Abstract
Angiotensin-converting enzyme 2 (ACE2) plays a pivotal role in the renin–angiotensin system and is closely related to coronavirus disease of 2019. However, the role of ACE2 in cancers remains unclear. We explored the pan-cancer expression patterns and prognostic value of ACE2 across multiple databases, including Oncomine, PrognoScan, Gene Expression Profiling Interactive Analysis, and Kaplan–Meier Plotter. Then, we investigated the correlations between ACE2 expression and immune infiltration in cancers. We found that tumor tissues had higher expression levels of ACE2 compared with normal tissue in the kidney and the liver and lower expression levels in the lung. High expression levels of ACE2 were beneficial to survival in ovarian serous cystadenocarcinoma, liver hepatocellular carcinoma, kidney renal papillary cell carcinoma, and kidney renal clear cell carcinoma, although this was not the case in lung squamous cell carcinoma. For those with a better prognosis, there were significant positive correlations between ACE2 expression and immune infiltrates, including B cells, CD8 + T cells, CD4 + T cells, neutrophils, macrophages, and dendritic cells. In conclusion, ACE2 could serve as a pan-cancer prognostic biomarker and is correlated with immune infiltrates.
Highlights
Cancer is a major cause of morbidity and mortality worldwide, creating huge health and economic burden on society (Siegel et al, 2019)
We calculated the coefficients for the correlation between Angiotensin-converting enzyme 2 (ACE2) expression and immune infiltration levels in 39 cancer types via the Tumor Immunity Estimate Resource (TIMER) database
ACE2 has been implicated in cardiac dysfunction, hypertension (Crackower et al, 2002), heart failure and ventricular remodeling (Donoghue et al, 2003; Zisman et al, 2003), diabetes (Tikellis et al, 2003), Ang 1–7 regulation during pregnancy (Brosnihan et al, 2003), and as a functional receptor for coronaviruses, including SARS-CoV and SARS-CoV-2 (Li et al, 2003; Zhou et al, 2020)
Summary
Cancer is a major cause of morbidity and mortality worldwide, creating huge health and economic burden on society (Siegel et al, 2019). This burden is expected to further increase owing to the growth in numbers of newly diagnosed cases. By 2030, 22 million new cancer cases and 13 million cancer-related deaths are expected each year (Ferlay et al, 2015). Value of ACE2 in Pan-Cancer targeted therapy, and immunotherapy, cancer-related mortality remains unsatisfactory. It is important to seek other therapeutic targets for cancer diagnosis and treatment actively
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