CHST4 Gene as a Potential Predictor of Clinical Outcome in Malignant Pleural Mesothelioma

Malignant pleural mesothelioma (MPM) develops primarily from asbestos exposures and has a poor prognosis. In this study, The Cancer Genome Atlas was used to perform a comprehensive survival analysis, which identified the gene as a potential predictor of favorable overall survival for patients with MPM. An enrichment analysis of favorable prognostic genes, including , showed immune-related ontological terms, whereas an analysis of unfavorable prognostic genes indicated cell-cycle-related terms. mRNA expression in MPM was significantly correlated with Bindea immune-gene signatures. To validate the relationship between expression and prognosis, we performed an immunohistochemical analysis of protein expression in 23 surgical specimens from surgically treated patients with MPM who achieved macroscopic complete resection. The score calculated from the proportion and intensity staining was used to compare the intensity of gene expression, which showed that expression was stronger in patients with a better postoperative prognosis. The median overall postoperative survival was 107.8 months in the high-expression-score group and 38.0 months in the low-score group ( = 0.044, log-rank test). Survival after recurrence was also significantly improved by expression. These results suggest that is useful as a prognostic biomarker in MPM.