Abstract
Cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC) is one of the most common tumors among females worldwide. RILPL2 was recently reported to be a promising biomarker for the treatment of breast cancer. This study aimed to investigate the potential role of RILPL2 in CESC. Totally 302 CESC patients' data were downloaded from The Cancer Genome Atlas database. All patients were divided into high or low RILPL2 groups according to the median expression of RILPL2. Subsequently, survival analysis, multivariate Cox regression, and experimental validation were performed on all CESC patient data. The Ualcan database was used to analyze the expression level and prognostic value of RILPL2 in pan-cancer. The Gene Set Cancer Analysis database was used for drug sensitivity analysis. Functional KEGG pathways were analyzed using gene set enrichment analysis. RILPL2 was generally down-regulated in a variety of tumors, and a high level of RILPL2 was associated with a better prognosis in CESC patients. Immunohistochemistry, western blotting, and qRT-PCR results showed that RILPL2 was significantly down-regulated in CESC cells and tissues. Besides, along with the increase of TNM Stage, the RILPL2 expression tended to decrease gradually. Patients with high RILPL2 expression showed lower resistance to small molecule drugs used in CESC progressions, such as Methotrexate, AZD7762, and Vinblastine, and a higher response rate to immunotherapy. Additionally, we identified 267 co-expressing genes of RILPL2, all of which jointly affected CESC progression through 15 complex pathways. Low RILPL2 expression was closely associated with the onset, progression, and poor prognosis of CESC. RILPL2 might be a promising optional biomarker for CESC patients' diagnosis and prognosis.