Abstract
INTRODUCTION: The most prevalent bone tumor with a relatively high level of aggressiveness and malignancy is osteosarcoma. The characteristics of the serpin family in osteosarcoma have not been defined. METHODS: In this study, the predictive significance of the serpin superfamily was investigated in the osteosarcoma and Gene Expression Omnibus (GEO) databases from The Cancer Genome Atlas (TCGA). RESULTS: It was discovered that SERPINH1 is a significant biological marker in osteosarcoma. According to the CCK-8, EdU, and Transwell assays as well as the IHC assay, SERPINH1 may promote osteosarcoma proliferation and migration. It is also more expressed in tumor samples than in healthy samples. SERPINH1 might forecast the effects of immunotherapy. Additionally, immune cells are interacted with through checkpoint, cytokine, and growth factor pathways in osteosarcomas with high SERPINH1 levels. The biological function, immunological characteristics, and treatment response (immunotherapy and chemotherapy responses) of patients with osteosarcoma were successfully predicted using a model related to SERPINH1. SERPINH1 and the SERPINH1-related score predict ferroptosis/pyroptosis/apoptosis/necroptosis in osteosarcoma. DISCUSSION: The SERPINH1-related score was an effective method for identifying osteosarcoma patients who would respond to immunotherapy and chemotherapy, as well as for predicting the survival outcomes of such patients.