Gender Disparity of EMT-related Gene Expression Affects Survival of Hepatocellular Carcinoma Patients

Cancer development and malignancy are caused by changes in expression levels of genes and proteins due to various factors, resulting in poor quality of life and shortened lives. Gender-induced differences such as hormones and activation of their receptors can also contribute to cancer development and malignancy in addition to external factors. To explore these correlations between gender and cancer malignancy, we investigated expression levels of epithelial-tomesenchymal transition (EMT)-related genes with gender disparity and their risks in relation to the overall survival of hepatocellular carcinoma patients using public databases including RNA sequencing data. Correlations between the expression of EMT-related gene selected in previously published literature and overall survival of male and female hepatocellular patients were statistically analyzed and shown as Kaplan-Meier survival curves using public databases from the Gene Expression Omnibus (GEO), the European Genome-phenome Archive (EPA), and The Cancer Genome Atlas (TCGA). Of genes analyzed, five transcription factors, two post-transcriptional regulators, and two post-translational regulators involved in EMT regulation showed different hazard ratios depending on gender in hepatocellular carcinoma patients. Taken together, these results demonstrate that the gender of hepatocellular patients might affect the regulation of EMT-related gene expression and cancer malignancy, leading to shortened overall survival.