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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Immunol.</journal-id>
<journal-title>Frontiers in Immunology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Immunol.</abbrev-journal-title>
<issn pub-type="epub">1664-3224</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fimmu.2022.859730</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Immunology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Long Non-Coding RNA RFPL3S Functions as a Biomarker of Prognostic and Immunotherapeutic Prediction in Testicular Germ Cell Tumor</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Guo</surname>
<given-names>Jie</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<xref ref-type="author-notes" rid="fn003">
<sup>&#x2020;</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1588267"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Wang</surname>
<given-names>Shuang</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
<xref ref-type="author-notes" rid="fn003">
<sup>&#x2020;</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Jiang</surname>
<given-names>Zhenzhen</given-names>
</name>
<xref ref-type="aff" rid="aff4">
<sup>4</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1493422"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Tang</surname>
<given-names>Le</given-names>
</name>
<xref ref-type="aff" rid="aff5">
<sup>5</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1475798"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Liu</surname>
<given-names>Zhizhong</given-names>
</name>
<xref ref-type="aff" rid="aff6">
<sup>6</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Cao</surname>
<given-names>Jian</given-names>
</name>
<xref ref-type="aff" rid="aff6">
<sup>6</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Hu</surname>
<given-names>Zhaolan</given-names>
</name>
<xref ref-type="aff" rid="aff7">
<sup>7</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Chen</surname>
<given-names>Xiao</given-names>
</name>
<xref ref-type="aff" rid="aff8">
<sup>8</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Luo</surname>
<given-names>Yanwei</given-names>
</name>
<xref ref-type="aff" rid="aff4">
<sup>4</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1407392"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Bo</surname>
<given-names>Hao</given-names>
</name>
<xref ref-type="aff" rid="aff9">
<sup>9</sup>
</xref>
<xref ref-type="aff" rid="aff10">
<sup>10</sup>
</xref>
<xref ref-type="author-notes" rid="fn001">
<sup>*</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/1190831"/>
</contrib>
</contrib-group> <aff id="aff1">
<sup>1</sup>
<institution>National Institution of Drug Clinical Trial, Xiangya Hospital, Central South University</institution>, <addr-line>Changsha</addr-line>, <country>China</country>
</aff>
<aff id="aff2">
<sup>2</sup>
<institution>China National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University</institution>, <addr-line>Changsha</addr-line>, <country>China</country>
</aff>
<aff id="aff3">
<sup>3</sup>
<institution>Medical Research Center and Clinical Laboratory, Xiangya Hospital, Central South University</institution>, <addr-line>Changsha</addr-line>, <country>China</country>
</aff>
<aff id="aff4">
<sup>4</sup>
<institution>Department of Blood Transfusion, The Third Xiangya Hospital of Central South University</institution>, <addr-line>Changsha</addr-line>, <country>China</country>
</aff>
<aff id="aff5">
<sup>5</sup>
<institution>Reproductive Medicine Center, Maternal and Child Health Care Hospital of Hunan Province</institution>, <addr-line>Changsha</addr-line>, <country>China</country>
</aff>
<aff id="aff6">
<sup>6</sup>
<institution>Department of Urology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University</institution>, <addr-line>Changsha</addr-line>, <country>China</country>
</aff>
<aff id="aff7">
<sup>7</sup>
<institution>Department of Anesthesiology, The Second Xiangya Hospital, Central South University</institution>, <addr-line>Changsha</addr-line>, <country>China</country>
</aff>
<aff id="aff8">
<sup>8</sup>
<institution>Department of Cosmedic, The First People&#x2019;s Hospital of Changde City</institution>, <addr-line>Changde</addr-line>, <country>China</country>
</aff>
<aff id="aff9">
<sup>9</sup>
<institution>NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University</institution>, <addr-line>Changsha</addr-line>, <country>China</country>
</aff>
<aff id="aff10">
<sup>10</sup>
<institution>Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya</institution>, <addr-line>Changsha</addr-line>, <country>China</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>Edited by: Adviti Naik, Qatar Biomedical Research Institute, Qatar</p>
</fn>
<fn fn-type="edited-by">
<p>Reviewed by: Ciputra Hartana, Ragon Institute, United States; Francesco Esposito, Istituto per l&#x2019;Endocrinologia e l&#x2019;oncologia &#x201c;Gaetano Salvatore, Consiglio Nazionale Delle Ricerche (CNR), Italy</p>
</fn>
<fn fn-type="corresp" id="fn001">
<p>*Correspondence: Hao Bo, <email xlink:href="mailto:1172886152@qq.com">1172886152@qq.com</email>
</p>
</fn>
<fn fn-type="equal" id="fn003">
<p>&#x2020;These authors have contributed equally to this work</p>
</fn>
<fn fn-type="other" id="fn002">
<p>This article was submitted to Cancer Immunity and Immunotherapy, a section of the journal Frontiers in Immunology</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>20</day>
<month>05</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="collection">
<year>2022</year>
</pub-date>
<volume>13</volume>
<elocation-id>859730</elocation-id>
<history>
<date date-type="received">
<day>21</day>
<month>01</month>
<year>2022</year>
</date>
<date date-type="accepted">
<day>21</day>
<month>04</month>
<year>2022</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2022 Guo, Wang, Jiang, Tang, Liu, Cao, Hu, Chen, Luo and Bo</copyright-statement>
<copyright-year>2022</copyright-year>
<copyright-holder>Guo, Wang, Jiang, Tang, Liu, Cao, Hu, Chen, Luo and Bo</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>The incidence of testicular germ cell tumor (TGCT) is currently on the rise worldwide, of which 15%-30% of patients have occur recurrence and metastasis. However, clinical methods for diagnosing TGCT and judging its prognosis remained inadequate. In this study, we aimed to explore the possibility of testis-specific long-chain non-coding RNA (lncRNA) Ret finger protein-like 3S (RFPL3S) as a biomarker for TGCT diagnosis, prognosis, and treatment response by reviewing the TGCT gene expression data in Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) databases. The cohort data and DNA methylation data of TGCT in TCGA were downloaded from TGCA, UCSC XENA, and GEO. The bioinformatic tools were used, including GEPIA2, Kaplan-Meier Plotter, LinkedOmics, UCSC XENA, Sangerbox Tools, GSCA, and Tumor Immune Dysfunction and Exclusion. Compared with normal testicular tissues, the RFPL3S expression was significantly reduced in TGCT, and was significantly negatively correlated with the patient&#x2019;s Tumor, Node, Metastasis stage. Hypermethylation and low copy number of RFPL3S were present in TGCT, and low RFPL3S was associated with short disease-free and progression-free intervals. Silencing RFPL3S significantly enhanced the invasion ability and proliferation ability of TGCT cells as evaluated by Transwell and CCK-8 experiments. Additionally, RFPL3S expression was positively correlated with the infiltration of immune-activating cells such as B cells, CD8+ T cells, cytotoxic T cells, and natural killer cells, and negatively correlated with the infiltration of immunosuppressive cells such as Th17 and Th2. Higher RFPL3S expression was present in patients with immunotherapy benefits. In conclusion, we determined that the testis-specific lncRNA RFPL3S functioned as a tumor suppressor in TGCT and could be used as a prognostic predictor of TGCT, as well as a marker to predict the effect of TGCT immunotherapy.</p>
</abstract>
<kwd-group>
<kwd>testicular germ cell tumor</kwd>
<kwd>long non-coding RNA</kwd>
<kwd>immunotherapy</kwd>
<kwd>biomarker</kwd>
<kwd>RFPL3S</kwd>
</kwd-group>
<contract-num rid="cn001">2020JJ5893, 2020JJ8001</contract-num>
<contract-sponsor id="cn001">Natural Science Foundation of&#xa0;Hunan Province<named-content content-type="fundref-id">10.13039/501100004735</named-content>
</contract-sponsor>
<counts>
<fig-count count="6"/>
<table-count count="0"/>
<equation-count count="0"/>
<ref-count count="46"/>
<page-count count="11"/>
<word-count count="3607"/>
</counts>
</article-meta>
</front>
<body>
<sec id="s1" sec-type="intro">
<title>Introduction</title>
<p>Testicular germ cell tumor (TGCT) is the most common solid tumor in young males aged 20-40 years, and is one of the most common causes of death from solid tumors in males of this age (<xref ref-type="bibr" rid="B1">1</xref>). TGCT can be divided into two categories: seminoma and non-seminoma. The incidence is currently rising worldwide (<xref ref-type="bibr" rid="B1">1</xref>, <xref ref-type="bibr" rid="B2">2</xref>), of which 15%-30% of patients have recurrence and metastasis. Such patients often have a poor prognosis (<xref ref-type="bibr" rid="B3">3</xref>). In recent years, researchers have found a variety of elevated genes expression in TGCTs. The novel germ cell markers, such as BOB1 and Prominin 1, were significantly up-regulated in seminoma (<xref ref-type="bibr" rid="B4">4</xref>). The expression of Aurora B expressed in spermatogonia and elevated in TGCTs (<xref ref-type="bibr" rid="B5">5</xref>). siRNA silenced the LIN28 gene in mice, and found that LIN28 plays an important role in the maintenance of seminoma (<xref ref-type="bibr" rid="B6">6</xref>). Houldsworth et&#xa0;al. found that Cyclin D2 and N-Myc were overexpressed in rat spermatogonia cells (<xref ref-type="bibr" rid="B7">7</xref>). Cyclin D2 is an early marker of carcinoma and plays an important role in the transformation of germ cell tumors (<xref ref-type="bibr" rid="B8">8</xref>). These studies demonstrate that TGCTs are caused by abnormal gene expression patterns, and genes related to mechanisms such as proliferation, pluripotency, and epigenetics, have different regulatory mechanisms in testicular tumor subtypes. The relationship between these gene targets and the pathogenesis of TGCT needs further study. Therefore, finding the biomarkers for early diagnosis and treatment response prediction in TGCT is particularly important.</p>
<p>These cancer-related RNA species are considered promising diagnostic, prognostic, and therapeutic targets, thus understanding their function in cancer development is becoming a major challenge (<xref ref-type="bibr" rid="B9">9</xref>). Studies have shown that long-chain non-coding RNAs (lncRNA) have good tissue and disease specificity and are promising biomarkers with clinical application (<xref ref-type="bibr" rid="B10">10</xref>, <xref ref-type="bibr" rid="B11">11</xref>). High-throughput gene chip technology and RNA sequencing provide reliable means to find effective lncRNAs biomarkers. Yang et&#xa0;al. found that lncRNA MEG3 regulated the growth of TGCT through PTEN/PI3K/AKT signaling (<xref ref-type="bibr" rid="B12">12</xref>). Our previous study found that the expression of LINC00467 was positively correlated with the poor prognosis and pathological grade of TGCT, and LNC00467 could promote the migration and invasion of TGCT cells by regulating the expression of AKT3 and influencing AKT phosphorylation (<xref ref-type="bibr" rid="B1">1</xref>).</p>
<p>Ret finger protein-like 3S (RFPL3S) is an antisense transcript (exons 1-4) of the RFPL3 gene without apparent ORF and repetitive elements. Additionally, RFPL3S is specifically and highly expressed in testis compared with other human tissues (<xref ref-type="bibr" rid="B13">13</xref>). Reportedly, RFPL3S plays an important role in tumorigenesis. RFPL3S functioned as a transcriptional factor on the promoter of human telomerase reverse transcriptase to promote lung cancer growth (<xref ref-type="bibr" rid="B14">14</xref>&#x2013;<xref ref-type="bibr" rid="B16">16</xref>), and acted as a potential stimulator of human immunodeficiency virus, type 1 (HIV-1) preintegration complex integration activity (<xref ref-type="bibr" rid="B17">17</xref>), suggesting that RFPL3S is involved in tumor growth and immune response. However, the role of RFPL3S in TGCT remains unknown.</p>
<p>Therefore, this study aimed to explore the possibility of testis-specific lncRNA RFPL3S as a biomarker for TGCT diagnosis, prognosis, and treatment response by reviewing the TGCT gene expression data in Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) databases. Here we revealed that the testis-specific lncRNA RFPL3S functioned as a tumor suppressor in TGCT and could be used as a prognostic predictor of TGCT, as well as a marker to predict the effect of TGCT immunotherapy.</p>
</sec>
<sec id="s2" sec-type="materials|methods">
<title>Materials and Methods</title>
<sec id="s2_1">
<title>Data Sources and Database</title>
<p>The cohort data and DNA methylation data of TGCT in TCGA were downloaded from UCSC XENA (<uri xlink:href="https://xena.ucsc.edu/">https://xena.ucsc.edu/</uri>) (<xref ref-type="bibr" rid="B18">18</xref>). The data of GSE3218 and the TCGA single-cell sequencing data GSE120508 were downloaded from GEO. GSE3218 consists of 17 seminomas, 42 non-seminomas germ cell tumors, and 5 normal testis specimens (<xref ref-type="bibr" rid="B19">19</xref>). GSE120508 consists of approximately 6500 testicular cells from young adults (<xref ref-type="bibr" rid="B20">20</xref>).</p>
<p>GEPIA2 (<uri xlink:href="http://gepia2.cancer-pku.cn/#index">http://gepia2.cancer-pku.cn/#index</uri>) was used to analyze the expression of RFPL3S in various tumors (<xref ref-type="bibr" rid="B21">21</xref>). The Kaplan-Meier Plotter database was used to analyze the relationship between RFPL3S and survival prognosis of TGCT patients (<xref ref-type="bibr" rid="B22">22</xref>). Based on TGCT data in TGCA, RFPL3S co-expression gene analysis, GO enrichment analysis, and GSEA enrichment analysis were performed using LinkedOmics (<uri xlink:href="http://www.linkedomics.org/login.php">http://www.linkedomics.org/login.php</uri>) (<xref ref-type="bibr" rid="B23">23</xref>). Based on the methylation number of RFPL3S, UCSC XENA was used to analyze the correlation between RFPL3S and DNA methylation and copy number, and the relationship between RFPL3S methylation and copy number and prognosis of TGCT patients. Correlations between RFPL3S and stromal and immune scores were analyzed using Sangerbox Tools (<uri xlink:href="http://www.sangerbox.com/tool">http://www.sangerbox.com/tool</uri>). GSCA (<uri xlink:href="http://bioinfo.life.hust.edu.cn/GSCA/#/">http://bioinfo.life.hust.edu.cn/GSCA/#/</uri>), was used to analyze the correlation between RFPL3S expression, methylation, copy data and various immune cells (<xref ref-type="bibr" rid="B24">24</xref>). The responsiveness of immune checkpoint inhibitors was predicted using the Tumor Immune Dysfunction and Exclusion (TIDE) algorithm (<xref ref-type="bibr" rid="B25">25</xref>).</p>
</sec>
<sec id="s2_2">
<title>Cell Culture and siRNA Transfection</title>
<p>NCCIT (CRL-2073) and Tcam-2 cell lines were purchased from the American Type Culture Collection (ATCC; Manassas, VA, USA). NCCIT cells and Tcam-2 cells were cultured in RPMI-1640 media plus 10% FBS and 1% penicillin at 37&#xb0;C in 5% CO<sub>2</sub>. For knockdown RFPL3S, 10*10<sup>5</sup> NCCIT and Tcam-2 cells were seeded in a 6-well plate. After the cells adhered, the transfection reagent Lip3000 mixed with RFPL3S siRNA or negative control (NC) siRNA (20 nM, Ribobio, Inc., Guangzhou, China) was added. After 6 hours of transfection, fresh complete medium was replaced, and subsequent experiments were carried out after culturing for 48 hours. The RFPL3S siRNA sequences were as follows: RFPL3S-siRNA-1: GTCACGTGTTTGCTTCACT, RFPL3S-siRNA-2: CCTTGATGTGTGAACAAAT. The nucleotide sequence of the non-target negative control (NC) was synthesized by Ribobio (Guangzhou, China).</p>
</sec>
<sec id="s2_3">
<title>Quantitative Real Time PCR</title>
<p>qRT-PCR was accomplished as described in our previous described (<xref ref-type="bibr" rid="B26">26</xref>). After siRNA transfection, NCCIT and Tcam-2 cells were used for total RNA extraction by TRIzol reagent (Invitrogen). a First Strand cDNA Synthesis Kit (Roche, NJ, USA) was used to reverse transcribe RNA into cDNA. qPCR was accomplished on a Roche real-time PCR detection system (LightCycler480, Roche, USA). The following primers were used: RFPL3S, forward: 5&#x2032;- GTCGTCAGAAATGAGGAGGAAGT-3&#x2032;; reverse: 5&#x2032;- TTGAAGTAGAAGAGAGGCATGGG-3&#x2032;; ACTB, forward: 5-CTGAGGATGCGAGGTTCTGCTTG-3, reverse: 5-GTCACCGGAGTCCATCACGAT-3.</p>
</sec>
<sec id="s2_4">
<title>Transwell Assay</title>
<p>Transwell assay was accomplished as described in our previous described (<xref ref-type="bibr" rid="B1">1</xref>). Briefly, NCCIT and Tcam-2 cells (2&#x2009;&#xd7;&#x2009;10<sup>4</sup>/well in 200&#x2009;&#xb5;l of 2% FBS medium) were seeded on the upper transwell chambers with Matrigel (Corning, USA). The lower chamber was filled with 800&#x2009;&#x3bc;l of 15% FBS medium. After culture for 48&#x2009;h, the cells that had migrated through the membranes were fixed with paraformaldehyde and were stained with crystal violet. Five random fields were photographed in each group, and the number of invaded cells were counted under a microscope.</p>
</sec>
<sec id="s2_5">
<title>Cell Counting Kit 8 Assay</title>
<p>CCK-8 assay was performed as described in our previous described (<xref ref-type="bibr" rid="B27">27</xref>). A CCK-8 kit was used for determining the cell viability of NCCIT and Tcam-2 cells after siRNA transfection according to the instructions.</p>
</sec>
<sec id="s2_6">
<title>Statistical Analysis</title>
<p>Cell biology experimental data were obtained from at least three independent experiments. Statistical analysis was performed using SPSS 19.0 software (SPSS, Chicago, IL, USA). Differences between the two groups were assessed by Student&#x2019;s t-test. A P value &lt; 0.05 indicates a statistically significant difference.</p>
</sec>
</sec>
<sec id="s3" sec-type="results">
<title>Results</title>
<sec id="s3_1">
<title>RFPL3S Was Downregulated in Testicular Germ Cell Tumor</title>
<p>At first, we analyzed the expression of RFPL3S in 33 tumors in the TCGA database through the TCGA pan-tumor data in the GEPIA database (<xref ref-type="bibr" rid="B28">28</xref>), and the results showed that RFPL3S was significantly highly expressed in TGCT (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1A</bold>
</xref>). We next used the TGCT cohort data in the TCGA database and the normal testicular gene expression data in the GTEX database to analyze the expression of RFPL3S in TGCT. We found that compared with normal testicular tissues, RFPL3S expression was significantly reduced in seminoma and non-seminoma (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1B</bold>
</xref>), and its expression in non-seminoma was lower than in seminoma (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1B</bold>
</xref>). The results of the TGCT cohort data (GSE3218) (<xref ref-type="bibr" rid="B19">19</xref>) was consistent with those in TCGA database (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1C</bold>
</xref>). In addition, we found that RFPL3S expression in TGCT was negatively correlated with patient&#x2019;s TNM stage, and its expression in stage I was significantly higher than in stage III (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1D</bold>
</xref>). RFPL3S expression was associated with metastasis, and was lower in patients with distant metastasis than in those with non-metastasis (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1D</bold>
</xref>). However, RFPL3S was not correlated with lymph node metastasis in TGCT patients (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1D</bold>
</xref>).</p>
<fig id="f1" position="float">
<label>Figure&#xa0;1</label>
<caption>
<p>The association between RFPL3S and the clinicopathological characteristics of TGCT. <bold>(A)</bold> GEPIA2 online tool was used to analyze the expression of RFPL3S in various tumors. RFPL3S was highest expressed in TGCT (indicated by red color). <bold>(B)</bold> Analysis for the expression of RFPL3S in seminoma, non-seminoma, and normal tissues in TGCT cohort from TCGA. <bold>(C)</bold> Analysis for the expression of RFPL3S in seminoma, non-seminoma, and normal tissues in GSE3218 cohort. <bold>(D)</bold> Analysis for the association of the expression of RFPL3S with the clinicopathological characteristics (clinical stage, distant metastasis, and lymph node metastasis) of TGCT from TCGA. The TCGA TGCT cohort data was downloaded from the UCSC XENA database (<uri xlink:href="https://xena.ucsc.edu/">https://xena.ucsc.edu/</uri>). The GSE3218 data was downloaded from the GEO database. Visualizing and interpreting cancer genomics data <italic>via</italic> the Xena platform. *P &lt; 0.05, **P &lt; 0.01, ***P &lt; 0.001. NS, no significant.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-13-859730-g001.tif"/>
</fig>
</sec>
<sec id="s3_2">
<title>The Diagnostic and Prognostic Value of RFPL3S on TGCT</title>
<p>Next, we studied the diagnostic and prognostic value of RFPL3S in TGCT based on the TCGA and GEO data (GSE3218). The RFPL3S expression could well distinguish normal tissues from seminoma, normal tissue from non-seminoma, and seminoma from non-seminoma (<xref ref-type="fig" rid="f2">
<bold>Figures&#xa0;2A, B</bold>
</xref>). In addition, we found a significant positive correlation between RFPL3S and disease-free interval (DFI) and progression free interval (PFI) in TGCT patients. Patients with high RFPL3S had higher DFI and PFI than those with low RFPL3S (<xref ref-type="fig" rid="f2">
<bold>Figure&#xa0;2C</bold>
</xref>). These data indicated that RFPL3S was a good TGCT tumor diagnosis and prognostic marker.</p>
<fig id="f2" position="float">
<label>Figure&#xa0;2</label>
<caption>
<p>The diagnostic and prognostic value of RFPL3S in TGCT. <bold>(A)</bold> Receiver operating characteristic (ROC) curve evaluated the diagnostic value of RFPL3S in distinguishing normal (N) from seminoma (SEM), normal (N) from non-seminoma (NSEM), and non-seminoma (NSEM) from seminoma (SEM) in GEO GSE3218 cohort. <bold>(B)</bold> ROC curve evaluated the diagnostic value of RFPL3S in distinguishing normal (N) form seminoma (SEM), normal (N) from non-seminoma (NSEM), and non-seminoma (NSEM) from seminoma (SEM) in TGCT cohort from TCGA. <bold>(C)</bold> Correlation between RFPL3S and disease-free interval (DFI) and progression free interval (PFI) of TGCT cohort from TCGA. Patients with high RFPL3S expression had higher DFI and PFI.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-13-859730-g002.tif"/>
</fig>
</sec>
<sec id="s3_3">
<title>RFPL3S Knockdown Inhibits Invasion and Proliferation of NCCIT and Tcam-2 Cells <italic>In Vitro</italic>
</title>
<p>We then used the testicular single cell sequencing data set GSE120508 to analyze RFPL3S expression in various types of cells (<xref ref-type="bibr" rid="B20">20</xref>), and observed that RFPL3S dominatingly expressed in germ cells (<xref ref-type="fig" rid="f3">
<bold>Figure&#xa0;3A</bold>
</xref>). Therefore, we speculated that RFPL3S played a role in TGCT cells rather than in the microenvironmental cells. To validate the function RFPL3S in TGCT, we designed two siRNA sequences to silence RFPL3S in NCCIT and Tcam-2 cells. The qPCR results showed that both siRNAs had a silencing effect, but the efficiency of siRNA1 was better than siRNA2 (<xref ref-type="fig" rid="f3">
<bold>Figure&#xa0;3B</bold>
</xref>). Silencing RFPL3S significantly enhanced the invasion ability (<xref ref-type="fig" rid="f3">
<bold>Figures&#xa0;3C, D</bold>
</xref>) and proliferation ability (<xref ref-type="fig" rid="f3">
<bold>Figures&#xa0;3E, F</bold>
</xref>) in NCCIT and Tcam-2 cells as evaluated by Transwell and CCK-8 experiments. We also found that the co-expressed genes and the downstream pathway of RFPL3S were associated with invasion and proliferation pathways, including ECM-receptor interaction, Focal adhesion, Adherent junction, PI3K-Akt signaling, Wnt signaling, and Hippo signaling (<xref ref-type="fig" rid="f4">
<bold>Figures&#xa0;4A&#x2013;C</bold>
</xref>).</p>
<fig id="f3" position="float">
<label>Figure&#xa0;3</label>
<caption>
<p>Knockdown RFPL3S inhibits invasion and proliferation of NCCIT and Tcam-2 cells. <bold>(A)</bold> The single-cell sequencing data of GSE120508 analyzes the expression of RFPL3S in different cell types, showing that RFPL3S mainly expressed in germ cell. (A: spermatogonial stem cells; B: spermatogonia in differentiation; C: primary spermatocytes; D: secondary spermatocytes; E: round spermatozoa; F: elongated spermatozoa; G: sperm 1; H: sperm 2; I: macrophages; J: endothelial cells; K: muscle-like cells; L: support Cell; M: mesenchymal cell.). <bold>(B)</bold> siRNA transfection knocked down RFPL3S in NCCIT and Tcam-2 cells. <bold>(C, D)</bold> Silencing RFPL3S significantly enhanced the invasion ability of NCCIT and Tcam-2 cells evaluating by Transwell assay. <bold>(E, F)</bold> Silencing RFPL3S significantly enhanced the proliferation ability of NCCIT and Tcam-2 cells evaluating by CCK-8 experiment. *P &lt; 0.05, **P &lt; 0.01, ***P &lt; 0.001. n.s, no significant.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-13-859730-g003.tif"/>
</fig>
<fig id="f4" position="float">
<label>Figure&#xa0;4</label>
<caption>
<p>GSEA analysis for the regulatory signaling pathway of RFPL3S. Based on the TCGA TGCT expression profile data, LinkedOmics (<uri xlink:href="http://www.linkedomics.org/login.ph">http://www.linkedomics.org/login.ph</uri>) was used to analyze the co-expressed genes of RFPL3S <bold>(A)</bold>, GO enrichment analysis <bold>(B)</bold>, and GSEA enrichment analysis <bold>(C)</bold>.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-13-859730-g004.tif"/>
</fig>
</sec>
<sec id="s3_4">
<title>The Association Between RFPL3S Expression, Methylation, and Copy Number in TGCT</title>
<p>We next explored the upstream regulatory mechanism of RFPL3S in TGCT. We found that the methylation level of RFPL3S in TGCT tissue was significantly higher than that in normal testicular tissue (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5A</bold>
</xref>). RFPL3S had 3 highly methylated regions, 2 regions located at the promoter and 1 region located at the intron 4 (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5B</bold>
</xref>). RFPL3S methylation level was negatively correlated with its expression (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5C</bold>
</xref>). In addition, we found that the higher RFPL3S methylation was associated with lower DFI and PFI in TGCT patients (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5D</bold>
</xref>). The copy number of RFPL3S was positively correlated with its expression (<xref ref-type="fig" rid="f5">
<bold>Figures&#xa0;5E, F</bold>
</xref>), but was negatively associated with DFI and PFI in TGCT patients (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5G</bold>
</xref>).</p>
<fig id="f5" position="float">
<label>Figure&#xa0;5</label>
<caption>
<p>The association between RFPL3S expression, methylation, and copy number in TCGA TGCT cohort. <bold>(A)</bold> The methylation level of RFPL3S in normal testicular tissues (N) and TGCT (T) tissues. <bold>(B)</bold> The high methylation regions were located at promoter (indicated by red and green arrows) and intron 4 (indicated by blue arrow). <bold>(C)</bold> RFPL3S methylation level was significantly negatively correlated with the expression level. <bold>(D)</bold> Correlation between RFPL3S methylation level and disease-free interval (DFI) and progression free interval (PFI) of TGCT cohort from TCGA. Patients with high RFPL3S methylation level had lower DFI and PFI. <bold>(E, F)</bold> Copy number was significantly positively correlated with the expression of RFPL3S. <bold>(G)</bold> Correlation between RFPL3S copy number and disease-free interval (DFI) and progression free interval (PFI) of TGCT cohort from TCGA. Patients with high RFPL3S copy number had higher DFI and PFI. CNV, copy number various. The UCSC XENA database was used to download the methylation data, expression data, and prognosis data of RFPL3S from the TCGA TGCT cohort. **P&lt; 0.01.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-13-859730-g005.tif"/>
</fig>
</sec>
<sec id="s3_5">
<title>The Association of RFPL3S and TGCT Tumor Immunity</title>
<p>The immune cell infiltration state in TGCT tissues has close correlation with immunotherapy response (<xref ref-type="bibr" rid="B29">29</xref>). We conducted immune cell analysis to explore the role of RFPL3S in TGCT tumor immunity. RFPL3S expression was negatively correlated with the matrix score of TGCT tissue, but positively correlated with the immune score (<xref ref-type="fig" rid="f6">
<bold>Figure&#xa0;6A</bold>
</xref>). RFPL3S expression was positively correlated with the infiltration of immune-activating cells such as B cells, CD8+T cells, cytotoxic T cells, and NK cells, whereas negatively correlated with the infiltration of immunosuppressive cells such as Th17 and Th2 (<xref ref-type="fig" rid="f6">
<bold>Figure&#xa0;6B</bold>
</xref>). Using the TIDE algorithm (<xref ref-type="bibr" rid="B25">25</xref>), we analyzed the correlation between RFPL3S expression and immunotherapy, and observed that the higher RFPL3S expression was associated with lower TIDE score and escape score in TGCT patients (<xref ref-type="fig" rid="f6">
<bold>Figure&#xa0;6C</bold>
</xref>), while was associated with higher the expression of the anti-tumor immune response markers CD274 and IFN-&#x3b3; (<xref ref-type="fig" rid="f6">
<bold>Figure&#xa0;6C</bold>
</xref>). We found that Higher RFPL3S expression was present in patients with positive cytotoxic T flag or with immunotherapy benefits (<xref ref-type="fig" rid="f6">
<bold>Figures&#xa0;6D&#x2013;F</bold>
</xref>), which had high diagnostic sensitivity and specificity (<xref ref-type="fig" rid="f6">
<bold>Figure&#xa0;6G</bold>
</xref>).</p>
<fig id="f6" position="float">
<label>Figure&#xa0;6</label>
<caption>
<p>The association of RFPL3S and TGCT tumor immunity. Tumor Immune Dysfunction and Exclusion algorithm was used to predict the response of a single sample to predictive immune checkpoint inhibitors based on the TCGA TGCT expression profile data. <bold>(A)</bold> RFPL3S expression was negatively correlated with stromal score, and positively correlated with Immune score. <bold>(B)</bold> Correlation between RFPL3S expression and immune infiltrates in TGCT. <bold>(C)</bold> Correlation between RFPL3S expression and TIDE score, exclusion score, CD274 expression, and IFN-&#x3b3; score in TGCT. <bold>(D&#x2013;F)</bold> higher RFPL3S expression was present in the immunotherapy benefit, response, and cytotoxic T flag positive patients. <bold>(G)</bold> RFPL3S had a high diagnostic sensitivity and specificity for distinguishing immunotherapy benefits from no-benefits (AUC = 84.9359), and response from non-response (AUC = 76.3975). *P &lt; 0.05, ****P &lt; 0.0001.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fimmu-13-859730-g006.tif"/>
</fig>
</sec>
</sec>
<sec id="s4" sec-type="discussion">
<title>Discussion</title>
<p>In recent years, the physiological functions of lncRNAs have been gradually elucidated, which are involved in various biological processes, such as chromatin remodeling, post-transcriptional regulation, protein translation and histone acetylation (<xref ref-type="bibr" rid="B30">30</xref>, <xref ref-type="bibr" rid="B31">31</xref>). Abnormally expressed lncRNAs in human malignant tumors are closely related to tumor cell proliferation, invasion, and metastasis (<xref ref-type="bibr" rid="B1">1</xref>). RFPL3S covers the entire coding part of sense exon 2 of RFPL3. The normal function of RFPL3S is likely to post-transcriptionally regulate the sense RFPL (<xref ref-type="bibr" rid="B13">13</xref>). RFPL3S has been associated with Opitz syndrome, which is an inherited disorder characterized by midline defects including hypertelorism, hypospadias, lip-palate-laryngotracheal clefts and imperforate anus (<xref ref-type="bibr" rid="B13">13</xref>, <xref ref-type="bibr" rid="B32">32</xref>). However, to our knowledge, there is no report on the role of RFPL3S in TGCTs. TGCTs including seminoma and non-seminoma, is characterized by slow progression and a good prognosis (<xref ref-type="bibr" rid="B33">33</xref>). At present, choosing an appropriate treatment modality is an important issue in the field of testicular tumor research (<xref ref-type="bibr" rid="B34">34</xref>). Studies have shown that classifying patients with tumor according to clinical information, including stage, grade, and molecular markers, and selecting appropriate treatment methods can improve patient prognosis and reduce adverse reactions related to surgery, radiotherapy, and chemotherapy (<xref ref-type="bibr" rid="B35">35</xref>). Therefore, combining large-scale databases such as TCGA, high-throughput GEO database, epidemiological, and prognostic databases to conduct in-depth mining of medical information is of great significance to guide TGCT treatment. This study is the first to discover the use of the expression profile of testis-specific lncRNA RFPL3S in differentiating seminoma from non-seminoma and prognostically predicting TGCT. High RFPL3S expression predicted a higher disease-free interval and progression free interval in TGCT patients.</p>
<p>Additionally, RFPL3S functioned as a tumor suppressor that significantly inhibited the invasion and proliferation of TGCT <italic>in vitro</italic>, and its expression was controlled by genetic factors (copy number variation) and epigenetic factors (DNA methylation). The analysis of downstream signaling pathways revealed that RFPL3S downregulation was associated with activated metastasis- and proliferation-related pathways, including extracellular matrix (ECM)-receptor interaction, Focal adhesion, Adherens junction, PI3K-AKT signaling, Wnt signaling, and Hippo signaling. The invasion and metastasis of tumor cells is a key factor that affects the prognosis of malignant tumors. The ECM is an important tissue barrier to prevent tumor metastasis. The main components, namely fibronectin and laminin, are linked to cell surface membrane integrin receptors, which determine the shape of cells and control cell differentiation and migration (<xref ref-type="bibr" rid="B36">36</xref>). Focal adhesion kinase plays an important role in cell cycle regulation, growth regulation, adhesion, cytoskeleton assembly, motility, and survival through a variety of signaling pathways (<xref ref-type="bibr" rid="B37">37</xref>). Studies have found that focal adhesion kinase is highly expressed in various tumors and plays an important role in the occurrence, development, invasion, and metastasis of tumors. Focal adhesion kinase may become a new target for tumor therapy (<xref ref-type="bibr" rid="B38">38</xref>).</p>
<p>In addition to its relationship with tumor cell proliferation and metastasis, we determined that higher RFPL3S expression was present in patients with immunotherapy benefit and response, and those positive with cytotoxic T flag. RFPL3S was associated with PI3K/AKT/mTOR, &#x3b2;-catenin/Wnt, and Hippo pathways, which have been associated with immunotherapy (<xref ref-type="bibr" rid="B39">39</xref>&#x2013;<xref ref-type="bibr" rid="B46">46</xref>). These results suggest that RFPL3S may be an effective marker for predicting the efficacy of immunotherapy in patients with TGCT.</p>
<p>In conclusion, we determined that the testis-specific lncRNA RFPL3S functioned as a tumor suppressor in TGCT and could be used as a prognostic predictor of TGCT, as well as a marker to predict the effect of TGCT immunotherapy.</p>
</sec>
<sec id="s5" sec-type="data-availability">
<title>Data Availability Statement</title>
<p>The original contributions presented in the study are included in the article/<xref ref-type="supplementary-material" rid="SF1">
<bold>Supplementary Material</bold>
</xref>. Further inquiries can be directed to the corresponding author.</p>
</sec>
<sec id="s6" sec-type="author-contributions">
<title>Author Contributions</title>
<p>All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis, and interpretation, or in all these areas. Took part in drafting, revising or critically reviewing the article. Gave final approval of the version to be published. Have agreed on the journal to which the article has been submitted, and agree to be accountable for all aspects of the work. All authors contributed to the article and approved the submitted version.</p>
</sec>
<sec id="s7" sec-type="funding-information">
<title>Funding</title>
<p>This work is supported by Natural Science Foundation of Hunan Province (2020JJ5893, 2020JJ8001, 2021JJ41091), Scientific Research Fund of Hunan Provincial Health and Family Planning Commission (Correlation Analysis of Human Sperm Apoptosis and Outcome of IVF Pregnancy, No. 2015-145), the Fundamental Research Funds for Health Commission of Hunan Province (C2019073), the Changsha Municipal Natural Science Foundation (kq2014033), The Project of Changde Science and Technology Bureau of Hunan Province in China(2019S186).</p>
</sec>
<sec id="s8" sec-type="COI-statement">
<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 id="s9" sec-type="disclaimer">
<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>
</body>
<back>
<sec id="s10" sec-type="supplementary-material">
<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/fimmu.2022.859730/full#supplementary-material">https://www.frontiersin.org/articles/10.3389/fimmu.2022.859730/full#supplementary-material</ext-link>
</p>
  <supplementary-material xlink:href="Image_1.tif" id="SF1" mimetype="image/tiff"/>
</sec>
<ref-list>
<title>References</title>
<ref id="B1">
<label>1</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Bo</surname> <given-names>H</given-names>
</name>
<name>
<surname>Zhu</surname> <given-names>F</given-names>
</name>
<name>
<surname>Liu</surname> <given-names>Z</given-names>
</name>
<name>
<surname>Deng</surname> <given-names>Q</given-names>
</name>
<name>
<surname>Liu</surname> <given-names>G</given-names>
</name>
<name>
<surname>Li</surname> <given-names>R</given-names>
</name>
<etal/>
</person-group>. <article-title>Integrated Analysis of High-Throughput Sequencing Data Reveals the Key Role of LINC00467 in the Invasion and Metastasis of Testicular Germ Cell Tumors</article-title>. <source>Cell Death Discov</source> (<year>2021</year>) <volume>7</volume>(<issue>1</issue>):<fpage>206</fpage>. doi: <pub-id pub-id-type="doi">10.1038/s41420-021-00588-9</pub-id>
</citation>
</ref>
<ref id="B2">
<label>2</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Shanmugalingam</surname> <given-names>T</given-names>
</name>
<name>
<surname>Soultati</surname> <given-names>A</given-names>
</name>
<name>
<surname>Chowdhury</surname> <given-names>S</given-names>
</name>
<name>
<surname>Rudman</surname> <given-names>S</given-names>
</name>
<name>
<surname>Van Hemelrijck</surname> <given-names>M</given-names>
</name>
</person-group>. <article-title>Global Incidence and Outcome of Testicular Cancer</article-title>. <source>Clin Epidemiol</source> (<year>2013</year>) <volume>5</volume>:<page-range>417&#x2013;27</page-range>. doi: <pub-id pub-id-type="doi">10.2147/CLEP.S34430</pub-id>
</citation>
</ref>
<ref id="B3">
<label>3</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Albers</surname> <given-names>P</given-names>
</name>
<name>
<surname>Albrecht</surname> <given-names>W</given-names>
</name>
<name>
<surname>Algaba</surname> <given-names>F</given-names>
</name>
<name>
<surname>Bokemeyer</surname> <given-names>C</given-names>
</name>
<name>
<surname>Cohn-Cedermark</surname> <given-names>G</given-names>
</name>
<name>
<surname>Fizazi</surname> <given-names>K</given-names>
</name>
<etal/>
</person-group>. <article-title>Guidelines on Testicular Cancer: 2015 Update</article-title>. <source>Eur Urol</source> (<year>2015</year>) <volume>68</volume>(<issue>6</issue>):<page-range>1054&#x2013;68</page-range>. doi: <pub-id pub-id-type="doi">10.1016/j.eururo.2015.07.044</pub-id>
</citation>
</ref>
<ref id="B4">
<label>4</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Gashaw</surname> <given-names>I</given-names>
</name>
<name>
<surname>Dushaj</surname> <given-names>O</given-names>
</name>
<name>
<surname>Behr</surname> <given-names>R</given-names>
</name>
<name>
<surname>Biermann</surname> <given-names>K</given-names>
</name>
<name>
<surname>Brehm</surname> <given-names>R</given-names>
</name>
<name>
<surname>Rubben</surname> <given-names>H</given-names>
</name>
<etal/>
</person-group>. <article-title>Novel Germ Cell Markers Characterize Testicular Seminoma and Fetal Testis</article-title>. <source>Mol Hum Reprod</source> (<year>2007</year>) <volume>13</volume>(<issue>10</issue>):<page-range>721&#x2013;7</page-range>. doi: <pub-id pub-id-type="doi">10.1093/molehr/gam059</pub-id>
</citation>
</ref>
<ref id="B5">
<label>5</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Chieffi</surname> <given-names>P</given-names>
</name>
<name>
<surname>Troncone</surname> <given-names>G</given-names>
</name>
<name>
<surname>Caleo</surname> <given-names>A</given-names>
</name>
<name>
<surname>Libertini</surname> <given-names>S</given-names>
</name>
<name>
<surname>Linardopoulos</surname> <given-names>S</given-names>
</name>
<name>
<surname>Tramontano</surname> <given-names>D</given-names>
</name>
<etal/>
</person-group>. <article-title>Aurora B Expression in Normal Testis and Seminomas</article-title>. <source>J Endocrinol</source> (<year>2004</year>) <volume>181</volume>(<issue>2</issue>):<page-range>263&#x2013;70</page-range>. doi: <pub-id pub-id-type="doi">10.1677/joe.0.1810263</pub-id>
</citation>
</ref>
<ref id="B6">
<label>6</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Cao</surname> <given-names>D</given-names>
</name>
<name>
<surname>Allan</surname> <given-names>RW</given-names>
</name>
<name>
<surname>Cheng</surname> <given-names>L</given-names>
</name>
<name>
<surname>Peng</surname> <given-names>Y</given-names>
</name>
<name>
<surname>Guo</surname> <given-names>CC</given-names>
</name>
<name>
<surname>Dahiya</surname> <given-names>N</given-names>
</name>
<etal/>
</person-group>. <article-title>RNA-Binding Protein LIN28 is a Marker for Testicular Germ Cell Tumors</article-title>. <source>Hum Pathol</source> (<year>2011</year>) <volume>42</volume>(<issue>5</issue>):<page-range>710&#x2013;8</page-range>. doi: <pub-id pub-id-type="doi">10.1016/j.humpath.2010.09.007</pub-id>
</citation>
</ref>
<ref id="B7">
<label>7</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Houldsworth</surname> <given-names>J</given-names>
</name>
<name>
<surname>Reuter</surname> <given-names>V</given-names>
</name>
<name>
<surname>Bosl</surname> <given-names>GJ</given-names>
</name>
<name>
<surname>Chaganti</surname> <given-names>RS</given-names>
</name>
</person-group>. <article-title>Aberrant Expression of Cyclin D2 is an Early Event in Human Male Germ Cell Tumorigenesis</article-title>. <source>Cell Growth Differ</source> (<year>1997</year>) <volume>8</volume>(<issue>3</issue>):<page-range>293&#x2013;9</page-range>.</citation>
</ref>
<ref id="B8">
<label>8</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Schmidt</surname> <given-names>BA</given-names>
</name>
<name>
<surname>Rose</surname> <given-names>A</given-names>
</name>
<name>
<surname>Steinhoff</surname> <given-names>C</given-names>
</name>
<name>
<surname>Strohmeyer</surname> <given-names>T</given-names>
</name>
<name>
<surname>Hartmann</surname> <given-names>M</given-names>
</name>
<name>
<surname>Ackermann</surname> <given-names>R</given-names>
</name>
</person-group>. <article-title>Up-Regulation of Cyclin-Dependent Kinase 4/Cyclin D2 Expression But Down-Regulation of Cyclin-Dependent Kinase 2/Cyclin E in Testicular Germ Cell Tumors</article-title>. <source>Cancer Res</source> (<year>2001</year>) <volume>61</volume>(<issue>10</issue>):<page-range>4214&#x2013;21</page-range>.</citation>
</ref>
<ref id="B9">
<label>9</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Barchi</surname> <given-names>M</given-names>
</name>
<name>
<surname>Bielli</surname> <given-names>P</given-names>
</name>
<name>
<surname>Dolci</surname> <given-names>S</given-names>
</name>
<name>
<surname>Rossi</surname> <given-names>P</given-names>
</name>
<name>
<surname>Grimaldi</surname> <given-names>P</given-names>
</name>
</person-group>. <article-title>Non-Coding RNAs and Splicing Activity in Testicular Germ Cell Tumors</article-title>. <source>Life (Basel)</source> (<year>2021</year>) <volume>11</volume>(<issue>8</issue>):<elocation-id>736</elocation-id>. doi: <pub-id pub-id-type="doi">10.3390/life11080736</pub-id>
</citation>
</ref>
<ref id="B10">
<label>10</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Statello</surname> <given-names>L</given-names>
</name>
<name>
<surname>Guo</surname> <given-names>CJ</given-names>
</name>
<name>
<surname>Chen</surname> <given-names>LL</given-names>
</name>
<name>
<surname>Huarte</surname> <given-names>M</given-names>
</name>
</person-group>. <article-title>Gene Regulation by Long non-Coding RNAs and its Biological Functions</article-title>. <source>Nat Rev Mol Cell Biol</source> (<year>2021</year>) <volume>22</volume>(<issue>2</issue>):<fpage>96</fpage>&#x2013;<lpage>118</lpage>. doi: <pub-id pub-id-type="doi">10.1038/s41580-020-00315-9</pub-id>
</citation>
</ref>
<ref id="B11">
<label>11</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Bhan</surname> <given-names>A</given-names>
</name>
<name>
<surname>Soleimani</surname> <given-names>M</given-names>
</name>
<name>
<surname>Mandal</surname> <given-names>SS</given-names>
</name>
</person-group>. <article-title>Long Noncoding RNA and Cancer: A New Paradigm</article-title>. <source>Cancer Res</source> (<year>2017</year>) <volume>77</volume>(<issue>15</issue>):<page-range>3965&#x2013;81</page-range>. doi: <pub-id pub-id-type="doi">10.1158/0008-5472.CAN-16-2634</pub-id>
</citation>
</ref>
<ref id="B12">
<label>12</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Yang</surname> <given-names>NQ</given-names>
</name>
<name>
<surname>Luo</surname> <given-names>XJ</given-names>
</name>
<name>
<surname>Zhang</surname> <given-names>J</given-names>
</name>
<name>
<surname>Wang</surname> <given-names>GM</given-names>
</name>
<name>
<surname>Guo</surname> <given-names>JM</given-names>
</name>
</person-group>. <article-title>Crosstalk Between Meg3 and miR-1297 Regulates Growth of Testicular Germ Cell Tumor Through PTEN/PI3K/AKT Pathway</article-title>. <source>Am J Transl Res</source> (<year>2016</year>) <volume>8</volume>(<issue>2</issue>):<page-range>1091&#x2013;9</page-range>.</citation>
</ref>
<ref id="B13">
<label>13</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Seroussi</surname> <given-names>E</given-names>
</name>
<name>
<surname>Kedra</surname> <given-names>D</given-names>
</name>
<name>
<surname>Pan</surname> <given-names>HQ</given-names>
</name>
<name>
<surname>Peyrard</surname> <given-names>M</given-names>
</name>
<name>
<surname>Schwartz</surname> <given-names>C</given-names>
</name>
<name>
<surname>Scambler</surname> <given-names>P</given-names>
</name>
<etal/>
</person-group>. <article-title>Duplications on Human Chromosome 22 Reveal a Novel Ret Finger Protein-like Gene Family With Sense and Endogenous Antisense Transcripts</article-title>. <source>Genome Res</source> (<year>1999</year>) <volume>9</volume>(<issue>9</issue>):<page-range>803&#x2013;14</page-range>. doi: <pub-id pub-id-type="doi">10.1101/gr.9.9.803</pub-id>
</citation>
</ref>
<ref id="B14">
<label>14</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Zohud</surname> <given-names>BA</given-names>
</name>
<name>
<surname>Guo</surname> <given-names>P</given-names>
</name>
<name>
<surname>Zohud</surname> <given-names>BA</given-names>
</name>
<name>
<surname>Li</surname> <given-names>F</given-names>
</name>
<name>
<surname>Hao</surname> <given-names>JJ</given-names>
</name>
<name>
<surname>Shan</surname> <given-names>X</given-names>
</name>
<etal/>
</person-group>. <article-title>Importin 13 Promotes NSCLC Progression by Mediating RFPL3 Nuclear Translocation and hTERT Expression Upregulation</article-title>. <source>Cell Death Dis</source> (<year>2020</year>) <volume>11</volume>(<issue>10</issue>):<fpage>879</fpage>. doi: <pub-id pub-id-type="doi">10.1038/s41419-020-03101-9</pub-id>
</citation>
</ref>
<ref id="B15">
<label>15</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Chen</surname> <given-names>W</given-names>
</name>
<name>
<surname>Lu</surname> <given-names>J</given-names>
</name>
<name>
<surname>Qin</surname> <given-names>Y</given-names>
</name>
<name>
<surname>Wang</surname> <given-names>J</given-names>
</name>
<name>
<surname>Tian</surname> <given-names>Y</given-names>
</name>
<name>
<surname>Shi</surname> <given-names>D</given-names>
</name>
<etal/>
</person-group>. <article-title>Ret Finger Protein-Like 3 Promotes Tumor Cell Growth by Activating Telomerase Reverse Transcriptase Expression in Human Lung Cancer Cells</article-title>. <source>Oncotarget</source> (<year>2014</year>) <volume>5</volume>(<issue>23</issue>):<page-range>11909&#x2013;23</page-range>. doi: <pub-id pub-id-type="doi">10.18632/oncotarget.2557</pub-id>
</citation>
</ref>
<ref id="B16">
<label>16</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Lin</surname> <given-names>C</given-names>
</name>
<name>
<surname>Qin</surname> <given-names>Y</given-names>
</name>
<name>
<surname>Zhang</surname> <given-names>H</given-names>
</name>
<name>
<surname>Gao</surname> <given-names>MY</given-names>
</name>
<name>
<surname>Wang</surname> <given-names>YF</given-names>
</name>
</person-group>. <article-title>EGF Upregulates RFPL3 and hTERT <italic>Via</italic> the MEK Signaling Pathway in Nonsmall Cell Lung Cancer Cells</article-title>. <source>Oncol Rep</source> (<year>2018</year>) <volume>40</volume>(<issue>1</issue>):<fpage>29</fpage>&#x2013;<lpage>38</lpage>. doi: <pub-id pub-id-type="doi">10.3892/or.2018.6417</pub-id>
</citation>
</ref>
<ref id="B17">
<label>17</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Tan</surname> <given-names>BH</given-names>
</name>
<name>
<surname>Suzuki</surname> <given-names>Y</given-names>
</name>
<name>
<surname>Takahashi</surname> <given-names>H</given-names>
</name>
<name>
<surname>Ying</surname> <given-names>PHR</given-names>
</name>
<name>
<surname>Takahashi</surname> <given-names>C</given-names>
</name>
<name>
<surname>Han</surname> <given-names>Q</given-names>
</name>
<etal/>
</person-group>. <article-title>Identification of RFPL3 Protein as a Novel E3 Ubiquitin Ligase Modulating the Integration Activity of Human Immunodeficiency Virus, Type 1 Preintegration Complex Using a Microtiter Plate-Based Assay</article-title>. <source>J Biol Chem</source> (<year>2014</year>) <volume>289</volume>(<issue>38</issue>):<page-range>26368&#x2013;82</page-range>. doi: <pub-id pub-id-type="doi">10.1074/jbc.M114.561662</pub-id>
</citation>
</ref>
<ref id="B18">
<label>18</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Goldman</surname> <given-names>MJ</given-names>
</name>
<name>
<surname>Craft</surname> <given-names>B</given-names>
</name>
<name>
<surname>Hastie</surname> <given-names>M</given-names>
</name>
<name>
<surname>Repecka</surname> <given-names>K</given-names>
</name>
<name>
<surname>McDade</surname> <given-names>F</given-names>
</name>
<name>
<surname>Kamath</surname> <given-names>A</given-names>
</name>
<etal/>
</person-group>. <article-title>Visualizing and Interpreting Cancer Genomics Data <italic>Via</italic> the Xena Platform</article-title>. <source>Nat Biotechnol</source> (<year>2020</year>) <volume>38</volume>(<issue>6</issue>):<page-range>675&#x2013;8</page-range>. doi: <pub-id pub-id-type="doi">10.1038/s41587-020-0546-8</pub-id>
</citation>
</ref>
<ref id="B19">
<label>19</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Korkola</surname> <given-names>JE</given-names>
</name>
<name>
<surname>Houldsworth</surname> <given-names>J</given-names>
</name>
<name>
<surname>Chadalavada</surname> <given-names>RS</given-names>
</name>
<name>
<surname>Olshen</surname> <given-names>AB</given-names>
</name>
<name>
<surname>Dobrzynski</surname> <given-names>D</given-names>
</name>
<name>
<surname>Reuter</surname> <given-names>VE</given-names>
</name>
<etal/>
</person-group>. <article-title>Down-Regulation of Stem Cell Genes, Including Those in a 200-Kb Gene Cluster at 12p13.31, is Associated With <italic>In Vivo</italic> Differentiation of Human Male Germ Cell Tumors</article-title>. <source> Cancer Res</source> (<year>2006</year>) <volume>66</volume>(<issue>2</issue>):<page-range>820&#x2013;7</page-range>. doi: <pub-id pub-id-type="doi">10.1158/0008-5472.CAN-05-2445</pub-id>
</citation>
</ref>
<ref id="B20">
<label>20</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Guo</surname> <given-names>J</given-names>
</name>
<name>
<surname>Grow</surname> <given-names>EJ</given-names>
</name>
<name>
<surname>Mlcochova</surname> <given-names>H</given-names>
</name>
<name>
<surname>Maher</surname> <given-names>GJ</given-names>
</name>
<name>
<surname>Lindskog</surname> <given-names>C</given-names>
</name>
<name>
<surname>Nie</surname> <given-names>X</given-names>
</name>
<etal/>
</person-group>. <article-title>The Adult Human Testis Transcriptional Cell Atlas</article-title>. <source>Cell Res</source> (<year>2018</year>) <volume>28</volume>(<issue>12</issue>):<page-range>1141&#x2013;57</page-range>. doi: <pub-id pub-id-type="doi">10.1038/s41422-018-0099-2</pub-id>
</citation>
</ref>
<ref id="B21">
<label>21</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Tang</surname> <given-names>Z</given-names>
</name>
<name>
<surname>Kang</surname> <given-names>B</given-names>
</name>
<name>
<surname>Li</surname> <given-names>C</given-names>
</name>
<name>
<surname>Chen</surname> <given-names>T</given-names>
</name>
<name>
<surname>Zhang</surname> <given-names>Z</given-names>
</name>
</person-group>. <article-title>GEPIA2: An Enhanced Web Server for Large-Scale Expression Profiling and Interactive Analysis</article-title>. <source>Nucleic Acids Res</source> (<year>2019</year>) <volume>47</volume>(<issue>W1</issue>):<page-range>W556&#x2013;W60</page-range>. doi: <pub-id pub-id-type="doi">10.1093/nar/gkz430</pub-id>
</citation>
</ref>
<ref id="B22">
<label>22</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Gyorffy</surname> <given-names>B</given-names>
</name>
</person-group>. <article-title>Survival Analysis Across the Entire Transcriptome Identifies Biomarkers With the Highest Prognostic Power in Breast Cancer</article-title>. <source>Comput Struct Biotechnol J</source> (<year>2021</year>) <volume>19</volume>:<page-range>4101&#x2013;9</page-range>. doi: <pub-id pub-id-type="doi">10.1016/j.csbj.2021.07.014</pub-id>
</citation>
</ref>
<ref id="B23">
<label>23</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Vasaikar</surname> <given-names>SV</given-names>
</name>
<name>
<surname>Straub</surname> <given-names>P</given-names>
</name>
<name>
<surname>Wang</surname> <given-names>J</given-names>
</name>
<name>
<surname>Zhang</surname> <given-names>B</given-names>
</name>
</person-group>. <article-title>LinkedOmics: Analyzing Multi-Omics Data Within and Across 32 Cancer Types</article-title>. <source>Nucleic Acids Res</source> (<year>2018</year>) <volume>46</volume>(<issue>D1</issue>):<page-range>D956&#x2013;D63</page-range>. doi: <pub-id pub-id-type="doi">10.1093/nar/gkx1090</pub-id>
</citation>
</ref>
<ref id="B24">
<label>24</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Liu</surname> <given-names>CJ</given-names>
</name>
<name>
<surname>Hu</surname> <given-names>FF</given-names>
</name>
<name>
<surname>Xia</surname> <given-names>MX</given-names>
</name>
<name>
<surname>Han</surname> <given-names>L</given-names>
</name>
<name>
<surname>Zhang</surname> <given-names>Q</given-names>
</name>
<name>
<surname>Guo</surname> <given-names>AY</given-names>
</name>
</person-group>. <article-title>Gscalite: A Web Server for Gene Set Cancer Analysis</article-title>. <source>Bioinformatics</source> (<year>2018</year>) <volume>34</volume>(<issue>21</issue>):<page-range>3771&#x2013;2</page-range>. doi: <pub-id pub-id-type="doi">10.1093/bioinformatics/bty411</pub-id>
</citation>
</ref>
<ref id="B25">
<label>25</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Jiang</surname> <given-names>P</given-names>
</name>
<name>
<surname>Gu</surname> <given-names>S</given-names>
</name>
<name>
<surname>Pan</surname> <given-names>D</given-names>
</name>
<name>
<surname>Fu</surname> <given-names>J</given-names>
</name>
<name>
<surname>Sahu</surname> <given-names>A</given-names>
</name>
<name>
<surname>Hu</surname> <given-names>X</given-names>
</name>
<etal/>
</person-group>. <article-title>Signatures of T Cell Dysfunction and Exclusion Predict Cancer Immunotherapy Response</article-title>. <source>Nat Med</source> (<year>2018</year>) <volume>24</volume>(<issue>10</issue>):<page-range>1550&#x2013;8</page-range>. doi: <pub-id pub-id-type="doi">10.1038/s41591-018-0136-1</pub-id>
</citation>
</ref>
<ref id="B26">
<label>26</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Bo</surname> <given-names>H</given-names>
</name>
<name>
<surname>Fan</surname> <given-names>L</given-names>
</name>
<name>
<surname>Li</surname> <given-names>J</given-names>
</name>
<name>
<surname>Liu</surname> <given-names>Z</given-names>
</name>
<name>
<surname>Zhang</surname> <given-names>S</given-names>
</name>
<name>
<surname>Shi</surname> <given-names>L</given-names>
</name>
<etal/>
</person-group>. <article-title>High Expression of Lncrna AFAP1-AS1 Promotes the Progression of Colon Cancer and Predicts Poor Prognosis</article-title>. <source>J Cancer</source> (<year>2018</year>) <volume>9</volume>(<issue>24</issue>):<page-range>4677&#x2013;83</page-range>. doi: <pub-id pub-id-type="doi">10.7150/jca.26461</pub-id>
</citation>
</ref>
<ref id="B27">
<label>27</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Luo</surname> <given-names>Y</given-names>
</name>
<name>
<surname>Liu</surname> <given-names>F</given-names>
</name>
<name>
<surname>Ma</surname> <given-names>J</given-names>
</name>
<name>
<surname>Fu</surname> <given-names>Y</given-names>
</name>
<name>
<surname>Gui</surname> <given-names>R</given-names>
</name>
</person-group>. <article-title>A Novel Epigenetic Regulation of circFoxp1 on Foxp1 in Colon Cancer Cells</article-title>. <source>Cell Death Dis</source> (<year>2020</year>) <volume>11</volume>(<issue>9</issue>):<fpage>782</fpage>. doi: <pub-id pub-id-type="doi">10.1038/s41419-020-03007-6</pub-id>
</citation>
</ref>
<ref id="B28">
<label>28</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Tang</surname> <given-names>Z</given-names>
</name>
<name>
<surname>Li</surname> <given-names>C</given-names>
</name>
<name>
<surname>Kang</surname> <given-names>B</given-names>
</name>
<name>
<surname>Gao</surname> <given-names>G</given-names>
</name>
<name>
<surname>Li</surname> <given-names>C</given-names>
</name>
<name>
<surname>Zhang</surname> <given-names>Z</given-names>
</name>
</person-group>. <article-title>GEPIA: A Web Server for Cancer and Normal Gene Expression Profiling and Interactive Analyses</article-title>. <source>Nucleic Acids Res</source> (<year>2017</year>) <volume>45</volume>(<issue>W1</issue>):<fpage>W98</fpage>&#x2013;<lpage>102</lpage>. doi: <pub-id pub-id-type="doi">10.1093/nar/gkx247</pub-id>
</citation>
</ref>
<ref id="B29">
<label>29</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Shah</surname> <given-names>S</given-names>
</name>
<name>
<surname>Ward</surname> <given-names>JE</given-names>
</name>
<name>
<surname>Bao</surname> <given-names>R</given-names>
</name>
<name>
<surname>Hall</surname> <given-names>CR</given-names>
</name>
<name>
<surname>Brockstein</surname> <given-names>BE</given-names>
</name>
<name>
<surname>Luke</surname> <given-names>JJ</given-names>
</name>
</person-group>. <article-title>Clinical Response of a Patient to Anti-PD-1 Immunotherapy and the Immune Landscape of Testicular Germ Cell Tumors</article-title>. <source>Cancer Immunol Res</source> (<year>2016</year>) <volume>4</volume>(<issue>11</issue>):<page-range>903&#x2013;9</page-range>. doi: <pub-id pub-id-type="doi">10.1158/2326-6066.CIR-16-0087</pub-id>
</citation>
</ref>
<ref id="B30">
<label>30</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Carouge</surname> <given-names>D</given-names>
</name>
<name>
<surname>Blanc</surname> <given-names>V</given-names>
</name>
<name>
<surname>Knoblaugh</surname> <given-names>SE</given-names>
</name>
<name>
<surname>Hunter</surname> <given-names>RJ</given-names>
</name>
<name>
<surname>Davidson</surname> <given-names>NO</given-names>
</name>
<name>
<surname>Nadeau</surname> <given-names>JH</given-names>
</name>
</person-group>. <article-title>Parent-of-Origin Effects of A1CF and AGO2 on Testicular Germ-Cell Tumors, Testicular Abnormalities, and Fertilization Bias</article-title>. <source>Proc Natl Acad Sci USA</source> (<year>2016</year>) <volume>113</volume>(<issue>37</issue>):<page-range>E5425&#x2013;33</page-range>. doi: <pub-id pub-id-type="doi">10.1073/pnas.1604773113</pub-id>
</citation>
</ref>
<ref id="B31">
<label>31</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Lu</surname> <given-names>M</given-names>
</name>
<name>
<surname>Tian</surname> <given-names>H</given-names>
</name>
<name>
<surname>Cao</surname> <given-names>YX</given-names>
</name>
<name>
<surname>He</surname> <given-names>X</given-names>
</name>
<name>
<surname>Chen</surname> <given-names>L</given-names>
</name>
<name>
<surname>Song</surname> <given-names>X</given-names>
</name>
<etal/>
</person-group>. <article-title>Downregulation of miR-320a/383-Sponge-Like Long Non-Coding RNA NLC1-C (Narcolepsy Candidate-Region 1 Genes) Is Associated With Male Infertility and Promotes Testicular Embryonal Carcinoma Cell Proliferation</article-title>. <source>Cell Death Dis</source> (<year>2015</year>) <volume>6</volume>:<elocation-id>e1960</elocation-id>. doi: <pub-id pub-id-type="doi">10.1038/cddis.2015.267</pub-id>
</citation>
</ref>
<ref id="B32">
<label>32</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Quaderi</surname> <given-names>NA</given-names>
</name>
<name>
<surname>Schweiger</surname> <given-names>S</given-names>
</name>
<name>
<surname>Gaudenz</surname> <given-names>K</given-names>
</name>
<name>
<surname>Franco</surname> <given-names>B</given-names>
</name>
<name>
<surname>Rugarli</surname> <given-names>EI</given-names>
</name>
<name>
<surname>Berger</surname> <given-names>W</given-names>
</name>
<etal/>
</person-group>. <article-title>Opitz G/BBB Syndrome, a Defect of Midline Development, is Due to Mutations in a New RING Finger Gene on Xp22</article-title>. <source>Nat Genet</source> (<year>1997</year>) <volume>17</volume>(<issue>3</issue>):<page-range>285&#x2013;91</page-range>. doi: <pub-id pub-id-type="doi">10.1038/ng1197-285</pub-id>
</citation>
</ref>
<ref id="B33">
<label>33</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Cardoso</surname> <given-names>AR</given-names>
</name>
<name>
<surname>Lobo</surname> <given-names>J</given-names>
</name>
<name>
<surname>Miranda-Goncalves</surname> <given-names>V</given-names>
</name>
<name>
<surname>Henrique</surname> <given-names>R</given-names>
</name>
<name>
<surname>Jeronimo</surname> <given-names>C</given-names>
</name>
</person-group>. <article-title>Epigenetic Alterations as Therapeutic Targets in Testicular Germ Cell Tumours: Current and Future Application of &#x2018;Epidrugs&#x2019;</article-title>. <source>Epigenetics</source> (<year>2021</year>) <volume>16</volume>(<issue>4</issue>):<page-range>353&#x2013;72</page-range>. doi: <pub-id pub-id-type="doi">10.1080/15592294.2020.1805682</pub-id>
</citation>
</ref>
<ref id="B34">
<label>34</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>De Martino</surname> <given-names>M</given-names>
</name>
<name>
<surname>Chieffi</surname> <given-names>P</given-names>
</name>
<name>
<surname>Esposito</surname> <given-names>F</given-names>
</name>
</person-group>. <article-title>miRNAs and Biomarkers in Testicular Germ Cell Tumors: An Update</article-title>. <source>Int J Mol Sci</source> (<year>2021</year>) <volume>22</volume>(<issue>3</issue>):<elocation-id>1380</elocation-id>. doi: <pub-id pub-id-type="doi">10.3390/ijms22031380</pub-id>
</citation>
</ref>
<ref id="B35">
<label>35</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Chovanec</surname> <given-names>M</given-names>
</name>
<name>
<surname>Lauritsen</surname> <given-names>J</given-names>
</name>
<name>
<surname>Bandak</surname> <given-names>M</given-names>
</name>
<name>
<surname>Oing</surname> <given-names>C</given-names>
</name>
<name>
<surname>Kier</surname> <given-names>GG</given-names>
</name>
<name>
<surname>Kreiberg</surname> <given-names>M</given-names>
</name>
<etal/>
</person-group>. <article-title>Late Adverse Effects and Quality of Life in Survivors of Testicular Germ Cell Tumour</article-title>. <source>Nat Rev Urol</source> (<year>2021</year>) <volume>18</volume>(<issue>4</issue>):<page-range>227&#x2013;45</page-range>. doi: <pub-id pub-id-type="doi">10.1038/s41585-021-00440-w</pub-id>
</citation>
</ref>
<ref id="B36">
<label>36</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Cui</surname> <given-names>Y</given-names>
</name>
<name>
<surname>Miao</surname> <given-names>C</given-names>
</name>
<name>
<surname>Liu</surname> <given-names>S</given-names>
</name>
<name>
<surname>Tang</surname> <given-names>J</given-names>
</name>
<name>
<surname>Zhang</surname> <given-names>J</given-names>
</name>
<name>
<surname>Bu</surname> <given-names>H</given-names>
</name>
<etal/>
</person-group>. <article-title>Clusterin Suppresses Invasion and Metastasis of Testicular Seminoma by Upregulating COL15a1</article-title>. <source>Mol Ther Nucleic Acids</source> (<year>2021</year>) <volume>26</volume>:<page-range>1336&#x2013;50</page-range>. doi: <pub-id pub-id-type="doi">10.1016/j.omtn.2021.11.004</pub-id>
</citation>
</ref>
<ref id="B37">
<label>37</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Andjilani</surname> <given-names>M</given-names>
</name>
<name>
<surname>Droz</surname> <given-names>JP</given-names>
</name>
<name>
<surname>Benahmed</surname> <given-names>M</given-names>
</name>
<name>
<surname>Tabone</surname> <given-names>E</given-names>
</name>
</person-group>. <article-title>Down-Regulation of FAK and IAPs by Laminin During Cisplatin-Induced Apoptosis in Testicular Germ Cell Tumors</article-title>. <source>Int J Oncol</source> (<year>2006</year>) <volume>28</volume>(<issue>2</issue>):<page-range>535&#x2013;42</page-range>. doi: <pub-id pub-id-type="doi">10.3892/ijo.28.2.535</pub-id>
</citation>
</ref>
<ref id="B38">
<label>38</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Dawson</surname> <given-names>JC</given-names>
</name>
<name>
<surname>Serrels</surname> <given-names>A</given-names>
</name>
<name>
<surname>Stupack</surname> <given-names>DG</given-names>
</name>
<name>
<surname>Schlaepfer</surname> <given-names>DD</given-names>
</name>
<name>
<surname>Frame</surname> <given-names>MC</given-names>
</name>
</person-group>. <article-title>Targeting FAK in Anticancer Combination Therapies</article-title>. <source>Nat Rev Cancer</source> (<year>2021</year>) <volume>21</volume>(<issue>5</issue>):<page-range>313&#x2013;24</page-range>. doi: <pub-id pub-id-type="doi">10.1038/s41568-021-00340-6</pub-id>
</citation>
</ref>
<ref id="B39">
<label>39</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Li</surname> <given-names>Q</given-names>
</name>
<name>
<surname>Sun</surname> <given-names>M</given-names>
</name>
<name>
<surname>Wang</surname> <given-names>M</given-names>
</name>
<name>
<surname>Feng</surname> <given-names>M</given-names>
</name>
<name>
<surname>Yang</surname> <given-names>F</given-names>
</name>
<name>
<surname>Li</surname> <given-names>L</given-names>
</name>
<etal/>
</person-group>. <article-title>Dysregulation of Wnt/beta-catenin Signaling by Protein Kinases in Hepatocellular Carcinoma and its Therapeutic Application</article-title>. <source>Cancer Sci</source> (<year>2021</year>) <volume>112</volume>(<issue>5</issue>):<page-range>1695&#x2013;706</page-range>. doi: <pub-id pub-id-type="doi">10.1111/cas.14861</pub-id>
</citation>
</ref>
<ref id="B40">
<label>40</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>He</surname> <given-names>Y</given-names>
</name>
<name>
<surname>Sun</surname> <given-names>MM</given-names>
</name>
<name>
<surname>Zhang</surname> <given-names>GG</given-names>
</name>
<name>
<surname>Yang</surname> <given-names>J</given-names>
</name>
<name>
<surname>Chen</surname> <given-names>KS</given-names>
</name>
<name>
<surname>Xu</surname> <given-names>WW</given-names>
</name>
<etal/>
</person-group>. <article-title>Targeting PI3K/Akt Signal Transduction for Cancer Therapy</article-title>. <source>Signal Transduct Target Ther</source> (<year>2021</year>) <volume>6</volume>(<issue>1</issue>):<fpage>425</fpage>. doi: <pub-id pub-id-type="doi">10.1038/s41392-021-00828-5</pub-id>
</citation>
</ref>
<ref id="B41">
<label>41</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Tan</surname> <given-names>S</given-names>
</name>
<name>
<surname>Xu</surname> <given-names>Y</given-names>
</name>
<name>
<surname>Wang</surname> <given-names>Z</given-names>
</name>
<name>
<surname>Wang</surname> <given-names>T</given-names>
</name>
<name>
<surname>Du</surname> <given-names>X</given-names>
</name>
<name>
<surname>Song</surname> <given-names>X</given-names>
</name>
<etal/>
</person-group>. <article-title>Tim-3 Hampers Tumor Surveillance of Liver-Resident and Conventional Nk Cells by Disrupting Pi3k Signaling</article-title>. <source>Cancer Res</source> (<year>2020</year>) <volume>80</volume>(<issue>5</issue>):<page-range>1130&#x2013;42</page-range>. doi: <pub-id pub-id-type="doi">10.1158/0008-5472.CAN-19-2332</pub-id>
</citation>
</ref>
<ref id="B42">
<label>42</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Zhang</surname> <given-names>XC</given-names>
</name>
<name>
<surname>Wang</surname> <given-names>J</given-names>
</name>
<name>
<surname>Shao</surname> <given-names>GG</given-names>
</name>
<name>
<surname>Wang</surname> <given-names>Q</given-names>
</name>
<name>
<surname>Qu</surname> <given-names>X</given-names>
</name>
<name>
<surname>Wang</surname> <given-names>B</given-names>
</name>
<etal/>
</person-group>. <article-title>Comprehensive Genomic and Immunological Characterization of Chinese Non-Small Cell Lung Cancer Patients</article-title>. <source>Nat Commun</source> (<year>2019</year>) <volume>10</volume>(<issue>1</issue>):<fpage>1772</fpage>. doi: <pub-id pub-id-type="doi">10.1038/s41467-019-09762-1</pub-id>
</citation>
</ref>
<ref id="B43">
<label>43</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Wall</surname> <given-names>JA</given-names>
</name>
<name>
<surname>Meza-Perez</surname> <given-names>S</given-names>
</name>
<name>
<surname>Scalise</surname> <given-names>CB</given-names>
</name>
<name>
<surname>Katre</surname> <given-names>A</given-names>
</name>
<name>
<surname>Londono</surname> <given-names>AI</given-names>
</name>
<name>
<surname>Turbitt</surname> <given-names>WJ</given-names>
</name>
<etal/>
</person-group>. <article-title>Manipulating the Wnt/beta-catenin Signaling Pathway to Promote Anti-Tumor Immune Infiltration Into the TME to Sensitize Ovarian Cancer to ICB Therapy</article-title>. <source>Gynecol Oncol</source> (<year>2021</year>) <volume>160</volume>(<issue>1</issue>):<page-range>285&#x2013;94</page-range>. doi: <pub-id pub-id-type="doi">10.1016/j.ygyno.2020.10.031</pub-id>
</citation>
</ref>
<ref id="B44">
<label>44</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Stampouloglou</surname> <given-names>E</given-names>
</name>
<name>
<surname>Cheng</surname> <given-names>N</given-names>
</name>
<name>
<surname>Federico</surname> <given-names>A</given-names>
</name>
<name>
<surname>Slaby</surname> <given-names>E</given-names>
</name>
<name>
<surname>Monti</surname> <given-names>S</given-names>
</name>
<name>
<surname>Szeto</surname> <given-names>GL</given-names>
</name>
<etal/>
</person-group>. <article-title>Yap Suppresses T-cell Function and Infiltration in the Tumor Microenvironment</article-title>. <source>PLoS Biol</source> (<year>2020</year>) <volume>18</volume>(<issue>1</issue>):<elocation-id>e3000591</elocation-id>. doi: <pub-id pub-id-type="doi">10.1371/journal.pbio.3000591</pub-id>
</citation>
</ref>
<ref id="B45">
<label>45</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Wang</surname> <given-names>J</given-names>
</name>
<name>
<surname>Huang</surname> <given-names>F</given-names>
</name>
<name>
<surname>Shi</surname> <given-names>Y</given-names>
</name>
<name>
<surname>Zhang</surname> <given-names>Q</given-names>
</name>
<name>
<surname>Xu</surname> <given-names>S</given-names>
</name>
<name>
<surname>Yao</surname> <given-names>Y</given-names>
</name>
<etal/>
</person-group>. <article-title>Rp11-323N12.5 Promotes the Malignancy and Immunosuppression of Human Gastric Cancer by Increasing YAP1 Transcription</article-title>. <source>Gastric Cancer</source> (<year>2021</year>) <volume>24</volume>(<issue>1</issue>):<fpage>85</fpage>&#x2013;<lpage>102</lpage>. doi: <pub-id pub-id-type="doi">10.1007/s10120-020-01099-9</pub-id>
</citation>
</ref>
<ref id="B46">
<label>46</label>
<citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname>Zhu</surname> <given-names>G</given-names>
</name>
<name>
<surname>Ren</surname> <given-names>D</given-names>
</name>
<name>
<surname>Lei</surname> <given-names>X</given-names>
</name>
<name>
<surname>Shi</surname> <given-names>R</given-names>
</name>
<name>
<surname>Zhu</surname> <given-names>S</given-names>
</name>
<name>
<surname>Zhou</surname> <given-names>N</given-names>
</name>
<etal/>
</person-group>. <article-title>Mutations Associated With No Durable Clinical Benefit to Immune Checkpoint Blockade in Non-S-Cell Lung Cancer</article-title>. <source>Cancers (Basel)</source> (<year>2021</year>) <volume>13</volume>(<issue>6</issue>):<elocation-id>1397</elocation-id>. doi: <pub-id pub-id-type="doi">10.3390/cancers13061397</pub-id>
</citation>
</ref>
</ref-list>
</back>
</article>