Abstract
Angiotensin-converting enzyme 2 (ACE2) is a member of the renin-angiotension system, however, the correlation between ACE2 and prognosis in UCEC (Uterine Corpus Endometrial Carcinoma) and KIRP (Kidney Renal Papillary Cell Carcinoma) is not clear. We analyzed the expression levels of ACE2 in the Oncomine and TIMER databases, the correlation between ACE2 and overall survival in the PrognoScan, GEPIA and Kaplan-Meier plotter databases. The correlation between ACE2 and immune infiltration level and the type markers of immune cells was investigated in TIMER database. A prognosis analysis based on the expression levels of ACE2 was further performed in related immune cells subgroup. The ACE2 promoter methylation profile was tested in the UALCAN database. In addition, we used GSE30589 and GSE52920 databases to elucidate the changes of ACE2 expression in vivo and in vitro after SARS-CoV infection. ACE2 was elevated in UCEC and KIRP, and high ACE2 had a favorable prognosis. The expression of ACE2 was positively correlated with the level of immune infiltration of macrophage in KIRP, B cell, CD4+T cell, neutrophil and dendritic cell immune infiltration levels in UCEC. ACE2 was significantly positively correlated with the type markers of B cells and neutrophils, macrophages in UCEC, while ACE2 in KIRP was positively correlated with the type markers of macrophages. High ACE2 expression level had a favorable prognosis in different enriched immune cells subgroups in UCEC and KIRP. And the promoter methylation levels of ACE2 in UCEC and KIRP were significantly reduced. What’s more, we found that the expression of ACE2 decreased in vivo and in vitro after SARS-CoV infection. In conclusion, ACE2 expression increased significantly in UCEC and KIRP, elevated ACE2 was positively correlated with immune infiltration and prognosis. Moreover, tumor tissues may be more susceptible to SARS-CoV-2 infection in COVID-19 patients with UCEC and KIRP, which may worsen the prognosis.
Highlights
UCEC (Uterine Corpus Endometrial Carcinoma) is a common gynecological cancer in the world [1,2,3]
S more, Angiotensin-converting enzyme 2 (ACE2) acts as a receptor for SARS-CoV-2 to enter cells, which means that tumor tissues that highly express ACE2 may be susceptible to SARS-CoV-2 infection
The immune cell type markers in UCEC and KIRP were further studied, after correction of tumor purity, ACE2 in UCEC was significantly positively correlated with FCRL2 and MS4A1 in B cells, it was positively correlated with FCGR3B, CEACAM3, SIGLEC5, CSF3R and S100A12 in neutrophils and CD84 in macrophages, while ACE2 in KIRP was positively correlated with CD68 and CD84 in macrophages www.aging-us.com (Table 1)
Summary
UCEC (Uterine Corpus Endometrial Carcinoma) is a common gynecological cancer in the world [1,2,3]. It is an epithelial malignant tumor of endometrium, which has a high mortality rate and seriously threatens the health of women [4, 5]. It can be divided into two types: estrogen dependent and non estrogen dependent [6]. The incidence of non estrogen dependent tumors is low, but the malignancy is high and the prognosis is poor [4, 7]. There is evidence that microsatellite unstable endometrial cancer has infiltration of granzyme B + cells, activated cytoxic T-lymphocytes, and PD-L1 + cells [9], which suggests that endometrial cancer can be treated with immunotherapy to improve prognosis
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