Abstract
OBJECTIVE: To analyze the expression of CREM in gastric cancer (GC) and its correlation with prognosis of the patients. METHODS: TCGA and GEO databases were used to analyze the expression levels of CREM mRNA in GC and adjacent tissues. Immunohistochemistry was used to examine the expression of CREM protein in 43 pairs of GC and adjacent tissues, and the correlation of CREM expression with clinicopathological features of the patients was analyzed. Kaplan-Meier survival analysis was used to explore the relationship between CREM expression and survival of GC patients. LinkedOmics database was used to annotate the GO function and KEGG pathway enrichment of CREM-related genes. RESULTS: Database analysis showed that CREM was highly expressed in GC tissues (P < 0.05) and positively correlated with poor prognosis in GC patients (P=0.01). Immunohistochemistry results showed significantly higher CREM expression in GC tissues than in paired adjacent tissues (P < 0.0001), and its expression level was correlated with T-stage and N-stage of the tumor (P < 0.05). The overall survival of GC patients with high expression of CREM was shorter (RR=4.02, P=0.0046). Gene enrichment analysis showed that high CREM expression promotes occurrence and progression of GC very likely through the cell adhesion signaling pathway. CONCLUSION: CREM is highly expressed in GC, and its high expression is associated with a poor prognosis of GC patients, suggesting the potential of CREM to serve as a prognostic indicator for GC.