Objective

The enzyme carboxyl ester lipase (CEL), known as bile salt-dependent lipase (BSDL) or bile salt-stimulated lipase (BSSL), is mainly expressed in pancreatic acinar cells and lactating mammary glands. To investigate the link between CEL expression of breast cancer (BC) tissues and the survival of BC patients by analyzing The Cancer Genome Atlas Breast Carcinoma (TCGA-BRCA) level 3 data.

Methods

The clinical information and RNA-sequencing (RNA-Seq) expression data were downloaded from TCGA. Patients were divided into a high CEL expression group and a low CEL expression group using the optimal cutoff value (5.611) identified from the ROC curve. Chi-square test and Fisher exact test were used to find the correlation between the expression of CEL and clinicopathologic features. To assess the diagnostic capability, the receiver operating characteristic (ROC) curve of CEL was drawn. The survival differences between high and low CEL expression groups were compared by Cox regression analysis. Log-rank test was applied to the calculation of p values and the comparison of the Kaplan–Meier curves. Furthermore, Gene Expression Omnibus (GEO) datasets were used for external data validation.

Results

Analysis of 1104 cases of tumor data showed that CEL was over-expressed in breast cancer. There were relationships between high CEL expression and clinicopathologic features. The high CEL expression group had a lower survival. By analyzing the area under the ROC curve (AUC) of CEL, it was found to have a limited diagnostic capability. CEL expression may be an independent prognostic factor for breast cancer survival through the multivariate analysis. The validation in GEO datasets also showed that CEL expression was higher in breast tumor tissues than in normal breast tissues. High CEL expression was associated with the poor overall survival of breast cancer.

Conclusions

High CEL expression may be an independent prognostic factor for the poor survival of breast cancer.

中文翻译：

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乳腺癌的新预后因素：羧基酯脂肪酶的高表达与不良生存有关。

目的

羧基酯脂肪酶（CEL）称为胆汁盐依赖性脂肪酶（BSDL）或胆盐刺激脂肪酶（BSSL），主要表达于胰腺腺泡细胞和泌乳的乳腺中。通过分析癌症基因组图谱乳腺癌（TCGA-BRCA）3级数据，研究乳腺癌（BC）组织的CEL表达与BC患者生存之间的联系。

方法

临床信息和RNA测序（RNA-Seq）表达数据从TCGA下载。使用从ROC曲线确定的最佳临界值（5.611）将患者分为高CEL表达组和低CEL表达组。卡方检验和Fisher精确检验用于发现CEL的表达与临床病理特征之间的相关性。为了评估诊断能力，绘制了CEL的接收器工作特性（ROC）曲线。通过Cox回归分析比较高和低CEL表达组之间的生存差异。对数秩检验用于p 值的计算和Kaplan–Meier曲线的比较。此外，基因表达综合（GEO）数据集用于外部数据验证。

结果

对1104例肿瘤数据的分析表明，CEL在乳腺癌中过表达。高CEL表达与临床病理特征之间存在关联。高CEL表达组的存活率较低。通过分析CEL的ROC曲线（AUC）下的面积，发现其诊断能力有限。通过多变量分析，CEL表达可能是乳腺癌生存的独立预后因素。在GEO数据集中的验证还表明，乳腺肿瘤组织中的CEL表达高于正常乳腺组织。高CEL表达与乳腺癌总体生存率低有关。

结论

高CEL表达可能是乳腺癌预后不良的独立预后因素。