High Expression of PDIA4 Contributes to Poor Prognosis in Glioma

This study aimed to investigate the expression and prognostic value of protein disulfide isomerase A4 (PDIA4) in glioma patients. We initially analyzed the expression of PDIA4 in various tumors using the Gene Expression Profiling Interactive Analysis 2 (GEPIA2) database. Then, we performed a retrospective analysis of clinical and pathological data of 118 patients with glioma from January 2015 to January 2019 at the Department of Neurosurgery, General Hospital of Ningxia Medical University. Additionally, normal brain tissue samples were obtained from three patients undergoing surgery for intracerebral hemorrhage. Immunofluorescence was utilized to evaluate PDIA4 expression in gliomas and normal brain tissues, and we analyzed the correlation between PDIA4 expression, tumor malignancy grade, and survival prognosis. GEPIA2 dataset analysis showed significantly higher PDIA4 expression in most tumor tissues compared to normal tissues, particularly in gliomas. Immunofluorescence revealed PDIA4 localization, primarily in the cytoplasm of tumor cells. Amongst 118 patients, PDIA4 expression positively correlated with age (p < 0.005), WHO tumor grade (p < 0.0001), but showed no correlation with gender, tumor size, or tumor location. Notably, glioma patients with high PDIA4 expression demonstrated significantly lower overall survival rates than those with low expression (p < 0.0001), especially in low-grade glioma patients (p < 0.0001), while no significant correlation was found in high-grade glioma patients (p < 0.1356). Multivariate analysis revealed that elevated high PDIA4 expression is an independent prognostic factor associated with adverse outcomes in glioma patients (p < 0.0001). PDIA4 emerges as a novel molecular biomarker for prognostic prediction in glioma patients. Its elevated expression is associated with unfavorable outcomes, highlighting its potential as both a therapeutic target and a prognostic indicator in glioma management.