Integrative analysis of endoplasmic reticulum stress-associated genes reveals prognostic biomarkers in cervical cancer

To investigate the expression characteristics of the endoplasmic reticulum stress-related protein Derlin-1 in cervical cancer tissue and its relationship with cervical intraepithelial neoplasia (CIN) tissue, high-risk HPV infection and clinicopathological characteristics, and analyze the potential role of Derlin-1 in the development of cervical cancer and its possible value as a prognostic biomarker. From March 2021 to March 2024, 49 patients with cervical cancer, 40 patients with CINII~III, and 30 patients with normal cervical tissue undergoing total hysterectomy due to uterine fibroids were collected. Hematoxylin and eosin (HE) staining was used to observe the histopathological morphology, and immunohistochemical SABC method was used to detect the expression level of Derlin-1 in each group of tissues, and its correlation with the patient’s clinical pathological characteristics (age, FIGO stage, degree of differentiation, lymph node metastasis, vascular tumor thrombus, pathological type) and high-risk HPV infection status was analyzed. The experimental data were statistically analyzed using χ² test and Fisher’s exact probability method. Derlin-1 was mainly localized in the cytoplasm and showed brownish-yellow granular staining. The positive expression rates of Derlin-1 in cervical cancer tissue, CIN tissue and normal cervical tissue were 55.1%(27/49), 32.5%(13/40) and 6.7%(2/30), respectively, with statistically significant differences ( P < 0.05). The expression level of Derlin-1 in cervical cancer tissue was significantly higher than that in CIN group (χ²=4.547, P = 0.033) and normal cervical group (χ²=18.789, P < 0.001); the expression level in CIN group was also higher than that in normal cervical group (χ²=6.795, P = 0.009). There was no significant difference between the expression of Derlin-1 and patient age, clinical stage, degree of differentiation, lymph node metastasis, vascular tumor thrombus and pathological type ( P > 0.05). In 49 cases of cervical cancer tissues, the detection rate of high-risk HPV was 75.5%(37/49), and the positive expression rate of Derlin-1 in HPV-positive patients was 64.9%(24/37), which was significantly higher than that in HPV-negative patients (25.0%(3/12)( P = 0.016). Derlin-1 is significantly over-expressed in cervical cancer tissues and is closely related to high-risk HPV infection, suggesting that Derlin-1 may promote the canceration process of cervical epithelial cells by participating in endoplasmic reticulum stress response and protein degradation pathways. Derlin-1 is expected to become a potential molecular marker for early diagnosis and prognosis assessment of cervical cancer, providing new ideas for molecular mechanism research and targeted treatment of cervical cancer.