ploidy and HRD. The results show that the downregulation of <italic>CHMP7</italic> may lead to chromosomal instability from another aspect. All these findings prompt us that <italic>CHMP7</italic> may be intimately involved in the DNA repair process and deserves to be explored in depth.</p>
<p>The immune microenvironment and immunotherapy represent emerging trends in oncology research. In addition to tumor cells, TME includes infiltrating immune and inflammatory cells, CAFs, ECM, microvasculature, and various cytokines and chemokines (<xref ref-type="bibr" rid="B2">Bilotta et al., 2022</xref>). The heterogeneity of TME is inextricably linked to the different response rates of patients with tumors to immunotherapy. Low <italic>CHMP7</italic> expression was significantly correlated with immunosuppressive TME, as evidenced by high infiltration of M2 macrophages and reduced CTL and cytokines. The analysis of the correlation between <italic>CHMP7</italic> and immune cell infiltration levels shows that <italic>CHMP7</italic> and M2 macrophages are significantly negatively correlated, which has been demonstrated with multiple algorithms and spatial transcriptional data. Significant elevations in <italic>CHMP7</italic> expression were detected following multiple cytokine immunotherapy cohorts. As the immune cell that primarily kills tumor cells in TME, lower <italic>CHMP7</italic> expression significantly inhibits the function of CTL, further leading to tumor progression and poor patient prognosis. Furthermore, <italic>CHMP7</italic> was identified to perform superiorly as a biomarker for predicting the efficacy of immunotherapy and chemotherapy (<xref ref-type="bibr" rid="B45">Zheng et al., 2023</xref>). <italic>CHMP7</italic> was superior to traditional biomarkers in several immunotherapy cohorts, such as TMB and MSI scores. <italic>CHMP7</italic> levels were significantly lower in the non-responder group for several common chemotherapeutic agents. The results suggest that downregulated <italic>CHMP7</italic> levels may lead to the occurrence of tumor drug resistance.</p>
</sec>
<sec sec-type="conclusion" id="s5">
<title>Conclusion</title>
<p>In this article, we utilized public databases such as TCGA, GTEx, TARGET, and single-cell sequencing data to provide a comprehensive and intensive analysis of the role of <italic>CHMP7</italic> in tumor development and therapy. <italic>CHMP7</italic> shows a predictive value for the prognosis of patients with tumors and is highly involved in tumor immunity. A strong correlation between <italic>CHMP7</italic> and TME immune cell infiltration has been observed, which is involved in the formation of suppressive TME and promotes tumor progression. <italic>CHMP7</italic> can potentially serve as a new biomarker for predicting the efficacy of chemotherapy and immunotherapy for tumors. As a gene of interest, <italic>CHMP7</italic> is expected to provide novel and promising targets for further treatment of patients with tumors.</p>
</sec>
</body>
<back>
<sec sec-type="data-availability" id="s6">
<title>Data availability statement</title>
<p>The original contributions presented in the study are included in the article/<xref ref-type="sec" rid="s12">Supplementary Material</xref>, further inquiries can be directed to the corresponding author.</p>
</sec>
<sec id="s7">
<title>Ethics statement</title>
<p>The studies involving humans were approved by The Ethics Committee of The Second Hospital of Jilin University. The studies were conducted in accordance with the local legislation and institutional requirements. The human samples used in this study were acquired from primarily isolated as part of your previous study for which ethical approval was obtained. Written informed consent for participation was not required from the participants or the participants&#x2019; legal guardians/next of kin in accordance with the national legislation and institutional requirements.</p>
</sec>
<sec id="s8">
<title>Author contributions</title>
<p>YG and MW drafted the manuscript, and SW reviewed and revised the manuscript. FL has contributed to the article revision and checking process. All authors contributed to the article and approved the submitted version.</p>
</sec>
<sec id="s9">
<title>Funding</title>
<p>This study was supported by Science and Technology Department of Changchun (Grant No. 3D5220102429).</p>
</sec>
<ack>
<p>The author express gratitude to the public databases, websites, and software used in the paper. The data visualization in the manuscript obtained assistance from Xiantao Academic (<ext-link ext-link-type="uri" xlink:href="https://www.xiantaozi.com/">https://www.xiantaozi.com/</ext-link>) and Sangerbox (<ext-link ext-link-type="uri" xlink:href="http://vip.sangerbox.com/">http://vip.sangerbox.com/</ext-link>).</p>
</ack>
<sec sec-type="COI-statement" id="s10">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec sec-type="disclaimer" id="s11">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
<sec id="s12">
<title>Supplementary material</title>
<p>The Supplementary Material for this article can be found online at: <ext-link ext-link-type="uri" xlink:href="https://www.frontiersin.org/articles/10.3389/fcell.2023.1211843/full#supplementary-material">https://www.frontiersin.org/articles/10.3389/fcell.2023.1211843/full&#x23;supplementary-material</ext-link>
</p>
<supplementary-material>
<label>SUPPLEMENTARY MATERIAL S1</label>
<caption>
<p>Correlation of <italic>CHMP7</italic> expression levels with cancer stemness scores. <bold>(A)</bold> Cancer stemness index based on epigenetic regulation of DNA methylation signatures. <bold>(B)</bold> Cancer stemness index based on differential methylation probes. <bold>(C)</bold> Cancer stemness index based on epigenetically regulated RNA expression. <bold>(D)</bold> Cancer stemness index based on enhancer elements/DNA methylation. <bold>(E)</bold> Cancer stemness index based on RNA expression.</p>
</caption>
</supplementary-material>
<supplementary-material>
<label>SUPPLEMENTARY MATERIAL S2</label>
<caption>
<p>AS events occurring with <italic>CHMP7</italic> in pan-cancerous tissues. <bold>(A)</bold> The read-in, read-out, and PSI values of <italic>CHMP7</italic> _alt_5prime_195490 in tumor and normal tissues. Differences in PSI value between tumor and adjacent normal tissue (left), and tumor and GTEx normal tissue (right); red dashed line refers to FDR of 0.05. <bold>(B)</bold> The read-in, read-out, and PSI values of <italic>CHMP7</italic>_exon_skip_482248 in tumor and normal tissues. Differences in PSI value between tumor and adjacent normal tissue (left), and tumor and GTEx normal tissue (right); red dashed line refers to FDR of 0.05. <bold>(C)</bold> PSI values of <italic>CHMP7</italic>_AD_83076 in tumor and normal tissues. <bold>(D)</bold> PSI values of <italic>CHMP7</italic>_ES_83072 in tumor and normal tissues. <bold>(E)</bold> PSI values of <italic>CHMP7</italic>_ES_83073 in tumor and normal tissues. <bold>(F)</bold> Differences in PSI value of <italic>CHMP7</italic>_AD_83076, <italic>CHMP7</italic>_ES_83072 and <italic>CHMP7</italic>_ES_83073 between tumor and adjacent normal tissue respectively. (AD, alternate donor site; ES, exon skipping).</p>
</caption>
</supplementary-material>
<supplementary-material>
<label>SUPPLEMENTARY MATERIAL S3</label>
<caption>
<p>Top 100 genes associated with <italic>CHMP7</italic> obtained from the GEPIA website.</p>
</caption>
</supplementary-material>
<supplementary-material>
<label>SUPPLEMENTARY MATERIAL S4</label>
<caption>
<p>Correlation of <italic>CHMP7</italic> expression levels and immune regulatory genes.</p>
</caption>
</supplementary-material>
<supplementary-material>
<label>SUPPLEMENTARY MATERIAL S5</label>
<caption>
<p>
<italic>CHMP7</italic> expression for Response and Non-response based on Pre-treatment Samples in each dataset.</p>
</caption>
</supplementary-material>
<supplementary-material>
<label>SUPPLEMENTARY MATERIAL S6</label>
<caption>
<p>Small molecule drugs related to <italic>CHMP7</italic> as predicted by the RNAact Drug website.</p>
</caption>
</supplementary-material>
<supplementary-material xlink:href="DataSheet3.zip" id="SM1" mimetype="application/zip" xmlns:xlink="http://www.w3.org/1999/xlink"/>
<supplementary-material xlink:href="DataSheet1.ZIP" id="SM2" mimetype="application/ZIP" xmlns:xlink="http://www.w3.org/1999/xlink"/>
<supplementary-material xlink:href="DataSheet2.ZIP" id="SM3" mimetype="application/ZIP" xmlns:xlink="http://www.w3.org/1999/xlink"/>
</sec>
<sec id="s13">
<title>Abbreviations</title>
<p>AS, alternative splicing; CAFs, cancer associated fibroblasts; CHMP7, charged multivesicular body protein 7; CTLs, cytotoxic T lymphocytes; ECM, extracellular matrix; TME, tumor microenvironment; DFS, disease-free survival; EGFR, epidermal growth factor receptor; ESCRT, endosomal sorting complex required for transport; EVs, extracellular vehicles; GEO, Gene Expression Omnibus database; GSEA, gene set enrichment analysis; HRD, homologous recombination deficiency; HRR, homologous recombination repair; ILVs, intraluminal vesicles; MSI, microsatellite instability; NEO, neoantigen; OS, overall survival; PPI, protein-protein interaction; PSI, percent spliced-in; TARGET, Therapeutically Applicable Research to Generate Effective Treatments; TCGA, the Cancer Genome Atlas; TMB, tumor mutation burden.</p>
</sec>
<ref-list>
<title>References</title>
<ref id="B1">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Baretti</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Le</surname>
<given-names>D. T.</given-names>
</name>
</person-group> (<year>2018</year>). <article-title>DNA mismatch repair in cancer</article-title>. <source>Pharmacol. Ther.</source> <volume>189</volume>, <fpage>45</fpage>&#x2013;<lpage>62</lpage>. <pub-id pub-id-type="doi">10.1016/j.pharmthera.2018.04.004</pub-id>
</citation>
</ref>
<ref id="B2">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Bilotta</surname>
<given-names>M. T.</given-names>
</name>
<name>
<surname>Antignani</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Fitzgerald</surname>
<given-names>D. J.</given-names>
</name>
</person-group> (<year>2022</year>). <article-title>Managing the TME to improve the efficacy of cancer therapy</article-title>. <source>Front. Immunol.</source> <volume>13</volume>, <fpage>954992</fpage>. <pub-id pub-id-type="doi">10.3389/fimmu.2022.954992</pub-id>
</citation>
</ref>
<ref id="B3">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Biswas</surname>
<given-names>S. K.</given-names>
</name>
<name>
<surname>Mantovani</surname>
<given-names>A.</given-names>
</name>
</person-group> (<year>2010</year>). <article-title>Macrophage plasticity and interaction with lymphocyte subsets: cancer as a paradigm</article-title>. <source>Nat. Immunol.</source> <volume>11</volume> (<issue>10</issue>), <fpage>889</fpage>&#x2013;<lpage>896</lpage>. <pub-id pub-id-type="doi">10.1038/ni.1937</pub-id>
</citation>
</ref>
<ref id="B4">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Blass</surname>
<given-names>E.</given-names>
</name>
<name>
<surname>Ott</surname>
<given-names>P. A.</given-names>
</name>
</person-group> (<year>2021</year>). <article-title>Advances in the development of personalized neoantigen-based therapeutic cancer vaccines</article-title>. <source>Nat. Rev. Clin. Oncol.</source> <volume>18</volume> (<issue>4</issue>), <fpage>215</fpage>&#x2013;<lpage>229</lpage>. <pub-id pub-id-type="doi">10.1038/s41571-020-00460-2</pub-id>
</citation>
</ref>
<ref id="B5">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Blencowe</surname>
<given-names>B. J.</given-names>
</name>
</person-group> (<year>2006</year>). <article-title>Alternative splicing: new insights from global analyses</article-title>. <source>Cell.</source> <volume>126</volume> (<issue>1</issue>), <fpage>37</fpage>&#x2013;<lpage>47</lpage>. <pub-id pub-id-type="doi">10.1016/j.cell.2006.06.023</pub-id>
</citation>
</ref>
<ref id="B6">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Coyne</surname>
<given-names>A. N.</given-names>
</name>
<name>
<surname>Baskerville</surname>
<given-names>V.</given-names>
</name>
<name>
<surname>Zaepfel</surname>
<given-names>B. L.</given-names>
</name>
<name>
<surname>Dickson</surname>
<given-names>D. W.</given-names>
</name>
<name>
<surname>Rigo</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Bennett</surname>
<given-names>F.</given-names>
</name>
<etal/>
</person-group> (<year>2021</year>). <article-title>Nuclear accumulation of CHMP7 initiates nuclear pore complex injury and subsequent TDP-43 dysfunction in sporadic and familial ALS</article-title>. <source>Sci. Transl. Med.</source> <volume>13</volume> (<issue>604</issue>), <fpage>eabe1923</fpage>. <pub-id pub-id-type="doi">10.1126/scitranslmed.abe1923</pub-id>
</citation>
</ref>
<ref id="B7">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Coyne</surname>
<given-names>A. N.</given-names>
</name>
<name>
<surname>Rothstein</surname>
<given-names>J. D.</given-names>
</name>
</person-group> (<year>2022</year>). <article-title>Nuclear pore complexes - a doorway to neural injury in neurodegeneration</article-title>. <source>Nat. Rev. Neurol.</source> <volume>18</volume> (<issue>6</issue>), <fpage>348</fpage>&#x2013;<lpage>362</lpage>. <pub-id pub-id-type="doi">10.1038/s41582-022-00653-6</pub-id>
</citation>
</ref>
<ref id="B8">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Gatta</surname>
<given-names>A. T.</given-names>
</name>
<name>
<surname>Carlton</surname>
<given-names>J. G.</given-names>
</name>
</person-group> (<year>2019</year>). <article-title>The ESCRT-machinery: closing holes and expanding roles</article-title>. <source>Curr. Opin. Cell. Biol.</source> <volume>59</volume>, <fpage>121</fpage>&#x2013;<lpage>132</lpage>. <pub-id pub-id-type="doi">10.1016/j.ceb.2019.04.005</pub-id>
</citation>
</ref>
<ref id="B9">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Genin</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Clement</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Fattaccioli</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Raes</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Michiels</surname>
<given-names>C.</given-names>
</name>
</person-group> (<year>2015</year>). <article-title>M1 and M2 macrophages derived from THP-1 cells differentially modulate the response of cancer cells to etoposide</article-title>. <source>BMC Cancer</source> <volume>15</volume>, <fpage>577</fpage>. <pub-id pub-id-type="doi">10.1186/s12885-015-1546-9</pub-id>
</citation>
</ref>
<ref id="B10">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Han</surname>
<given-names>Q.</given-names>
</name>
<name>
<surname>Lv</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Wei</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Lei</surname>
<given-names>X.</given-names>
</name>
<name>
<surname>Lin</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Li</surname>
<given-names>G.</given-names>
</name>
<etal/>
</person-group> (<year>2019</year>). <article-title>Vps4A mediates the localization and exosome release of &#x3b2;-catenin to inhibit epithelial-mesenchymal transition in hepatocellular carcinoma</article-title>. <source>Cancer Lett.</source> <volume>457</volume>, <fpage>47</fpage>&#x2013;<lpage>59</lpage>. <pub-id pub-id-type="doi">10.1016/j.canlet.2019.04.035</pub-id>
</citation>
</ref>
<ref id="B11">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Hausman</surname>
<given-names>D. M.</given-names>
</name>
</person-group> (<year>2019</year>). <article-title>What is cancer?</article-title> <source>Perspect. Biol. Med.</source> <volume>62</volume> (<issue>4</issue>), <fpage>778</fpage>&#x2013;<lpage>784</lpage>. <pub-id pub-id-type="doi">10.1353/pbm.2019.0046</pub-id>
</citation>
</ref>
<ref id="B12">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Iranzo</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Martincorena</surname>
<given-names>I.</given-names>
</name>
<name>
<surname>Koonin</surname>
<given-names>E. V.</given-names>
</name>
</person-group> (<year>2018</year>). <article-title>Cancer-mutation network and the number and specificity of driver mutations</article-title>. <source>Proc. Natl. Acad. Sci. U. S. A.</source> <volume>115</volume> (<issue>26</issue>), <fpage>E6010</fpage>&#x2013;<lpage>e9</lpage>. <pub-id pub-id-type="doi">10.1073/pnas.1803155115</pub-id>
</citation>
</ref>
<ref id="B13">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Isono</surname>
<given-names>E.</given-names>
</name>
</person-group> (<year>2021</year>). <article-title>ESCRT is a great sealer: non-endosomal function of the ESCRT machinery in membrane repair and autophagy</article-title>. <source>Plant Cell. Physiol.</source> <volume>62</volume> (<issue>5</issue>), <fpage>766</fpage>&#x2013;<lpage>774</lpage>. <pub-id pub-id-type="doi">10.1093/pcp/pcab045</pub-id>
</citation>
</ref>
<ref id="B14">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Jackson</surname>
<given-names>S. P.</given-names>
</name>
<name>
<surname>Bartek</surname>
<given-names>J.</given-names>
</name>
</person-group> (<year>2009</year>). <article-title>The DNA-damage response in human biology and disease</article-title>. <source>Nature</source> <volume>461</volume> (<issue>7267</issue>), <fpage>1071</fpage>&#x2013;<lpage>1078</lpage>. <pub-id pub-id-type="doi">10.1038/nature08467</pub-id>
</citation>
</ref>
<ref id="B15">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Kocaturk</surname>
<given-names>N. M.</given-names>
</name>
<name>
<surname>Akkoc</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Kig</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>Bayraktar</surname>
<given-names>O.</given-names>
</name>
<name>
<surname>Gozuacik</surname>
<given-names>D.</given-names>
</name>
<name>
<surname>Kutlu</surname>
<given-names>O.</given-names>
</name>
</person-group> (<year>2019</year>). <article-title>Autophagy as a molecular target for cancer treatment</article-title>. <source>Eur. J. Pharm. Sci.</source> <volume>134</volume>, <fpage>116</fpage>&#x2013;<lpage>137</lpage>. <pub-id pub-id-type="doi">10.1016/j.ejps.2019.04.011</pub-id>
</citation>
</ref>
<ref id="B16">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Korbei</surname>
<given-names>B.</given-names>
</name>
</person-group> (<year>2022</year>). <article-title>Ubiquitination of the ubiquitin-binding machinery: how early ESCRT components are controlled</article-title>. <source>Essays Biochem.</source> <volume>66</volume> (<issue>2</issue>), <fpage>169</fpage>&#x2013;<lpage>177</lpage>. <pub-id pub-id-type="doi">10.1042/EBC20210042</pub-id>
</citation>
</ref>
<ref id="B17">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Ledermann</surname>
<given-names>J. A.</given-names>
</name>
<name>
<surname>Drew</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Kristeleit</surname>
<given-names>R. S.</given-names>
</name>
</person-group> (<year>2016</year>). <article-title>Homologous recombination deficiency and ovarian cancer</article-title>. <source>Eur. J. Cancer</source> <volume>60</volume>, <fpage>49</fpage>&#x2013;<lpage>58</lpage>. <pub-id pub-id-type="doi">10.1016/j.ejca.2016.03.005</pub-id>
</citation>
</ref>
<ref id="B18">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Lee</surname>
<given-names>S. S.</given-names>
</name>
<name>
<surname>Cheah</surname>
<given-names>Y. K.</given-names>
</name>
</person-group> (<year>2019</year>). <article-title>The interplay between MicroRNAs and cellular components of tumour microenvironment (TME) on non-small-cell lung cancer (NSCLC) progression</article-title>. <source>J. Immunol. Res.</source> <volume>2019</volume>, <fpage>3046379</fpage>. <pub-id pub-id-type="doi">10.1155/2019/3046379</pub-id>
</citation>
</ref>
<ref id="B19">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Levy</surname>
<given-names>J. M. M.</given-names>
</name>
<name>
<surname>Towers</surname>
<given-names>C. G.</given-names>
</name>
<name>
<surname>Thorburn</surname>
<given-names>A.</given-names>
</name>
</person-group> (<year>2017</year>). <article-title>Targeting autophagy in cancer</article-title>. <source>Nat. Rev. Cancer</source> <volume>17</volume> (<issue>9</issue>), <fpage>528</fpage>&#x2013;<lpage>542</lpage>. <pub-id pub-id-type="doi">10.1038/nrc.2017.53</pub-id>
</citation>
</ref>
<ref id="B20">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Lewandowska</surname>
<given-names>A. M.</given-names>
</name>
<name>
<surname>Rudzki</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Rudzki</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Lewandowski</surname>
<given-names>T.</given-names>
</name>
<name>
<surname>Laskowska</surname>
<given-names>B.</given-names>
</name>
</person-group> (<year>2019</year>). <article-title>Environmental risk factors for cancer - review paper</article-title>. <source>Ann. Agric. Environ. Med.</source> <volume>26</volume> (<issue>1</issue>), <fpage>1</fpage>&#x2013;<lpage>7</lpage>. <pub-id pub-id-type="doi">10.26444/aaem/94299</pub-id>
</citation>
</ref>
<ref id="B21">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Li</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Sun</surname>
<given-names>N.</given-names>
</name>
<name>
<surname>Lu</surname>
<given-names>Z.</given-names>
</name>
<name>
<surname>Sun</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Huang</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Chen</surname>
<given-names>Z.</given-names>
</name>
<etal/>
</person-group> (<year>2017</year>). <article-title>Prognostic alternative mRNA splicing signature in non-small cell lung cancer</article-title>. <source>Cancer Lett.</source> <volume>393</volume>, <fpage>40</fpage>&#x2013;<lpage>51</lpage>. <pub-id pub-id-type="doi">10.1016/j.canlet.2017.02.016</pub-id>
</citation>
</ref>
<ref id="B22">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Li</surname>
<given-names>Z.</given-names>
</name>
<name>
<surname>Pearlman</surname>
<given-names>A. H.</given-names>
</name>
<name>
<surname>Hsieh</surname>
<given-names>P.</given-names>
</name>
</person-group> (<year>2016</year>). <article-title>DNA mismatch repair and the DNA damage response</article-title>. <source>DNA Repair (Amst)</source> <volume>38</volume>, <fpage>94</fpage>&#x2013;<lpage>101</lpage>. <pub-id pub-id-type="doi">10.1016/j.dnarep.2015.11.019</pub-id>
</citation>
</ref>
<ref id="B23">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Liang</surname>
<given-names>X.</given-names>
</name>
<name>
<surname>Zhang</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Wang</surname>
<given-names>Z.</given-names>
</name>
<name>
<surname>Zhang</surname>
<given-names>X.</given-names>
</name>
<name>
<surname>Dai</surname>
<given-names>Z.</given-names>
</name>
<name>
<surname>Zhang</surname>
<given-names>J.</given-names>
</name>
<etal/>
</person-group> (<year>2022</year>). <article-title>JMJD8 is an M2 macrophage biomarker, and it associates with DNA damage repair to facilitate stemness maintenance, chemoresistance, and immunosuppression in pan-cancer</article-title>. <source>Front. Immunol.</source> <volume>13</volume>, <fpage>875786</fpage>. <pub-id pub-id-type="doi">10.3389/fimmu.2022.875786</pub-id>
</citation>
</ref>
<ref id="B24">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Lim</surname>
<given-names>Z. F.</given-names>
</name>
<name>
<surname>Ma</surname>
<given-names>P. C.</given-names>
</name>
</person-group> (<year>2019</year>). <article-title>Emerging insights of tumor heterogeneity and drug resistance mechanisms in lung cancer targeted therapy</article-title>. <source>J. Hematol. Oncol.</source> <volume>12</volume> (<issue>1</issue>), <fpage>134</fpage>. <pub-id pub-id-type="doi">10.1186/s13045-019-0818-2</pub-id>
</citation>
</ref>
<ref id="B25">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Malta</surname>
<given-names>T. M.</given-names>
</name>
<name>
<surname>Sokolov</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Gentles</surname>
<given-names>A. J.</given-names>
</name>
<name>
<surname>Burzykowski</surname>
<given-names>T.</given-names>
</name>
<name>
<surname>Poisson</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Weinstein</surname>
<given-names>J. N.</given-names>
</name>
<etal/>
</person-group> (<year>2018</year>). <article-title>Machine learning identifies stemness features associated with oncogenic dedifferentiation</article-title>. <source>Cell.</source> <volume>173</volume> (<issue>2</issue>), <fpage>338</fpage>&#x2013;<lpage>354.e15</lpage>. <pub-id pub-id-type="doi">10.1016/j.cell.2018.03.034</pub-id>
</citation>
</ref>
<ref id="B26">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Mami-Chouaib</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Blanc</surname>
<given-names>C.</given-names>
</name>
<name>
<surname>Corgnac</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Hans</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Malenica</surname>
<given-names>I.</given-names>
</name>
<name>
<surname>Granier</surname>
<given-names>C.</given-names>
</name>
<etal/>
</person-group> (<year>2018</year>). <article-title>Resident memory T cells, critical components in tumor immunology</article-title>. <source>J. Immunother. Cancer</source> <volume>6</volume> (<issue>1</issue>), <fpage>87</fpage>. <pub-id pub-id-type="doi">10.1186/s40425-018-0399-6</pub-id>
</citation>
</ref>
<ref id="B27">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>M&#xfc;ller</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>May</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Bird</surname>
<given-names>T. G.</given-names>
</name>
</person-group> (<year>2021</year>). <article-title>Ploidy dynamics increase the risk of liver cancer initiation</article-title>. <source>Nat. Commun.</source> <volume>12</volume> (<issue>1</issue>), <fpage>1896</fpage>. <pub-id pub-id-type="doi">10.1038/s41467-021-21897-8</pub-id>
</citation>
</ref>
<ref id="B28">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Nakagawa</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Fujita</surname>
<given-names>M.</given-names>
</name>
</person-group> (<year>2018</year>). <article-title>Whole genome sequencing analysis for cancer genomics and precision medicine</article-title>. <source>Cancer Sci.</source> <volume>109</volume> (<issue>3</issue>), <fpage>513</fpage>&#x2013;<lpage>522</lpage>. <pub-id pub-id-type="doi">10.1111/cas.13505</pub-id>
</citation>
</ref>
<ref id="B29">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Padma</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Patra</surname>
<given-names>R.</given-names>
</name>
<name>
<surname>Sen Gupta</surname>
<given-names>P. S.</given-names>
</name>
<name>
<surname>Panda</surname>
<given-names>S. K.</given-names>
</name>
<name>
<surname>Rana</surname>
<given-names>M. K.</given-names>
</name>
<name>
<surname>Mukherjee</surname>
<given-names>S.</given-names>
</name>
</person-group> (<year>2023</year>). <article-title>Cell surface fibroblast activation protein-2 (Fap2) of fusobacterium nucleatum as a vaccine candidate for therapeutic intervention of human colorectal cancer: an immunoinformatics approach</article-title>. <source>Vaccines (Basel).</source> <volume>11</volume> (<issue>3</issue>), <fpage>525</fpage>. <pub-id pub-id-type="doi">10.3390/vaccines11030525</pub-id>
</citation>
</ref>
<ref id="B30">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Patra</surname>
<given-names>R.</given-names>
</name>
<name>
<surname>Chakraborty</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Das</surname>
<given-names>N. C.</given-names>
</name>
<name>
<surname>Mukherjee</surname>
<given-names>S.</given-names>
</name>
</person-group> (<year>2023</year>). <article-title>An integrated omics study on the role of HDAC9 gene in the oncogenic events of human gastrointestinal-tract associated cancers</article-title>. <source>Hum. Gene</source> <volume>37</volume>, <fpage>201189</fpage>. <pub-id pub-id-type="doi">10.1016/j.humgen.2023.201189</pub-id>
</citation>
</ref>
<ref id="B31">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Patra</surname>
<given-names>R.</given-names>
</name>
<name>
<surname>Das</surname>
<given-names>N. C.</given-names>
</name>
<name>
<surname>Mukherjee</surname>
<given-names>S.</given-names>
</name>
</person-group> (<year>2021</year>). <article-title>Exploring the differential expression and prognostic significance of the COL11A1 gene in human colorectal carcinoma: an integrated bioinformatics approach</article-title>. <source>Front. Genet.</source> <volume>12</volume>, <fpage>608313</fpage>. <pub-id pub-id-type="doi">10.3389/fgene.2021.608313</pub-id>
</citation>
</ref>
<ref id="B32">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Ritter</surname>
<given-names>A. T.</given-names>
</name>
<name>
<surname>Shtengel</surname>
<given-names>G.</given-names>
</name>
<name>
<surname>Xu</surname>
<given-names>C. S.</given-names>
</name>
<name>
<surname>Weigel</surname>
<given-names>A.</given-names>
</name>
<name>
<surname>Hoffman</surname>
<given-names>D. P.</given-names>
</name>
<name>
<surname>Freeman</surname>
<given-names>M.</given-names>
</name>
<etal/>
</person-group> (<year>2022</year>). <article-title>ESCRT-mediated membrane repair protects tumor-derived cells against T cell attack</article-title>. <source>Science</source> <volume>376</volume> (<issue>6591</issue>), <fpage>377</fpage>&#x2013;<lpage>382</lpage>. <pub-id pub-id-type="doi">10.1126/science.abl3855</pub-id>
</citation>
</ref>
<ref id="B33">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Slade</surname>
<given-names>D.</given-names>
</name>
</person-group> (<year>2020</year>). <article-title>PARP and PARG inhibitors in cancer treatment</article-title>. <source>Genes. Dev.</source> <volume>34</volume> (<issue>5-6</issue>), <fpage>360</fpage>&#x2013;<lpage>394</lpage>. <pub-id pub-id-type="doi">10.1101/gad.334516.119</pub-id>
</citation>
</ref>
<ref id="B34">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Sturm</surname>
<given-names>G.</given-names>
</name>
<name>
<surname>Finotello</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Petitprez</surname>
<given-names>F.</given-names>
</name>
<name>
<surname>Zhang</surname>
<given-names>J. D.</given-names>
</name>
<name>
<surname>Baumbach</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Fridman</surname>
<given-names>W. H.</given-names>
</name>
<etal/>
</person-group> (<year>2019</year>). <article-title>Comprehensive evaluation of transcriptome-based cell-type quantification methods for immuno-oncology</article-title>. <source>Bioinformatics</source> <volume>35</volume> (<issue>14</issue>), <fpage>i436</fpage>&#x2013;<lpage>i445</lpage>. <pub-id pub-id-type="doi">10.1093/bioinformatics/btz363</pub-id>
</citation>
</ref>
<ref id="B35">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Sun</surname>
<given-names>D.</given-names>
</name>
<name>
<surname>Li</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Cao</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>He</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Lei</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Peng</surname>
<given-names>J.</given-names>
</name>
<etal/>
</person-group> (<year>2020</year>). <article-title>Cancer burden in China: trends, risk factors and prevention</article-title>. <source>Cancer Biol. Med.</source> <volume>17</volume> (<issue>4</issue>), <fpage>879</fpage>&#x2013;<lpage>895</lpage>. <pub-id pub-id-type="doi">10.20892/j.issn.2095-3941.2020.0387</pub-id>
</citation>
</ref>
<ref id="B36">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Thorsson</surname>
<given-names>V.</given-names>
</name>
<name>
<surname>Gibbs</surname>
<given-names>D. L.</given-names>
</name>
<name>
<surname>Brown</surname>
<given-names>S. D.</given-names>
</name>
<name>
<surname>Wolf</surname>
<given-names>D.</given-names>
</name>
<name>
<surname>Bortone</surname>
<given-names>D. S.</given-names>
</name>
<name>
<surname>Ou Yang</surname>
<given-names>T. H.</given-names>
</name>
<etal/>
</person-group> (<year>2018</year>). <article-title>The immune landscape of cancer</article-title>. <source>Immunity</source> <volume>48</volume> (<issue>4</issue>), <fpage>812</fpage>&#x2013;<lpage>830.e14</lpage>. <pub-id pub-id-type="doi">10.1016/j.immuni.2018.03.023</pub-id>
</citation>
</ref>
<ref id="B37">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Ule</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Blencowe</surname>
<given-names>B. J.</given-names>
</name>
</person-group> (<year>2019</year>). <article-title>Alternative splicing regulatory networks: functions, mechanisms, and evolution</article-title>. <source>Mol. Cell.</source> <volume>76</volume> (<issue>2</issue>), <fpage>329</fpage>&#x2013;<lpage>345</lpage>. <pub-id pub-id-type="doi">10.1016/j.molcel.2019.09.017</pub-id>
</citation>
</ref>
<ref id="B38">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Vietri</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Radulovic</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Stenmark</surname>
<given-names>H.</given-names>
</name>
</person-group> (<year>2020</year>). <article-title>The many functions of ESCRTs</article-title>. <source>Nat. Rev. Mol. Cell. Biol.</source> <volume>21</volume> (<issue>1</issue>), <fpage>25</fpage>&#x2013;<lpage>42</lpage>. <pub-id pub-id-type="doi">10.1038/s41580-019-0177-4</pub-id>
</citation>
</ref>
<ref id="B39">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Vogelstein</surname>
<given-names>B.</given-names>
</name>
<name>
<surname>Papadopoulos</surname>
<given-names>N.</given-names>
</name>
<name>
<surname>Velculescu</surname>
<given-names>V. E.</given-names>
</name>
<name>
<surname>Zhou</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Diaz</surname>
<given-names>L. A.</given-names>
<suffix>Jr.</suffix>
</name>
<name>
<surname>Kinzler</surname>
<given-names>K. W.</given-names>
</name>
</person-group> (<year>2013</year>). <article-title>Cancer genome landscapes</article-title>. <source>Science</source> <volume>339</volume> (<issue>6127</issue>), <fpage>1546</fpage>&#x2013;<lpage>1558</lpage>. <pub-id pub-id-type="doi">10.1126/science.1235122</pub-id>
</citation>
</ref>
<ref id="B40">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Wei</surname>
<given-names>D.</given-names>
</name>
<name>
<surname>Zhan</surname>
<given-names>W.</given-names>
</name>
<name>
<surname>Gao</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Huang</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Gong</surname>
<given-names>R.</given-names>
</name>
<name>
<surname>Wang</surname>
<given-names>W.</given-names>
</name>
<etal/>
</person-group> (<year>2021</year>). <article-title>RAB31 marks and controls an ESCRT-independent exosome pathway</article-title>. <source>Cell. Res.</source> <volume>31</volume> (<issue>2</issue>), <fpage>157</fpage>&#x2013;<lpage>177</lpage>. <pub-id pub-id-type="doi">10.1038/s41422-020-00409-1</pub-id>
</citation>
</ref>
<ref id="B41">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Wei</surname>
<given-names>J. X.</given-names>
</name>
<name>
<surname>Lv</surname>
<given-names>L. H.</given-names>
</name>
<name>
<surname>Wan</surname>
<given-names>Y. L.</given-names>
</name>
<name>
<surname>Cao</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Li</surname>
<given-names>G. L.</given-names>
</name>
<name>
<surname>Lin</surname>
<given-names>H. M.</given-names>
</name>
<etal/>
</person-group> (<year>2015</year>). <article-title>Vps4A functions as a tumor suppressor by regulating the secretion and uptake of exosomal microRNAs in human hepatoma cells</article-title>. <source>Hepatology</source> <volume>61</volume> (<issue>4</issue>), <fpage>1284</fpage>&#x2013;<lpage>1294</lpage>. <pub-id pub-id-type="doi">10.1002/hep.27660</pub-id>
</citation>
</ref>
<ref id="B42">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Xie</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Zhang</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Tian</surname>
<given-names>W.</given-names>
</name>
<name>
<surname>Zou</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Tang</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Zheng</surname>
<given-names>S.</given-names>
</name>
<etal/>
</person-group> (<year>2022</year>). <article-title>The pan-cancer multi-omics landscape of FOXO family relevant to clinical outcome and drug resistance</article-title>. <source>Int. J. Mol. Sci.</source> <volume>23</volume> (<issue>24</issue>), <fpage>15647</fpage>. <pub-id pub-id-type="doi">10.3390/ijms232415647</pub-id>
</citation>
</ref>
<ref id="B43">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Yoshihara</surname>
<given-names>K.</given-names>
</name>
<name>
<surname>Shahmoradgoli</surname>
<given-names>M.</given-names>
</name>
<name>
<surname>Mart&#xed;nez</surname>
<given-names>E.</given-names>
</name>
<name>
<surname>Vegesna</surname>
<given-names>R.</given-names>
</name>
<name>
<surname>Kim</surname>
<given-names>H.</given-names>
</name>
<name>
<surname>Torres-Garcia</surname>
<given-names>W.</given-names>
</name>
<etal/>
</person-group> (<year>2013</year>). <article-title>Inferring tumour purity and stromal and immune cell admixture from expression data</article-title>. <source>Nat. Commun.</source> <volume>4</volume>, <fpage>2612</fpage>. <pub-id pub-id-type="doi">10.1038/ncomms3612</pub-id>
</citation>
</ref>
<ref id="B44">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Zhang</surname>
<given-names>Z.</given-names>
</name>
<name>
<surname>Wang</surname>
<given-names>Z. X.</given-names>
</name>
<name>
<surname>Chen</surname>
<given-names>Y. X.</given-names>
</name>
<name>
<surname>Wu</surname>
<given-names>H. X.</given-names>
</name>
<name>
<surname>Yin</surname>
<given-names>L.</given-names>
</name>
<name>
<surname>Zhao</surname>
<given-names>Q.</given-names>
</name>
<etal/>
</person-group> (<year>2022</year>). <article-title>Integrated analysis of single-cell and bulk RNA sequencing data reveals a pan-cancer stemness signature predicting immunotherapy response</article-title>. <source>Genome Med.</source> <volume>14</volume> (<issue>1</issue>), <fpage>45</fpage>. <pub-id pub-id-type="doi">10.1186/s13073-022-01050-w</pub-id>
</citation>
</ref>
<ref id="B45">
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Zheng</surname>
<given-names>S.</given-names>
</name>
<name>
<surname>Liang</surname>
<given-names>J. Y.</given-names>
</name>
<name>
<surname>Tang</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Xie</surname>
<given-names>J.</given-names>
</name>
<name>
<surname>Zou</surname>
<given-names>Y.</given-names>
</name>
<name>
<surname>Yang</surname>
<given-names>A.</given-names>
</name>
<etal/>
</person-group> (<year>2023</year>). <article-title>Dissecting the role of cancer-associated fibroblast-derived biglycan as a potential therapeutic target in immunotherapy resistance: A tumor bulk and single-cell transcriptomic study</article-title>. <source>Clin. Transl. Med.</source> <volume>13</volume> (<issue>2</issue>), <fpage>e1189</fpage>. <pub-id pub-id-type="doi">10.1002/ctm2.1189</pub-id>
</citation>
</ref>
</ref-list>
</back>
</article>