3. Discussion
Leiomyosarcoma is an uncommon cancer originating from smooth muscle cells, capable of manifesting in various body regions such as the uterus, cervix, rectum, heart, and genitourinary system [
19,
20]. The incidence of uterine leiomyosarcoma, especially in relation to uterine fibroids, may be 1% in uterine cancer, but it has a poor prognosis and is a is a highly aggressive tumor [
21]. According to leiomyosarcoma, our recent research has identified several genes that were significantly expressed, including CCNA, CDC20, CENPA, HJURP, HMMR, KIF11, NUSAP1, PLK4, PRC1, KIF20A, KIF4A, MAD2L1, SPAG5, TK1, TOP2A, and ZWINT. The identification of 25 differentially expressed genes (DEGs) from five datasets provides a significant insight into the molecular landscape of uterine leiomyosarcoma. Among these, PMGs—MOXD1, NDRG2, OLFM1, KIF20A, HMMR, ABCA6, TGFBR2, PLK4, PRC1, and ZWINT—were potentially localized at the plasma membrane of cancer cells. The localization of these DEGs at the plasma membrane is critically important for their potential as targets in chimeric antigen receptor (CAR) T-cell therapy [
22].
The plasma membrane localization of differentially expressed genes (DEGs) in uterine leiomyosarcoma cells is of particular interest in the context of CAR T-cell therapy. DEGs localized at the plasma membrane, or plasma membrane genes (PMGs), are accessible to CAR T-cells, which are engineered to recognize and bind to specific antigens on the cell surface [
23,
24]. This accessibility is crucial because CAR T-cells can exert their cytotoxic effects directly upon binding to the target antigens. Targeting PMGs ensures that CAR T-cells can effectively identify and destroy cancer cells without affecting normal cells that do not express these specific antigens. Additionally, the overexpression of these PMGs in uterine leiomyosarcoma, as observed in the GEPIA database, further supports their candidacy as therapeutic targets [
22]. The higher density of these antigens on the surface of cancer cells enhances the specificity and efficacy of CAR T-cell therapy, potentially leading to more effective and targeted cancer treatments.
Cell mitosis is a fundamental process for cell division and proliferation. In cancer, this process is often dysregulated, leading to uncontrolled cell growth and tumor development, which could potentially be targets of anticancer treatments. The mitotic spindle, a structure composed of microtubules, segregates chromosomes into daughter cells during cell division. Proper functioning of the spindle, chromosomes, kinetochore, and mitotic spindle is essential for accurate chromosome segregation. Dysregulation of these processes can result in genomic instability, a hallmark of cancer, contributing to tumor progression and resistance to therapy [
25,
26]. Understanding the molecular mechanisms underlying these dysregulated processes in uterine leiomyosarcoma is critical for developing targeted therapies that can effectively combat this aggressive cancer type.
In leiomyosarcoma, the dysregulation of genes involved in these processes can lead to genomic instability [
25,
26]. The DEGs identified, which play roles in cell mitosis, spindle assembly, chromosome segregation, and kinetochore function, are often overexpressed or mutated in cancer cells, contributing to the uncontrolled proliferation and survival of these cells. Specifically, genes such as HMMR, KIF20A, PRC1, and ZWINT, which have high betweenness centrality scores in protein networks, are crucial regulators of mitosis and spindle dynamics. Their overexpression may lead to aberrant cell division and tumor progression [
22].
Hyaluronan Mediated Motility Receptor (HMMR) plays a critical role in cell-matrix interactions and migration, with its overexpression in cancer linked to invasion and metastasis [
27]. Its localization on the plasma membrane makes it a viable target for CAR T-cells, offering a strategy to reduce metastatic potential in tumors [
27]. Beyond its role as a hyaluronan receptor, HMMR regulates homeostasis, mitosis, and meiosis, highlighting its multifaceted functions [
27].
Research indicates that HMMR influences chemoresistance in gastric cancer and is regulated by the AR-mTOR-SRF axis in prostate cancer, associating it with tumor progression and metastasis [
28]. In uterine leiomyosarcoma, HMMR expression correlates with poor outcomes, suggesting its prognostic value [
29]. High HMMR levels predict poor prognosis in renal cell carcinoma and adverse outcomes in lung adenocarcinoma, linking it to immune infiltrates [
28,
29]. The role of HMMR in colorectal cancer remains to be fully clarified, while in breast cancer, it promotes proliferation and metastasis, underscoring its oncogenic potential [
30,
31]. HMMR also enhances peritoneal implantation of gastric cancer by facilitating cell-cell interactions, contributing to cancer progression [
32]. In summary, HMMR is integral to cancer biology, influencing tumor growth, metastasis, and treatment response. Understanding HMMR's molecular mechanisms can aid in developing targeted therapies and improving cancer patient outcomes.
KIF20A (Kinesin Family Member 20A) is a motor protein involved in mitosis and intracellular transport. Overexpression of KIF20A is frequently observed in various cancers and is associated with poor prognosis [
33]. The localization of KIF20A on the plasma membrane offers a unique opportunity for CAR T-cells to recognize and target cancer cells exhibiting high KIF20A expression, thereby inhibiting cancer cell proliferation.
PRC1 (Protein Regulator of Cytokinesis 1) is essential for regulating cytokinesis during cell division and is implicated in various cancers, including uterine leiomyosarcoma, where its overexpression drives cancer cell proliferation [
34]. The oncogenic properties of PRC1 have been studied in numerous tumors, highlighting its potential as a diagnostic and therapeutic biomarker in hepatocellular carcinoma and other malignancies [
35].
PRC1, part of the microtubule-associated proteins (MAPs) family, plays a vital role in cytokinesis, aiding in the initiation and completion of this critical cellular process [
34]. Research has demonstrated PRC1's essential role in maintaining spindle stability, ensuring proper chromosome segregation, and completing cytokinesis, all crucial for correct cell division [
36]. PRC1's phosphorylation by CDKs, such as CDK16, has been linked to the progression and metastasis of triple-negative breast cancer, illustrating the complex regulatory mechanisms involving PRC1 in cancer development [
37].
Dysregulation of PRC1 has been correlated with poor prognosis in ovarian cancer, underscoring its value as a prognostic marker and therapeutic target [
38]. In hepatocellular carcinoma, targeting PRC1 to reduce its levels has been proposed as a potential strategy to inhibit tumor growth, demonstrating its oncogenic role [
39]. PRC1 overexpression is associated with poor prognosis in colon cancer, suggesting its use as a prognostic indicator and therapeutic target [
40]. In oral squamous cell carcinoma, PRC1 is crucial for regulating proliferation and cell cycle progression, emphasizing its importance in cancer biology [
41].
Given these findings and PRC1's localization on the plasma membrane, it serves as an effective target for CAR T-cells, which can recognize and eliminate cells with high PRC1 expression. Because PRC1 is localized on the plasma membrane and involved in rapid tumor cell division, it presents an effective target for CAR T-cells, which can identify and eliminate cells with high PRC1 expression.
ZWINT (ZW10 Interacting Kinetochore Protein) is involved in kinetochore function and cell division. Overexpression of ZWINT is associated with uncontrolled cell division, a hallmark of cancer [
42]. Targeting ZWINT on the plasma membrane, CAR T-cells can intervene in the uncontrolled cell division process, providing a direct antiproliferative effect on tumor cells.
The future prospects of this research extend beyond its application in CAR-T cell therapy, including the development of UCS target proteins as monoclonal antibody targets for antibody-drug conjugate (ADC) therapy [
43]. ADCs are comprised of a monoclonal antibody, a cytotoxic drug (payload), and a linker that connects the antibody to the drug. The monoclonal antibody is specifically designed to target an antigen expressed on the surface of tumor cells [
44]. Upon binding to the target antigen, the ADC is internalized, and the linker is cleaved within the cell, releasing the cytotoxic drug to exert its lethal effect. The choice of linker is crucial, requiring stability in the bloodstream to prevent premature drug release while ensuring efficient release within the target cells. This specific targeting enhances the effectiveness of chemotherapy formulations, minimizing systemic toxicity and improving therapeutic efficacy [
45]. We hope that the results of this study inspire and guide future research and development of anti-cancer drugs, leveraging both CAR-T cell and ADC technologies.
In conclusion, through rigorous bioinformatics analysis, we identified HMMR, KIF20A, PRC1, and ZWINT as key candidates due to their involvement in critical cellular processes such as the cell cycle, chromosome segregation, and mitotic spindle assembly. These genes overexpression in LMS compared to normal tissues underscores their potential as tumor-associated antigens (TAAs) for CAR T-cell targeting.
The identification of these TAA and their corresponding protein products provides a valuable foundation for the development of CAR T-cell therapies tailored to LMS. By targeting these specific antigens, CAR T-cells can be designed to selectively eliminate LMS cells, potentially improving treatment efficacy and reducing off-target effects. This study not only enhances our understanding of the molecular underpinnings of LMS but also opens new avenues for therapeutic interventions in this challenging malignancy.
The relevance and novelty of this research are further supported by recent advancements and clinical trials in CAR T-cell therapy. For instance, the successful application of CAR T-cells targeting specific antigens in other solid tumors provides a promising outlook for similar strategies in LMS. As the field of cancer immunotherapy continues to evolve, the integration of genomic data and bioinformatics approaches will be crucial in identifying and validating new therapeutic targets, ultimately paving the way for personalized and precision medicine in oncology.
Figure 1.
Topology of the GSE samples used. The volcano and mean plots represent significant genes, marked by red and blue dots. Each GSE used includes 3 samples of normal cells and cancer cells, represented by green and purple bar graphs. The UMAP plot represents the similarity of clusters based on the distance between nodes, with green nodes representing each normal cell sample and purple nodes representing each cancer cell sample. A) GSE205596, B) GSE68295, C) GSE64763, D) GSE36610, E) GSE9511.
Figure 1.
Topology of the GSE samples used. The volcano and mean plots represent significant genes, marked by red and blue dots. Each GSE used includes 3 samples of normal cells and cancer cells, represented by green and purple bar graphs. The UMAP plot represents the similarity of clusters based on the distance between nodes, with green nodes representing each normal cell sample and purple nodes representing each cancer cell sample. A) GSE205596, B) GSE68295, C) GSE64763, D) GSE36610, E) GSE9511.
Figure 2.
Identification of the DEGs and its related biological process. (A) Identification of DEGs between GSE. (B) Mutations that occur in DEGs based on CBIOPortal database. (C) Localization of DEGs based on GeneCard database. (D) Biological processes from DEGs based on the reactome pathway database.
Figure 2.
Identification of the DEGs and its related biological process. (A) Identification of DEGs between GSE. (B) Mutations that occur in DEGs based on CBIOPortal database. (C) Localization of DEGs based on GeneCard database. (D) Biological processes from DEGs based on the reactome pathway database.
Figure 3.
The bioactivity of DEGs and Network Proteins. A) Deg's gene ontology. B) top pathway from the REACTOME database. C) DEG's network. The red node is a protein that localized in the cell membrane. The border node represents the degree centrality score of the node; thicker are higher. The node size represents the score between centrality and the node; larger are higher. The background color shows the cluster, where Gene Cluster 1 has a purple background color and an unclustered background gene. D) Bioactivity of Cluster 1 Based on a STRING Database. The yellow node is a gene involved in mitotic and spindle regulation. The border node shows localized protein in the cell membrane. E) Significant DEGs are expressed in Leiomyosarcoma based on GEPIA database. The red bar shows the score of the UCS sample, and the black bar shows the score of the normal sample.
Figure 3.
The bioactivity of DEGs and Network Proteins. A) Deg's gene ontology. B) top pathway from the REACTOME database. C) DEG's network. The red node is a protein that localized in the cell membrane. The border node represents the degree centrality score of the node; thicker are higher. The node size represents the score between centrality and the node; larger are higher. The background color shows the cluster, where Gene Cluster 1 has a purple background color and an unclustered background gene. D) Bioactivity of Cluster 1 Based on a STRING Database. The yellow node is a gene involved in mitotic and spindle regulation. The border node shows localized protein in the cell membrane. E) Significant DEGs are expressed in Leiomyosarcoma based on GEPIA database. The red bar shows the score of the UCS sample, and the black bar shows the score of the normal sample.
Figure 4.
Biological processes of CCNA2 in cell cycle progression related to the cell cycle, apoptosis, and cancer pathway. The analysis was performed through the Metacore database.
Figure 4.
Biological processes of CCNA2 in cell cycle progression related to the cell cycle, apoptosis, and cancer pathway. The analysis was performed through the Metacore database.
Figure 5.
Biological processes of CDC20, CENPA, MAD2L, and ZWINT involved in spindle assembly checkpoint bioactivity. The analysis was performed through the Metacore database.
Figure 5.
Biological processes of CDC20, CENPA, MAD2L, and ZWINT involved in spindle assembly checkpoint bioactivity. The analysis was performed through the Metacore database.
Figure 6.
Biological processes of KIF11 by encoded KNSL1 in spindle assembly bioactivity through an unknown mechanism. The analysis was performed through the Metacore database.
Figure 6.
Biological processes of KIF11 by encoded KNSL1 in spindle assembly bioactivity through an unknown mechanism. The analysis was performed through the Metacore database.
Figure 7.
RHAMM as a part of cancer metastatic. The analysis was performed through the Metacore database.
Figure 7.
RHAMM as a part of cancer metastatic. The analysis was performed through the Metacore database.
Figure 8.
Biological processes of TK1 inhibition induce DNA fragmentation and apoptosis. The analysis was performed through the Metacore database.
Figure 8.
Biological processes of TK1 inhibition induce DNA fragmentation and apoptosis. The analysis was performed through the Metacore database.
Figure 9.
HJURP fusion is observed in prostate cancer. The analysis was performed through the Metacore database.
Figure 9.
HJURP fusion is observed in prostate cancer. The analysis was performed through the Metacore database.
Figure 5.
The study designs. The study began by collecting GSE data and analyzing it in stages to obtain genes that could potentially be developed as targets for CAR T-cell therapy.
Figure 5.
The study designs. The study began by collecting GSE data and analyzing it in stages to obtain genes that could potentially be developed as targets for CAR T-cell therapy.
Table 1.
GEO profile of five dataset used.
Table 1.
GEO profile of five dataset used.
GEO profile |
Year |
Cancer sample |
Normal sample |
Platform |
Annotation platform |
GSE205596 [10] |
2023 |
Leiomyosarcoma (9) |
Uterine smooth muscle (9) |
GPL24676 |
Illumina NovaSeq 6000 (Homo sapiens) |
GSE68295 [11] |
2017 |
Leiomyosarcoma (3) |
Uterine myometrium (3) |
GPL6480 |
Agilent-014850 Whole Human Genome Microarray 4x44K G4112F (Probe Name version) |
GSE64763 [12] |
2015 |
Leiomyosarcoma (25) |
Uterine myometrium (29) |
GPL571 |
[HG-U133A_2] Affymetrix Human Genome U133A 2.0 Array |
GSE36610 [13] |
2012 |
Leiomyosarcoma (12) |
Uterine myometrium (10) |
GPL7363 |
Illumina HumanWG-6_V2_0_R2 |
GSE9511 [14] |
2008 |
Leiomyosarcoma (8) |
Uterine myometrium (4) |
GPL80 |
[Hu6800] Affymetrix Human Full Length HuGeneFL Array |
Table 2.
Topology of the DEGs protein network.
Table 2.
Topology of the DEGs protein network.
Protein name |
Betweenness Centrality |
Degree |
Cluster |
ABCA6 |
0.00E+00 |
0 |
Unclustered |
ADIRF |
0.00E+00 |
0 |
Unclustered |
CCNA2 |
6.80E-04 |
15 |
Cluster 1 |
CDC20 |
6.80E-04 |
15 |
Cluster 1 |
CENPA |
6.80E-04 |
15 |
Cluster 1 |
FOXG1 |
0.00E+00 |
0 |
Unclustered |
HJURP |
6.80E-04 |
15 |
Cluster 1 |
HMMR |
6.80E-04 |
15 |
Cluster 1 |
KIF11 |
6.80E-04 |
15 |
Cluster 1 |
KIF20A |
6.80E-04 |
15 |
Cluster 1 |
KIF4A |
6.80E-04 |
15 |
Cluster 1 |
MAD2L1 |
6.80E-04 |
15 |
Cluster 1 |
MOXD1 |
0.00E+00 |
0 |
Unclustered |
NDRG2 |
0.00E+00 |
0 |
Unclustered |
NUSAP1 |
6.80E-04 |
15 |
Cluster 1 |
OLFM1 |
0.00E+00 |
0 |
Unclustered |
PALMD |
0.00E+00 |
0 |
Unclustered |
PLK4 |
0.00E+00 |
14 |
Cluster 1 |
PRC1 |
6.80E-04 |
15 |
Cluster 1 |
RUNDC3B |
0.00E+00 |
0 |
Unclustered |
SPAG5 |
6.80E-04 |
15 |
Cluster 1 |
TGFBR2 |
0.00E+00 |
0 |
Unclustered |
TK1 |
0.00E+00 |
14 |
Cluster 1 |
TOP2A |
6.80E-04 |
15 |
Cluster 1 |
ZWINT |
6.80E-04 |
15 |
Cluster 1 |
Table 3.
STRING cluster bioactivity of 16 DEGs in the main network.
Table 3.
STRING cluster bioactivity of 16 DEGs in the main network.
Term name |
Description |
FDR value |
Genes ratio |
Gene input name |
CL:6604 |
Mixed, incl. Amplification of signal from the kinetochores, and Condensin complex |
6.08E-18 |
12/93 |
KIF11, SPAG5, CENPA, CDC20, ZWINT, KIF4A, HMMR, PRC1, KIF20A, TOP2A, HJURP, NUSAP1. |
CL:6596 |
Mixed, incl. Mitotic Spindle Checkpoint, and Mitotic sister chromatid segregation |
6.11E-18 |
13/151 |
KIF11, MAD2L1, SPAG5, CENPA, CDC20, ZWINT, KIF4A, HMMR, PRC1, KIF20A, TOP2A, HJURP, NUSAP1. |
CL:6608 |
Mixed, incl. Regulation of mitotic sister chromatid segregation, and Kinesin motor domain, conserved site |
1.79E-14 |
9/51 |
KIF11, SPAG5, CDC20, KIF4A, HMMR, PRC1, KIF20A, TOP2A, NUSAP1. |
CL:6610 |
Mixed, incl. Spindle elongation, and Polo-like kinase mediated events |
4.76E-13 |
8/41 |
KIF11, SPAG5, KIF4A, HMMR, PRC1, KIF20A, TOP2A, NUSAP1. |
CL:6619 |
Mixed, incl. Spindle elongation, and Outer kinetochore |
2.74E-12 |
7/24 |
KIF11, KIF4A, HMMR, PRC1, KIF20A, TOP2A, NUSAP1. |
CL:6620 |
Mixed, incl. Spindle elongation, and Axon hillock |
1.66E-11 |
6/12 |
KIF11, KIF4A, HMMR, PRC1, TOP2A, NUSAP1. |