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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">OL</journal-id>
<journal-title-group>
<journal-title>Oncology Letters</journal-title>
</journal-title-group>
<issn pub-type="ppub">1792-1074</issn>
<issn pub-type="epub">1792-1082</issn>
<publisher>
<publisher-name>D.A. Spandidos</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3892/ol.2020.11266</article-id>
<article-id pub-id-type="publisher-id">OL-0-0-11266</article-id>
<article-categories>
<subj-group>
<subject>Articles</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Biglycan as a potential diagnostic and prognostic biomarker in multiple human cancers</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author"><name><surname>Zhao</surname><given-names>Shou-Feng</given-names></name>
<xref rid="af1-ol-0-0-11266" ref-type="aff">1</xref></contrib>
<contrib contrib-type="author"><name><surname>Yin</surname><given-names>Xue-Jing</given-names></name>
<xref rid="af2-ol-0-0-11266" ref-type="aff">2</xref></contrib>
<contrib contrib-type="author"><name><surname>Zhao</surname><given-names>Wen-Ju</given-names></name>
<xref rid="af3-ol-0-0-11266" ref-type="aff">3</xref></contrib>
<contrib contrib-type="author"><name><surname>Liu</surname><given-names>Le-Cui</given-names></name>
<xref rid="af4-ol-0-0-11266" ref-type="aff">4</xref></contrib>
<contrib contrib-type="author"><name><surname>Wang</surname><given-names>Zhi-Peng</given-names></name>
<xref rid="af5-ol-0-0-11266" ref-type="aff">5</xref>
<xref rid="c1-ol-0-0-11266" ref-type="corresp"/></contrib>
</contrib-group>
<aff id="af1-ol-0-0-11266"><label>1</label>Central Laboratories, Qingdao Municipal Hospital, Qingdao, Shandong 266000, P.R. China</aff>
<aff id="af2-ol-0-0-11266"><label>2</label>Department of Pharmacy, Qingdao Mental Health Centre, Qingdao, Shandong 266235, P.R. China</aff>
<aff id="af3-ol-0-0-11266"><label>3</label>Operating Room, Qingdao Jinhua Gynecology Hospital, Qingdao, Shandong 266235, P.R. China</aff>
<aff id="af4-ol-0-0-11266"><label>4</label>Neonatal Department, Wulian County People&#x0027;s Hospital, Wulian, Shandong 262300, P.R. China</aff>
<aff id="af5-ol-0-0-11266"><label>5</label>Marine Science and Engineering College, Qingdao Agricultural University, Qingdao, Shandong 266109, P.R. China</aff>
<author-notes>
<corresp id="c1-ol-0-0-11266"><italic>Correspondence to</italic>: Dr Zhi-Peng Wang, Marine Science and Engineering College, Qingdao Agricultural University, 17 Wenhai Road, Jimo, Qingdao, Shandong 266109, P.R. China, E-mail: <email>wangzp@ysfri.ac.cn</email></corresp>
</author-notes>
<pub-date pub-type="ppub">
<month>03</month>
<year>2020</year></pub-date>
<pub-date pub-type="epub">
<day>08</day>
<month>01</month>
<year>2020</year></pub-date>
<volume>19</volume>
<issue>3</issue>
<fpage>1673</fpage>
<lpage>1682</lpage>
<history>
<date date-type="received"><day>16</day><month>02</month><year>2019</year></date>
<date date-type="accepted"><day>16</day><month>08</month><year>2019</year></date>
</history>
<permissions>
<copyright-statement>Copyright: &#x00A9; Zhao et al.</copyright-statement>
<copyright-year>2020</copyright-year>
<license license-type="open-access">
<license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by-nc-nd/4.0/">Creative Commons Attribution-NonCommercial-NoDerivs License</ext-link>, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.</license-p></license>
</permissions>
<abstract>
<p>Biglycan (BGN), a key member of the small leucine-rich proteoglycan family, is an important component of the extracellular matrix. Clinical studies have demonstrated that upregulation of BGN is associated with poor prognosis in patients with various types of solid cancer. The present study analyzed the mRNA expression levels of BGN in various types of solid cancer when compared with that in normal tissues via the Oncomine database. The UALCAN, OncoLnc and Kaplan-Meier Plotter databases were additionally used to evaluate the prognostic values of BGN in patients with solid cancer and co-expression gene analysis was conducted using the protein-protein interaction networks of BGN. The present study observed that the mRNA expression levels of BGN were increased in bladder, brain and central nervous system, breast, colorectal, esophageal, gastric, head and neck, lung, ovarian and 28 subtypes of cancer compared with normal tissues. The increased expression of BGN was identified to be associated with a poor outcome in ovarian and gastric cancer. Based on the co-expression network, BGN was identified as the key gene in a 43-gene network. The present findings of increased expression of BGN in solid tumors and its positive association with poor outcome on patient survival indicate that BGN may serve as a prognostic marker and as a target for novel therapeutics for multiple types of cancer.</p>
</abstract>
<kwd-group>
<kwd>biglycan</kwd>
<kwd>biomarker</kwd>
<kwd>cancer</kwd>
</kwd-group>
</article-meta>
</front>
<body>
<sec sec-type="intro">
<title>Introduction</title>
<p>Cancer is considered as one of the four major non-communicable diseases (<xref rid="b1-ol-0-0-11266" ref-type="bibr">1</xref>). Due to a delay in diagnosis, its poor prognosis and high recurrence rate, cancer is becoming one of the leading causes of mortality worldwide (<xref rid="b2-ol-0-0-11266" ref-type="bibr">2</xref>,<xref rid="b3-ol-0-0-11266" ref-type="bibr">3</xref>). Cancer incidence and mortality rates have increased over the last decade. The global cancer burden is estimated to have risen to 18.1 million new cancer cases, and 9.6 million cancer-associated mortalities were reported in 2018 (<xref rid="b4-ol-0-0-11266" ref-type="bibr">4</xref>), compared with 12.7 million and 7.6 million, respectively, in 2008 (<xref rid="b5-ol-0-0-11266" ref-type="bibr">5</xref>). Therefore, there is an urgent need to explore novel potential cancer biomarkers that will have beneficial prognostic and therapeutic implications.</p>
<p>Biglycan (BGN; also known as proteoglycan-1 and dermatan sulfate PG-1) is a single-copy gene localized on the long arm of human X chromosome Xq13-qter (<xref rid="b6-ol-0-0-11266" ref-type="bibr">6</xref>). This gene contains at least two introns and it spans ~6 kb in length (<xref rid="b7-ol-0-0-11266" ref-type="bibr">7</xref>). BGN is a key member of the small leucine-rich proteoglycan family that resides at the cell surface or in the pericellular space of tissues (<xref rid="b8-ol-0-0-11266" ref-type="bibr">8</xref>). BGN is typically expressed in the nerve, bone, cartilage, skin and muscles, modulating the morphology, growth, adhesion, bone mineralization, inflammation, migration and differentiation of epithelial cells (<xref rid="b9-ol-0-0-11266" ref-type="bibr">9</xref>). The upregulation of BGN has been reported in multiple types of solid cancer, including ovarian carcinoma (<xref rid="b10-ol-0-0-11266" ref-type="bibr">10</xref>), prostate cancer (<xref rid="b11-ol-0-0-11266" ref-type="bibr">11</xref>), pancreatic cancer (<xref rid="b12-ol-0-0-11266" ref-type="bibr">12</xref>), gastric cancer (<xref rid="b13-ol-0-0-11266" ref-type="bibr">13</xref>) and colon cancer (<xref rid="b14-ol-0-0-11266" ref-type="bibr">14</xref>). Overexpressed BGN has been reported to be associated with the aggressive growth and metastasis of tumors (<xref rid="b13-ol-0-0-11266" ref-type="bibr">13</xref>,<xref rid="b14-ol-0-0-11266" ref-type="bibr">14</xref>), and with a worse prognosis for patients with gastric cancer (<xref rid="b15-ol-0-0-11266" ref-type="bibr">15</xref>) and pancreatic adenocarcinoma (<xref rid="b16-ol-0-0-11266" ref-type="bibr">16</xref>). These findings suggest that the <italic>BGN</italic> gene may act as either a potential therapeutic target or prognostic biomarker in multiple types of cancer. However, the transcriptional expression and prognostic value of the <italic>BGN</italic> gene in human cancers requires further investigation.</p>
<p>The present study investigated the mRNA expression levels of BGN in human normal and cancer tissues, using the Oncomine database. In addition, the prognostic value of BGN mRNA expression in patients with cancer was also assessed using the UALCAN, OncoLnc and the Kaplan-Meier Plotter databases. Finally, co-expression gene analysis was conducted using the protein-protein interaction (PPI) networks of BGN.</p>
</sec>
<sec sec-type="materials|methods">
<title>Materials and methods</title>
<sec>
<title/>
<sec>
<title>Analysis of BGN expression in multiple cancers using Oncomine</title>
<p>Oncomine is a cancer microarray database and web-based data-mining platform aimed at facilitating discovery from genome-wide expression analyses, as well as comparing the transcriptome data in multiple types of cancer, respective to normal tissues (<xref rid="b17-ol-0-0-11266" ref-type="bibr">17</xref>). To date, the Oncomine database contains 19 cancer types, 715 datasets and 86,733 samples, corresponding to ~48 million gene expression measurements. Differential mRNA level analyses of BGN were compared between normal tissues and malignant human tissues in different types of cancer, using the Oncomine database. In the present study, the thresholds were set at 2-fold change, P&#x003C;1&#x00D7;10<sup>&#x2212;4</sup> and the top 10&#x0025; gene rank.</p>
</sec>
<sec>
<title>Analysis using the Kaplan-Meier (KM) plotter, UALCAN and OncoLnc databases</title>
<p>The prognostic significance of the mRNA expression levels of BGN in various types of cancer was evaluated using KM plotter (<uri xlink:href="http://www.kmplot.com">http://www.kmplot.com</uri>), UALCAN (<uri xlink:href="http://ualcan.path.uab.edu">http://ualcan.path.uab.edu</uri>) and OncoLnc (<uri xlink:href="http://oncolnc.org">http://oncolnc.org</uri>). These online databases can be used to assess the effect of gene expression on cancer prognosis. The three databases of KM plotter, OncoLnc and UALCAN contain the same RNA-seq data (from TCGA) for 20 <uri xlink:href="http://www.kmplot.com/analysis/index.php?p=service&#x0026;cancer=pancancer_rnaseq">http://www.kmplot.com/analysis/index.php?p=service&#x0026;cancer=pancancer_rnaseq</uri>, 21 (<xref rid="b18-ol-0-0-11266" ref-type="bibr">18</xref>) and 35 (<xref rid="b19-ol-0-0-11266" ref-type="bibr">19</xref>) types and subtypes of cancer, respectively. KM plotter also contain the gene chip data [from GEO (breast cancer: GSE12276, GSE16391, GSE12093, GSE11121, GSE9195, GSE7390, GSE6532, GSE5327, GSE4922, GSE3494, GSE2990, GSE2034, GSE1456; ovarian cancer: GSE14764, GSE15622, GSE19829, GSE3149, GSE9891, GSE18520, GSE26712; lung cancer: GSE4573, GSE14814, GSE8894, GSE19188, GSE3141, GSE31210, GSE29013, GSE37745; gastric cancer: GSE44740, GSE51725, GSE13911, GSE43346, and GSE3526)] (<xref rid="b20-ol-0-0-11266" ref-type="bibr">20</xref>&#x2013;<xref rid="b23-ol-0-0-11266" ref-type="bibr">23</xref>) for breast cancer (BC), lung cancer (LC), gastric cancer (GC) and ovarian cancer (OC). Therefore, the prognostic significance of the mRNA expression levels of BGN in various types of carcinomas, including BC, LC, GC and OC was evaluated using RNA-seq data and confirmed by gene chip data. The overall survival rate (OS) in patients with other types and subtypes of carcinomas was estimated using RNA-seq by KM plotter, OncoLnc or UALCAN databases.</p>
<p>The KM plotter is able to assess the effect of 54,675 genes on survival using 10,461 cancer samples. In this database, the types and subtypes of cancer samples were observed from RNA-sequencing (RNA-seq) data while the lung (<xref rid="b22-ol-0-0-11266" ref-type="bibr">22</xref>), ovarian (<xref rid="b21-ol-0-0-11266" ref-type="bibr">21</xref>), gastric (<xref rid="b23-ol-0-0-11266" ref-type="bibr">23</xref>), and breast (<xref rid="b20-ol-0-0-11266" ref-type="bibr">20</xref>) cancer samples were also analyzed from gene chip microarrays.</p>
<p>Patient samples were divided into two cohorts according to the median expression of the <italic>BGN</italic> gene (high vs. low expression). The present study analyzed the overall survival (OS) in patients using a Kaplan-Meier survival plot. Briefly, the <italic>BGN</italic> gene was uploaded into the respective databases to obtain the Kaplan-Meier survival plots, in which the number-at-risk was presented below the main plot. Affymetrix ID (or RNA-seq ID), log rank P-value and hazard ratio (HR) with 95&#x0025; confidence intervals were calculated and displayed on the webpage. P&#x003C;0.05 was considered to indicate a statistically significant difference.</p>
<p>UALCAN, is an interactive web resource for analyzing cancer transcriptome data, built on PERL-common gateway interface with high quality graphics using JavaScript and Cascading Style Sheets. UALCAN was used to construct an algorithm based on The Cancer Genome Atlas (TCGA) level 3 RNA-seq database (<uri xlink:href="https://portal.gdc.cancer.gov/">https://portal.gdc.cancer.gov/</uri>). UALCAN can provide publication quality graphs and plots depicting gene expressions and patient survival information based on gene expression (<xref rid="b19-ol-0-0-11266" ref-type="bibr">19</xref>). P&#x003C;0.05 was considered to indicate a statistically significant difference.</p>
<p>OncoLnc is a tool for interactively exploring survival correlations. OncoLnc contains survival data for 8,647 patients from 21 cancer studies performed by TCGA, along with RNA-seq expression for mRNAs and microRNAs from TCGA and long non-coding RNA expressions from MiTranscriptome (&#x03B2; release) (<uri xlink:href="http://www.mitranscriptome.com/">http://www.mitranscriptome.com/</uri>). OncoLnc stores precomputed survival analyses, allowing users to quickly explore survival correlations for up to 21 types of cancer in a single click (<xref rid="b18-ol-0-0-11266" ref-type="bibr">18</xref>). The <italic>BGN</italic> gene was uploaded into the database to obtain the patient survival information. P&#x003C;0.05 was considered to indicate a statistically significant difference.</p>
</sec>
<sec>
<title>Co-expression and PPI network construction</title>
<p>The present study extracted the top 50 co-expressed genes that have similar expression pattern with <italic>BGN</italic> gene, based on Pearson correlation score across all tumor samples from the GEPIA database (<uri xlink:href="http://gepia.cancerpku.cn/index.html">http://gepia.cancerpku.cn/index.html</uri>). Then, the 11.0 Search Tool for the Retrieval of Interacting Genes/Proteins database (<uri xlink:href="http://string-db.org/">http://string-db.org/</uri>), was used to construct a PPI network with these co-expressed genes (<xref rid="b24-ol-0-0-11266" ref-type="bibr">24</xref>). The PPI pairs were extracted with a combined score of 0.4. Subsequently, the PPI network was visualized using the Cytoscape 3.7.0 software (<uri xlink:href="http://www.cytoscape.org/">http://www.cytoscape.org/</uri>).</p>
</sec>
</sec>
</sec>
<sec sec-type="results">
<title>Results</title>
<sec>
<title/>
<sec>
<title>Increased expression of BGN in multiple types of solid cancer</title>
<p>As illustrated in <xref rid="f1-ol-0-0-11266" ref-type="fig">Fig. 1</xref>, Oncomine contained a total of 421 research studies for the <italic>BGN</italic> gene. In 78 analyses, <italic>BGN</italic> exhibited statistically significant differences, 5 of which revealed lower mRNA expression levels in solid tumors compared with normal tissues, while 73 analyses indicated the opposite result (<xref rid="f1-ol-0-0-11266" ref-type="fig">Fig. 1</xref>). <italic>BGN</italic> gene expression was the most upregulated in bladder, brain and central nervous system (CNS), breast, colorectal, gastric, head and neck, pancreatic cancer and other cancer, followed by esophageal, kidney, liver, ovarian cancer, and lung cancer (<xref rid="f1-ol-0-0-11266" ref-type="fig">Fig. 1</xref>). Results in the investigation of <italic>BGN</italic> gene expression have been inconsistent in a number of studies (<xref rid="b25-ol-0-0-11266" ref-type="bibr">25</xref>&#x2013;<xref rid="b33-ol-0-0-11266" ref-type="bibr">33</xref>), including kidney, liver, pancreatic, and prostate cancer. The expression levels of BGN in cervical cancer and melanoma were not significantly changed (<xref rid="f1-ol-0-0-11266" ref-type="fig">Fig. 1</xref>). The <italic>BGN</italic> gene expression status in lymphoma, leukemia, sarcoma and myeloma was not analyzed in this study as they are not classified as solid cancers (<xref rid="b34-ol-0-0-11266" ref-type="bibr">34</xref>).</p>
<p>Solid cancers, in which BGN was reported to be upregulated consistently in different studies, were examined further in the various cancer subtypes using the Oncomine datasets. The data summarized in <xref rid="tI-ol-0-0-11266" ref-type="table">Table I</xref> revealed that there was a significant increase in expression of BGN in BLC, including subtype of IBLCA) (n=53), when compared with that in normal tissues (n=3) in the study by Blaveri <italic>et al</italic> (<xref rid="b35-ol-0-0-11266" ref-type="bibr">35</xref>). The BGN mRNA expression was significantly elevated in brain and CNS cancer, including subtype of GBM (n=130) when compared with normal tissues (n=30) in the study conducted by Bredel <italic>et al</italic> (<xref rid="b36-ol-0-0-11266" ref-type="bibr">36</xref>). The mRNA expression of BGN was significantly elevated in BC, including subtypes BRCA, DBC, DCIS, IDBC, IDBCs, IDC, IDC-L, ILBC, ILC, LBC, MBC and TBC (n=2,540) compared with that in normal tissues (n=240), which was performed by Ma <italic>et al</italic> (<xref rid="b37-ol-0-0-11266" ref-type="bibr">37</xref>), Curtis <italic>et al</italic> (<xref rid="b38-ol-0-0-11266" ref-type="bibr">38</xref>), Karnoub <italic>et al</italic> (<xref rid="b39-ol-0-0-11266" ref-type="bibr">39</xref>), Perou <italic>et al</italic> (<xref rid="b40-ol-0-0-11266" ref-type="bibr">40</xref>), Zhao <italic>et al</italic> (<xref rid="b41-ol-0-0-11266" ref-type="bibr">41</xref>) and TCGA studies (<xref rid="b42-ol-0-0-11266" ref-type="bibr">42</xref>,<xref rid="b43-ol-0-0-11266" ref-type="bibr">43</xref>) The mRNA expression of BGN was also significantly upregulated in CC, including subtypes COAD, CMA, RSA, CeAC and READ (n=463), when compared with that in normal tissues (n=150), which was reported in the studies conducted by Kaiser <italic>et al</italic> (<xref rid="b44-ol-0-0-11266" ref-type="bibr">44</xref>), Skrzypczak <italic>et al</italic> (<xref rid="b45-ol-0-0-11266" ref-type="bibr">45</xref>), Graudens <italic>et al</italic> (<xref rid="b46-ol-0-0-11266" ref-type="bibr">46</xref>), TCGA (<xref rid="b47-ol-0-0-11266" ref-type="bibr">47</xref>), Gaedcke <italic>et al</italic> (<xref rid="b48-ol-0-0-11266" ref-type="bibr">48</xref>), and Hong <italic>et al</italic> (<xref rid="b49-ol-0-0-11266" ref-type="bibr">49</xref>). BGN mRNA expression was also significantly upregulated in EC, including subtype ESCC (n=84), when compared with that in normal tissues (n=80), which was reported in the studies of Su <italic>et al</italic> (<xref rid="b50-ol-0-0-11266" ref-type="bibr">50</xref>), Hu <italic>et al</italic> (<xref rid="b51-ol-0-0-11266" ref-type="bibr">51</xref>) and Hao <italic>et al</italic> (<xref rid="b52-ol-0-0-11266" ref-type="bibr">52</xref>). BGN mRNA expression was also significantly higher in GC, including subtypes ITGA, DGAC and GMA (n=265), when compared with that in normal tissues (n=171), as reported by Chen <italic>et al</italic> (<xref rid="b53-ol-0-0-11266" ref-type="bibr">53</xref>), Cho <italic>et al</italic> (<xref rid="b54-ol-0-0-11266" ref-type="bibr">54</xref>), Wang <italic>et al</italic> (<xref rid="b55-ol-0-0-11266" ref-type="bibr">55</xref>), D&#x0027;Errico <italic>et al</italic> (<xref rid="b56-ol-0-0-11266" ref-type="bibr">56</xref>) and Cui <italic>et al</italic> (<xref rid="b57-ol-0-0-11266" ref-type="bibr">57</xref>). The mRNA expression of BGN was also significantly increased in HNC, including subtype SGACC (n=16) compared with that in normal tissues (n=6) in the study by Frierson <italic>et al</italic> (<xref rid="b58-ol-0-0-11266" ref-type="bibr">58</xref>). The mRNA expression of BGN was significantly higher in LC, including subtype SCC (n=34) compared with that in normal tissues (n=28) in the study by Talbot <italic>et al</italic> (<xref rid="b59-ol-0-0-11266" ref-type="bibr">59</xref>). The mRNA expression of BGN was increased significantly in OC, including subtypes SSPC and OSC (n=799) compared with that in normal tissues (n=22), as reported by Welsh <italic>et al</italic> (<xref rid="b60-ol-0-0-11266" ref-type="bibr">60</xref>), and Bonome <italic>et al</italic> (<xref rid="b61-ol-0-0-11266" ref-type="bibr">61</xref>), and studies listed in TCGA (<xref rid="b62-ol-0-0-11266" ref-type="bibr">62</xref>). The mRNA expression of BGN was increased significantly in other types of cancer, including subtype SBCC (n=15) compared with that in normal tissues (n=4), as reported by Riker <italic>et al</italic> (<xref rid="b63-ol-0-0-11266" ref-type="bibr">63</xref>). Therefore, the expression of BGN was significantly increased in human solid cancers, including 10 types and 28 subtypes of carcinoma. These results indicate that the mRNA expression of BGN is elevated in a wide range of tumors, when compared with that in normal tissues.</p>
</sec>
<sec>
<title>High BGN expression and survival outcome in multiple types of solid cancer</title>
<p>The expression of BGN was significantly increased in certain types of human solid cancers, including bladder, brain and CNS, breast, colorectal, gastric, head and neck, esophageal, ovarian, lung and other cancers, however there was no data on the downregulation of the BGN from the database (<xref rid="tI-ol-0-0-11266" ref-type="table">Table I</xref>). The present study used the Kaplan-Meier Plotter, OncoLnc and UALCAN databases to identify the association between survival time and the mRNA levels of BGN in patients with different types and subtypes of solid cancer.</p>
<p>As shown in <xref rid="tII-ol-0-0-11266" ref-type="table">Table II</xref>, <italic>BGN</italic> gene with a significant association with patient survival can be identified in GC and OC (P&#x003C;0.05). There is no significant association of BGN upregulation with patient survival in BC, EC (P&#x003E;0.05), IBC, READ, COAD, and ESCC (P&#x003E;0.05). The survival rate of patients with LC with P&#x003E;0.05 in RNA-seq and P&#x003C;0.05 in microarray analysis requires further investigation. Therefore, high BGN mRNA expression may potentially be associated with the prognosis in patients with BLC, LSCC, and OSC, as the present analyses provided RNA-seq analysis results (P&#x003C;0.05) without microarray analysis confirmation (<xref rid="tII-ol-0-0-11266" ref-type="table">Table II</xref>). The association between BGN mRNA expression and prognosis in patients with other types of cancer and subtypes of cancer requires further investigation as there is no prognostic data in the KM plotter, OncoLnc and UALCAN database (<xref rid="tIII-ol-0-0-11266" ref-type="table">Table III</xref>).</p>
<p>As presented in <xref rid="f2-ol-0-0-11266" ref-type="fig">Fig. 2</xref>, high expression of BGN was significantly associated with shorter OS time in patients with GC [HR=1.9 (1.56&#x2013;2.32), P=1.3&#x00D7;10<sup>&#x2212;10</sup> in microarry analysis; HR=1.59 (1.13&#x2013;2.24), P=6.8&#x00D7;10<sup>&#x2212;3</sup> in RNA-seq analysis] and OC [HR=1.28 (1.11&#x2013;1.47), P=4.4&#x00D7;10<sup>&#x2212;4</sup> in microarry analysis; HR=1.45 (1.09&#x2013;1.93), P=9.3&#x00D7;10<sup>&#x2212;3</sup> in RNA-seq analysis].</p>
<p>In summary, high BGN mRNA expression in gastric cancer and ovarian cancer was significantly associated with poor overall survival. High BGN mRNA expression was indicated to be associated with poor clinical outcome in the prognosis of patients with bladder cancer, lung squamous cell carcinoma, and ovarian serous cystadenocarcinoma. However, the association between BGN mRNA upregulation and prognosis in patients with other types and subtypes of cancer requires further examination.</p>
</sec>
<sec>
<title>PPI network construction</title>
<p>The GEPIA database was used to download the top 50 co-expressed genes, then the PPI was generated (<xref rid="f3-ol-0-0-11266" ref-type="fig">Fig. 3</xref>). In the network, BGN directly interacted with 42 neighboring genes, including <italic>ANTXR1, AEBP1, CDH11, CTHRC1, EFEMP2, FAP, LEPRE1, LRRC15, LUM, MMP14, MRC2, MXRA5, OLFML2B, PCOLCE, PDGFRB, PXDN, SERPINH1, SFRP2, SPARC, SULF1, TGF&#x03B2;3, THBS2, THY1</italic>, genes of the disintegrin and metalloproteinase gene family, collagen family genes, the integrin subunit gene family and lastly the lysyl oxidase-like gene family, which jointly regulate the occurrence and development of human tumors. Jointly genes with similar expression patterns are likely to have related functions (<xref rid="b64-ol-0-0-11266" ref-type="bibr">64</xref>). For example, enrichment indicates that <italic>BGN</italic>-coexpressed genes are at least partially biologically connected in developing multiple cancers (<xref rid="b65-ol-0-0-11266" ref-type="bibr">65</xref>). The basic interaction between the neighboring genes is the &#x2018;functional association&#x2019;. The two proteins that both contribute jointly to a specific biological function can interact specifically without touching at all, such as when a transcription factor helps to regulate the expression and production of another protein, or when two enzymes exchange a specific substrate via diffusion. The exact molecular mechanisms in cancer associated with BGN remain unclear (<xref rid="b66-ol-0-0-11266" ref-type="bibr">66</xref>). BGN upregulation has been implicated in the inflammatory response triggered by transforming growth factor &#x03B2; (TGF-&#x03B2;) (<xref rid="b8-ol-0-0-11266" ref-type="bibr">8</xref>,<xref rid="b67-ol-0-0-11266" ref-type="bibr">67</xref>,<xref rid="b68-ol-0-0-11266" ref-type="bibr">68</xref>). In the PPI network, TGF-&#x03B2;3 may play an important role to regulate the expression of BGN, however, the influence of TGF-&#x03B2;3 needs to be further investigated.</p>
</sec>
</sec>
</sec>
<sec sec-type="discussion">
<title>Discussion</title>
<p>In the present study, the mRNA expression levels of BGN were systematically analyzed, and the results indicated that BGN was upregulated in various types of cancerous tissues, when compared with that in normal tissues. Previous studies have demonstrated that significantly increased levels of BGN are frequently detected in the clinical samples of patients with gastric (<xref rid="b13-ol-0-0-11266" ref-type="bibr">13</xref>), breast (<xref rid="b69-ol-0-0-11266" ref-type="bibr">69</xref>), colorectal (<xref rid="b70-ol-0-0-11266" ref-type="bibr">70</xref>), lung (<xref rid="b71-ol-0-0-11266" ref-type="bibr">71</xref>), ovarian (<xref rid="b10-ol-0-0-11266" ref-type="bibr">10</xref>) and pancreatic cancer (<xref rid="b16-ol-0-0-11266" ref-type="bibr">16</xref>). In addition, high expression of BGN in patients with solid cancer is significantly associated with poor outcome (<xref rid="b15-ol-0-0-11266" ref-type="bibr">15</xref>). Solid cancer include BLC, brain and CNS cancer, BC, cervical cancer, CC, EC, GC, HNC, kidney cancer, liver cancer, LC, melanoma, OC, pancreatic cancer, prostate cancer (<xref rid="b72-ol-0-0-11266" ref-type="bibr">72</xref>). Consistent with these studies, the present analyses demonstrated that BGN expression levels were increased in the majority of cancers, such as bladder, brain and central nervous system, breast, colorectal, esophageal, gastric, head and neck, lung, ovarian, and 28 subtype cancers, when compared with that in normal tissues. In addition, the current prognosis analyses revealed that high tissue BGN expression predicts worse survival in GC and OC. High BGN mRNA expression was associated with poor overall survival in patients with BLC, LSCC, and OSC. Therefore, BGN may be employed as either a novel prognostic biomarker or as a promising therapeutic target for human carcinomas, which is consistent with the findings of previous reports (<xref rid="b15-ol-0-0-11266" ref-type="bibr">15</xref>,<xref rid="b73-ol-0-0-11266" ref-type="bibr">73</xref>). The 43 genes with similar expression patterns are likely to have related functions in the aggressive growth and metastasis of cancers (<xref rid="b64-ol-0-0-11266" ref-type="bibr">64</xref>). In the PPI network, the genes of <italic>AEBP1, MMP14, OLFML2B, PDGFRB, SERPINE1, SPARC, SFRP2, COL1A2, COL6A3, THBS2, COL5A2, COL11A1, FAP, MXRA5</italic> and <italic>THY1</italic> were upregulated in solid cancer tissues, and significantly associated with the overall survival of patients with cancer (<xref rid="b74-ol-0-0-11266" ref-type="bibr">74</xref>&#x2013;<xref rid="b82-ol-0-0-11266" ref-type="bibr">82</xref>). Some genes in the PPI network, including <italic>AEBP1, OLFML2B, PDGFRB, SERPINE1, COL1A2, COL6A3</italic>, and <italic>THBS2</italic> have been reported to be associated with metastasis, invasion and migration in cancer cells (<xref rid="b74-ol-0-0-11266" ref-type="bibr">74</xref>,<xref rid="b76-ol-0-0-11266" ref-type="bibr">76</xref>,<xref rid="b80-ol-0-0-11266" ref-type="bibr">80</xref>,<xref rid="b83-ol-0-0-11266" ref-type="bibr">83</xref>,<xref rid="b84-ol-0-0-11266" ref-type="bibr">84</xref>). The enrichment of BGN-coexpressed genes indicates that the proteins are at least partially biologically connected as a group (<xref rid="b64-ol-0-0-11266" ref-type="bibr">64</xref>). However, a detailed understanding of the mechanism associated with the function of BGN is currently lacking; therefore, further functional studies are warranted in the future. In addition, the BGN protein expression levels or the signaling pathways potentially involved require further investigation. Finally, studies utilizing larger cohorts, specific cancers, or larger prospective studies also need to be conducted in order to validate the prognostic values of BGN.</p>
<p>In summary, the present study comprehensively analyzed the mRNA expression levels and prognostic value of BGN in the most common types of cancer, and the results indicated that BGN exhibited significantly high expression levels in cancer tissues compared with normal tissues in multiple types of cancer. The present findings indicated that BGN may serve as a promising prognostic biomarker and therapeutic target for patients with BLCA and STAD.</p>
</sec>
</body>
<back>
<ack>
<title>Acknowledgements</title>
<p>Not applicable.</p>
</ack>
<sec>
<title>Funding</title>
<p>No funding was received.</p>
</sec>
<sec>
<title>Availability of data and materials</title>
<p>The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.</p>
</sec>
<sec>
<title>Authors&#x0027; contributions</title>
<p>SFZ conceived and designed the study. XJY, WJZ, LCL and ZPW made substantial contributions to the design of the current study, acquisition of data, interpretation of data and revising the manuscript. All authors read and approved the final manuscript.</p>
</sec>
<sec>
<title>Ethics approval and consent to participate</title>
<p>Not applicable.</p>
</sec>
<sec>
<title>Patient consent for publication</title>
<p>Not applicable.</p>
</sec>
<sec>
<title>Competing interests</title>
<p>The authors declare that they have no competing interests.</p>
</sec>
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</back>
<floats-group>
<fig id="f1-ol-0-0-11266" position="float">
<label>Figure 1.</label>
<caption><p>mRNA expression levels of BGN in different types of cancer from the Oncomine database. The schematic reveals the numbers of datasets with statistically significant mRNA overexpression (red) or underexpression (blue) of the target gene. Darker red indicates higher <italic>BGN</italic> expression, Darker blue indicates lower <italic>BGN</italic> expression. The color is determined by the best gene rank percentile for the analyses within the cell. The number in each cell represents the number of analyses that met the thresholds of: Gene, BGN; analysis type, cancer vs. normal; and data type, mRNA. The thresholds were set at 2-fold change, P&#x003C;1&#x00D7;10<sup>&#x2212;4</sup> and the top 10&#x0025; gene rank. For cervical cancer, melanoma, myeloma and prostate cancer, there was no analysis (white cell) that met the aforementioned thresholds. The gene rank was analyzed using the percentile of target gene in the top of all genes measured in each analysis. BGN, biglycan; CNS, central nervous system.</p></caption>
<graphic xlink:href="ol-19-03-1673-g00.tif"/>
</fig>
<fig id="f2-ol-0-0-11266" position="float">
<label>Figure 2.</label>
<caption><p>OS curves of patients with different types of cancer divided by BGN expression. High expression levels of the <italic>BGN</italic> gene exhibited a significant association with lower OS time in patients with (A) gastric cancer (gene chip data), (B) gastric cancer (RNA-seq data), (C) ovarian cancer (gene chip data), (D) ovarian cancer (RNA-seq data). The plots were generated using the KM plotter database. The red lines indicate patients with <italic>BGN</italic> gene expression above the median value, and the black lines indicate patients with <italic>BGN</italic> gene expression below the median value. OS, overall survival; <italic>BGN</italic>, biglycan; HR, hazard ratio.</p></caption>
<graphic xlink:href="ol-19-03-1673-g01.tif"/>
</fig>
<fig id="f3-ol-0-0-11266" position="float">
<label>Figure 3.</label>
<caption><p>PPI network for BGN and its potential interacting proteins. Genes that were co-expressed in cancer together with BGN were extracted from the GEPIA database, and then a PPI network was established using the STRING database and visualized using the Cytoscape software. TGF&#x03B2;3 was highlighted in yellow because it may play an important role to regulate the expression of BGN. PPI, protein-protein interactions; BGN, biglycan; TGF&#x03B2;3, transforming growth factor &#x03B2;3.</p></caption>
<graphic xlink:href="ol-19-03-1673-g02.tif"/>
</fig>
<table-wrap id="tI-ol-0-0-11266" position="float">
<label>Table I.</label>
<caption><p>Significant changes of biglycan mRNA expression between different subtypes of bladder, brain and CNS, breast, colorectal, esophageal, gastric, head and neck, lung, ovarian, other types of cancer and 28 subtypes cancer.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="bottom">Type of cancer</th>
<th align="center" valign="bottom">Cancer Subtype (n)</th>
<th align="center" valign="bottom">Normal, n</th>
<th align="center" valign="bottom">Fold change</th>
<th align="center" valign="bottom">t-test</th>
<th align="center" valign="bottom">P-value</th>
<th align="center" valign="bottom">Rank, &#x0025;</th>
<th align="center" valign="bottom">(Refs.)</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top">Bladder</td>
<td align="left" valign="top">Infiltrating Bladder Urothelial Carcinoma (IBLCA) (<xref rid="b53-ol-0-0-11266" ref-type="bibr">53</xref>)</td>
<td align="center" valign="top">3</td>
<td align="center" valign="top">2.391</td>
<td align="center" valign="top">6.799</td>
<td align="center" valign="top">7.02&#x00D7;10<sup>&#x2212;7</sup></td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">(<xref rid="b35-ol-0-0-11266" ref-type="bibr">35</xref>)</td>
</tr>
<tr>
<td align="left" valign="top">Brain and CNS</td>
<td align="left" valign="top">Glioblastoma (GBM) (<xref rid="b27-ol-0-0-11266" ref-type="bibr">27</xref>)</td>
<td align="center" valign="top">4</td>
<td align="center" valign="top">3.055</td>
<td align="center" valign="top">13.066</td>
<td align="center" valign="top">6.77&#x00D7;10<sup>&#x2212;14</sup></td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">(<xref rid="b36-ol-0-0-11266" ref-type="bibr">36</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Glioblastoma (GBM) (<xref rid="b22-ol-0-0-11266" ref-type="bibr">22</xref>)</td>
<td align="center" valign="top">3</td>
<td align="center" valign="top">13.32</td>
<td align="center" valign="top">7.773</td>
<td align="center" valign="top">4.92&#x00D7;10<sup>&#x2212;5</sup></td>
<td align="center" valign="top">4</td>
<td/>
</tr>
<tr>
<td/>
<td align="left" valign="top">Glioblastoma (GBM) (<xref rid="b81-ol-0-0-11266" ref-type="bibr">81</xref>)</td>
<td align="center" valign="top">23</td>
<td align="center" valign="top">2.163</td>
<td align="center" valign="top">7.599</td>
<td align="center" valign="top">7.14&#x00D7;10<sup>&#x2212;11</sup></td>
<td align="center" valign="top">7</td>
<td/>
</tr>
<tr>
<td align="left" valign="top">Breast</td>
<td align="left" valign="top">Ductal Breast Carcinoma in Situ Stroma (DCIS) (<xref rid="b11-ol-0-0-11266" ref-type="bibr">11</xref>)</td>
<td align="center" valign="top">14</td>
<td align="center" valign="top">13.191</td>
<td align="center" valign="top">7.155</td>
<td align="center" valign="top">2.28&#x00D7;10<sup>&#x2212;11</sup></td>
<td/>
<td align="center" valign="top">(<xref rid="b37-ol-0-0-11266" ref-type="bibr">37</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Invasive Ductal Breast Carcinoma Stroma (IDC) (<xref rid="b9-ol-0-0-11266" ref-type="bibr">9</xref>)</td>
<td align="center" valign="top">14</td>
<td align="center" valign="top">7.232</td>
<td align="center" valign="top">5.357</td>
<td align="center" valign="top">1.27&#x00D7;10<sup>&#x2212;6</sup></td>
<td align="center" valign="top">1</td>
<td/>
</tr>
<tr>
<td/>
<td align="left" valign="top">Invasive Lobular Breast Carcinoma (ILC) (<xref rid="b36-ol-0-0-11266" ref-type="bibr">36</xref>)</td>
<td align="center" valign="top">61</td>
<td align="center" valign="top">3.312</td>
<td align="center" valign="top">13.142</td>
<td align="center" valign="top">1.58&#x00D7;10<sup>&#x2212;22</sup></td>
<td align="center" valign="top">&#x00A0;&#x00A0;1</td>
<td align="center" valign="top">(<xref rid="b42-ol-0-0-11266" ref-type="bibr">42</xref>,<xref rid="b43-ol-0-0-11266" ref-type="bibr">43</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Invasive Breast Carcinoma (BRCA) (<xref rid="b76-ol-0-0-11266" ref-type="bibr">76</xref>)</td>
<td align="center" valign="top">61</td>
<td align="center" valign="top">3.131</td>
<td align="center" valign="top">14.001</td>
<td align="center" valign="top">1.22&#x00D7;10<sup>&#x2212;27</sup></td>
<td align="center" valign="top">1</td>
<td/>
</tr>
<tr>
<td/>
<td align="left" valign="top">Male Breast Carcinoma (MBC) (<xref rid="b3-ol-0-0-11266" ref-type="bibr">3</xref>)</td>
<td align="center" valign="top">61</td>
<td align="center" valign="top">4.661</td>
<td align="center" valign="top">10.406</td>
<td align="center" valign="top">3.76&#x00D7;10<sup>&#x2212;5</sup></td>
<td align="center" valign="top">4</td>
<td/>
</tr>
<tr>
<td/>
<td align="left" valign="top">Mixed Lobular and Ductal Breast Carcinoma (IDC-L) (<xref rid="b7-ol-0-0-11266" ref-type="bibr">7</xref>)</td>
<td align="center" valign="top">61</td>
<td align="center" valign="top">2.780</td>
<td align="center" valign="top">5.576</td>
<td align="center" valign="top">8.56&#x00D7;10<sup>&#x2212;5</sup></td>
<td align="center" valign="top">4</td>
<td/>
</tr>
<tr>
<td/>
<td align="left" valign="top">Invasive Ductal Breast Carcinoma (IDC) (389)</td>
<td align="center" valign="top">61</td>
<td align="center" valign="top">2.714</td>
<td align="center" valign="top">14.829</td>
<td align="center" valign="top">5.11&#x00D7;10<sup>&#x2212;25</sup></td>
<td align="center" valign="top">5</td>
<td/>
</tr>
<tr>
<td/>
<td align="left" valign="top">Tubular Breast Carcinoma (TBC) (67)</td>
<td align="center" valign="top">144</td>
<td align="center" valign="top">3.014</td>
<td align="center" valign="top">18.174</td>
<td align="center" valign="top">4.05&#x00D7;10<sup>&#x2212;41</sup></td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">(<xref rid="b38-ol-0-0-11266" ref-type="bibr">38</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Invasive Lobular Breast Carcinoma (ILBC) (148)</td>
<td align="center" valign="top">144</td>
<td align="center" valign="top">3.087</td>
<td align="center" valign="top">19.715</td>
<td align="center" valign="top">8.92&#x00D7;10<sup>&#x2212;56</sup></td>
<td align="center" valign="top">1</td>
<td/>
</tr>
<tr>
<td/>
<td align="left" valign="top">Invasive Ductal and Invasive Lobular Breast</td>
<td align="center" valign="top">144</td>
<td align="center" valign="top">2.885</td>
<td align="center" valign="top">14.973</td>
<td align="center" valign="top">4.81&#x00D7;10<sup>&#x2212;33</sup></td>
<td align="center" valign="top">1</td>
<td/>
</tr>
<tr>
<td/>
<td align="left" valign="top">Carcinoma (IDC and ILC) (90)</td>
<td/>
<td/>
<td/>
<td/>
<td/>
<td/>
</tr>
<tr>
<td/>
<td align="left" valign="top">Breast Carcinoma (BC) (14)</td>
<td align="center" valign="top">144</td>
<td align="center" valign="top">2.884</td>
<td align="center" valign="top">5.505</td>
<td align="center" valign="top">3.00&#x00D7;10<sup>&#x2212;5</sup></td>
<td align="center" valign="top">4</td>
<td/>
</tr>
<tr>
<td/>
<td align="left" valign="top">Invasive Ductal Breast Carcinoma (IDC) (1556)</td>
<td align="center" valign="top">144</td>
<td align="center" valign="top">2.988</td>
<td align="center" valign="top">26.199</td>
<td align="center" valign="top">1.50&#x00D7;10<sup>&#x2212;62</sup></td>
<td align="center" valign="top">5</td>
<td/>
</tr>
<tr>
<td/>
<td align="left" valign="top">Medullary Breast Carcinoma (MBC) (32)</td>
<td align="center" valign="top">144</td>
<td align="center" valign="top">2.256</td>
<td align="center" valign="top">6.302</td>
<td align="center" valign="top">1.13&#x00D7;10<sup>&#x2212;7</sup></td>
<td align="center" valign="top">9</td>
<td/>
</tr>
<tr>
<td/>
<td align="left" valign="top">Invasive Ductal Breast Carcinoma Stroma (IDBCs) (7)</td>
<td align="center" valign="top">15</td>
<td align="center" valign="top">3.546</td>
<td align="center" valign="top">6.337</td>
<td align="center" valign="top">2.70&#x00D7;10<sup>&#x2212;6</sup></td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">(39)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Ductal Breast Carcinoma (DBC) (36)</td>
<td align="center" valign="top">3</td>
<td align="center" valign="top">3.337</td>
<td align="center" valign="top">9.550</td>
<td align="center" valign="top">7.02&#x00D7;10<sup>&#x2212;6</sup></td>
<td align="center" valign="top">2</td>
<td align="center" valign="top">(40)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Lobular Breast Carcinoma (LBC) (21)</td>
<td align="center" valign="top">3</td>
<td align="center" valign="top">3.337</td>
<td align="center" valign="top">10.925</td>
<td align="center" valign="top">1.22&#x00D7;10<sup>&#x2212;7</sup></td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">(41)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Invasive Ductal Breast Carcinoma (IDBC) (38)</td>
<td align="center" valign="top">3</td>
<td align="center" valign="top">6.756</td>
<td align="center" valign="top">12.230</td>
<td align="center" valign="top">1.80&#x00D7;10<sup>&#x2212;6</sup></td>
<td align="center" valign="top">5</td>
<td/>
</tr>
<tr>
<td align="left" valign="top">Colorectal</td>
<td align="left" valign="top">Colon Adenocarcinoma (COAD) (41)</td>
<td align="center" valign="top">5</td>
<td align="center" valign="top">3.200</td>
<td align="center" valign="top">13.125</td>
<td align="center" valign="top">1.74&#x00D7;10<sup>&#x2212;15</sup></td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">(44)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Colon Mucinous Adenocarcinoma (CMA) (13)</td>
<td align="center" valign="top">5</td>
<td align="center" valign="top">2.942</td>
<td align="center" valign="top">9.781</td>
<td align="center" valign="top">6.65 &#x00D7;10<sup>&#x2212;8</sup></td>
<td align="center" valign="top">1</td>
<td/>
</tr>
<tr>
<td/>
<td align="left" valign="top">Rectosigmoid Adenocarcinoma (RSA) (10)</td>
<td align="center" valign="top">5</td>
<td align="center" valign="top">3.799</td>
<td align="center" valign="top">7.377</td>
<td align="center" valign="top">4.85&#x00D7;10<sup>&#x2212;6</sup></td>
<td align="center" valign="top">2</td>
<td/>
</tr>
<tr>
<td/>
<td align="left" valign="top">Cecum Adenocarcinoma (CeAC) (17)</td>
<td align="center" valign="top">5</td>
<td align="center" valign="top">3.039</td>
<td align="center" valign="top">6.529</td>
<td align="center" valign="top">1.17&#x00D7;10<sup>&#x2212;6</sup></td>
<td align="center" valign="top">4</td>
<td/>
</tr>
<tr>
<td/>
<td align="left" valign="top">Colorectal Carcinoma (CC) (36)</td>
<td align="center" valign="top">24</td>
<td align="center" valign="top">4.795</td>
<td align="center" valign="top">8.671</td>
<td align="center" valign="top">3.32&#x00D7;10<sup>&#x2212;12</sup></td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">(<xref rid="b45-ol-0-0-11266" ref-type="bibr">45</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Colorectal Carcinoma (CC) (18)</td>
<td align="center" valign="top">12</td>
<td align="center" valign="top">2.563</td>
<td align="center" valign="top">5.442</td>
<td align="center" valign="top">5.94&#x00D7;10<sup>&#x2212;6</sup></td>
<td align="center" valign="top">4</td>
<td align="center" valign="top">(<xref rid="b46-ol-0-0-11266" ref-type="bibr">46</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Colon Carcinoma (cc) (5)</td>
<td align="center" valign="top">10</td>
<td align="center" valign="top">7.740</td>
<td align="center" valign="top">15.965</td>
<td align="center" valign="top">3.60&#x00D7;10<sup>&#x2212;10</sup></td>
<td align="center" valign="top">2</td>
<td align="center" valign="top">(<xref rid="b45-ol-0-0-11266" ref-type="bibr">45</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Colon Adenocarcinoma (COAD) (5)</td>
<td align="center" valign="top">10</td>
<td align="center" valign="top">4.099</td>
<td align="center" valign="top">14.219</td>
<td align="center" valign="top">6.23&#x00D7;10<sup>&#x2212;9</sup></td>
<td align="center" valign="top">2</td>
<td/>
</tr>
<tr>
<td/>
<td align="left" valign="top">Colon Mucinous Adenocarcinoma (CMA) (101)</td>
<td align="center" valign="top">22</td>
<td align="center" valign="top">2.324</td>
<td align="center" valign="top">11.956</td>
<td align="center" valign="top">3.48&#x00D7;10<sup>&#x2212;19</sup></td>
<td align="center" valign="top">3</td>
<td align="center" valign="top">(<xref rid="b47-ol-0-0-11266" ref-type="bibr">47</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Rectal Adenocarcinoma (READ) (22)</td>
<td align="center" valign="top">22</td>
<td align="center" valign="top">3.772</td>
<td align="center" valign="top">10.097</td>
<td align="center" valign="top">4.62&#x00D7;10<sup>&#x2212;11</sup></td>
<td align="center" valign="top">3</td>
<td/>
</tr>
<tr>
<td/>
<td align="left" valign="top">Rectal Adenocarcinoma (READ) (60)</td>
<td align="center" valign="top">22</td>
<td align="center" valign="top">2.065</td>
<td align="center" valign="top">8.557</td>
<td align="center" valign="top">3.90&#x00D7;10<sup>&#x2212;13</sup></td>
<td align="center" valign="top">7</td>
<td/>
</tr>
<tr>
<td/>
<td align="left" valign="top">Rectal Adenocarcinoma (READ) (65)</td>
<td align="center" valign="top">65</td>
<td align="center" valign="top">2.068</td>
<td align="center" valign="top">11.751</td>
<td align="center" valign="top">2.16&#x00D7;10<sup>&#x2212;19</sup></td>
<td align="center" valign="top">6</td>
<td align="center" valign="top">(<xref rid="b48-ol-0-0-11266" ref-type="bibr">48</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Colorectal Carcinoma (CC) (70)</td>
<td align="center" valign="top">12</td>
<td align="center" valign="top">3.508</td>
<td align="center" valign="top">9.208</td>
<td align="center" valign="top">4.02&#x00D7;10<sup>&#x2212;9</sup></td>
<td align="center" valign="top">7</td>
<td align="center" valign="top">(<xref rid="b49-ol-0-0-11266" ref-type="bibr">49</xref>)</td>
</tr>
<tr>
<td align="left" valign="top">Esophageal</td>
<td align="left" valign="top">Esophageal Squamous Cell Carcinoma (ESCC) (53)</td>
<td align="center" valign="top">53</td>
<td align="center" valign="top">2.795</td>
<td align="center" valign="top">10.666</td>
<td align="center" valign="top">3.73&#x00D7;10<sup>&#x2212;17</sup></td>
<td align="center" valign="top">2</td>
<td align="center" valign="top">(<xref rid="b50-ol-0-0-11266" ref-type="bibr">50</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Esophageal Squamous Cell Carcinoma (ESCC) (17)</td>
<td align="center" valign="top">17</td>
<td align="center" valign="top">2.964</td>
<td align="center" valign="top">5.524</td>
<td align="center" valign="top">3.47&#x00D7;10<sup>&#x2212;6</sup></td>
<td align="center" valign="top">5</td>
<td align="center" valign="top">(<xref rid="b51-ol-0-0-11266" ref-type="bibr">51</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Esophageal Adenocarcinoma (EA) (14)</td>
<td align="center" valign="top">10</td>
<td align="center" valign="top">10.158</td>
<td align="center" valign="top">8.460</td>
<td align="center" valign="top">8.51&#x00D7;10<sup>&#x2212;5</sup></td>
<td align="center" valign="top">5</td>
<td align="center" valign="top">(<xref rid="b52-ol-0-0-11266" ref-type="bibr">52</xref>)</td>
</tr>
<tr>
<td align="left" valign="top">Gastric</td>
<td align="left" valign="top">Gastric Intestinal Type Adenocarcinoma(ITGA) (62)</td>
<td align="center" valign="top">29</td>
<td align="center" valign="top">4.852</td>
<td align="center" valign="top">18.317</td>
<td align="center" valign="top">4.31&#x00D7;10<sup>&#x2212;32</sup></td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">(<xref rid="b53-ol-0-0-11266" ref-type="bibr">53</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Diffuse Gastric Adenocarcinoma (DGAC) (13)</td>
<td align="center" valign="top">29</td>
<td align="center" valign="top">6.483</td>
<td align="center" valign="top">23.103</td>
<td align="center" valign="top">1.13&#x00D7;10<sup>&#x2212;17</sup></td>
<td align="center" valign="top">1</td>
<td/>
</tr>
<tr>
<td/>
<td align="left" valign="top">Gastric mixed Adenocarcinoma (GMA) (8)</td>
<td align="center" valign="top">29</td>
<td align="center" valign="top">9.700</td>
<td align="center" valign="top">11.684</td>
<td align="center" valign="top">1.63&#x00D7;10<sup>&#x2212;6</sup></td>
<td align="center" valign="top">1</td>
<td/>
</tr>
<tr>
<td/>
<td align="left" valign="top">Diffuse Gastric Adenocarcinoma (DGAC) (31)</td>
<td align="center" valign="top">19</td>
<td align="center" valign="top">3.287</td>
<td align="center" valign="top">8.446</td>
<td align="center" valign="top">2.38&#x00D7;10<sup>&#x2212;11</sup></td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">(<xref rid="b54-ol-0-0-11266" ref-type="bibr">54</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Gastric Intestinal Type Adenocarcinoma (ITGA) (20)</td>
<td align="center" valign="top">19</td>
<td align="center" valign="top">3.038</td>
<td align="center" valign="top">6.251</td>
<td align="center" valign="top">4.01&#x00D7;10<sup>&#x2212;7</sup></td>
<td align="center" valign="top">1</td>
<td/>
</tr>
<tr>
<td/>
<td align="left" valign="top">Gastric Cancer (GC) (15)</td>
<td align="center" valign="top">12</td>
<td align="center" valign="top">5.721</td>
<td align="center" valign="top">5.853</td>
<td align="center" valign="top">2.49&#x00D7;10<sup>&#x2212;6</sup></td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">(<xref rid="b55-ol-0-0-11266" ref-type="bibr">55</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Diffuse Gastric Adenocarcinoma (DGAC) (6)</td>
<td align="center" valign="top">31</td>
<td align="center" valign="top">6.207</td>
<td align="center" valign="top">5.794</td>
<td align="center" valign="top">9.36&#x00D7;10<sup>&#x2212;5</sup></td>
<td align="center" valign="top">2</td>
<td align="center" valign="top">(<xref rid="b56-ol-0-0-11266" ref-type="bibr">56</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Gastric Mixed Adenocarcinoma (GMA) (4)</td>
<td align="center" valign="top">31</td>
<td align="center" valign="top">9.737</td>
<td align="center" valign="top">8.460</td>
<td align="center" valign="top">1.49&#x00D7;10<sup>&#x2212;5</sup></td>
<td align="center" valign="top">3</td>
<td/>
</tr>
<tr>
<td/>
<td align="left" valign="top">Gastric Intestinal Type Adenocarcinoma (ITGA) (26)</td>
<td align="center" valign="top">31</td>
<td align="center" valign="top">4.413</td>
<td align="center" valign="top">7.512</td>
<td align="center" valign="top">2.59&#x00D7;10<sup>&#x2212;9</sup></td>
<td align="center" valign="top">5</td>
<td/>
</tr>
<tr>
<td/>
<td align="left" valign="top">Gastric Cancer (GC) (80)</td>
<td align="center" valign="top">80</td>
<td align="center" valign="top">3.226</td>
<td align="center" valign="top">5.032</td>
<td align="center" valign="top">6.55&#x00D7;10<sup>&#x2212;7</sup></td>
<td align="center" valign="top">2</td>
<td align="center" valign="top">(<xref rid="b57-ol-0-0-11266" ref-type="bibr">57</xref>)</td>
</tr>
<tr>
<td align="left" valign="top">Head and neck</td>
<td align="left" valign="top">Salivary Gland Adenoid Cystic Carcinoma (SGACC) (16)</td>
<td align="center" valign="top">6</td>
<td align="center" valign="top">4.703</td>
<td align="center" valign="top">11.107</td>
<td align="center" valign="top">5.90&#x00D7;10<sup>&#x2212;10</sup></td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">(<xref rid="b58-ol-0-0-11266" ref-type="bibr">58</xref>)</td>
</tr>
<tr>
<td align="left" valign="top">Lung</td>
<td align="left" valign="top">Squamous Cell Carcinoma (SCC) (34)</td>
<td align="center" valign="top">28</td>
<td align="center" valign="top">2.177</td>
<td align="center" valign="top">5.194</td>
<td align="center" valign="top">1.45&#x00D7;10<sup>&#x2212;6</sup></td>
<td align="center" valign="top">10</td>
<td align="center" valign="top">(<xref rid="b59-ol-0-0-11266" ref-type="bibr">59</xref>)</td>
</tr>
<tr>
<td align="left" valign="top">Ovarian</td>
<td align="left" valign="top">Ovarian Serous Surface Papillary Carcinoma (SSPC) (28)</td>
<td align="center" valign="top">4</td>
<td align="center" valign="top">36.947</td>
<td align="center" valign="top">7.443</td>
<td align="center" valign="top">2.62&#x00D7;10<sup>&#x2212;8</sup></td>
<td align="center" valign="top">2</td>
<td align="center" valign="top">(<xref rid="b60-ol-0-0-11266" ref-type="bibr">60</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Ovarian Carcinoma (OC) (185)</td>
<td align="center" valign="top">10</td>
<td align="center" valign="top">3.105</td>
<td align="center" valign="top">10.018</td>
<td align="center" valign="top">9.77&#x00D7;10<sup>&#x2212;9</sup></td>
<td align="center" valign="top">7</td>
<td align="center" valign="top">(<xref rid="b61-ol-0-0-11266" ref-type="bibr">61</xref>)</td>
</tr>
<tr>
<td/>
<td align="left" valign="top">Ovarian Serous Cystadenocarcinoma (OSC) (586)</td>
<td align="center" valign="top">8</td>
<td align="center" valign="top">2.706</td>
<td align="center" valign="top">8.141</td>
<td align="center" valign="top">2.09&#x00D7;10<sup>&#x2212;5</sup></td>
<td align="center" valign="top">10</td>
<td align="center" valign="top">(<xref rid="b62-ol-0-0-11266" ref-type="bibr">62</xref>)</td>
</tr>
<tr>
<td align="left" valign="top">Other cancer</td>
<td align="left" valign="top">Skin Basal Cell Carcinoma (SBCC) (15)</td>
<td align="center" valign="top">4</td>
<td align="center" valign="top">5.312</td>
<td align="center" valign="top">11.144</td>
<td align="center" valign="top">1.81 &#x00D7;10<sup>&#x2212;9</sup></td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">(<xref rid="b63-ol-0-0-11266" ref-type="bibr">63</xref>)</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="tfn1-ol-0-0-11266"><p>Cancer samples were compared with normal tissues. CNS, central nervous system; TCGA, The Cancer Genome Atlas; IBLCA Infiltrating Bladder Urothelial Carcinoma.</p></fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="tII-ol-0-0-11266" position="float">
<label>Table II.</label>
<caption><p>Overall survival of patients with different types of cancer with overexpressed <italic>BGN</italic> gene.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="bottom">Cancer types</th>
<th align="center" valign="bottom">RNA-seq P-value (database)</th>
<th align="center" valign="bottom">gene chip P-value (database)</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top">Breast cancer</td>
<td align="center" valign="top">0.2556<sup><xref rid="tfn3-ol-0-0-11266" ref-type="table-fn">a</xref></sup></td>
<td align="center" valign="top">0.7210<sup><xref rid="tfn3-ol-0-0-11266" ref-type="table-fn">a</xref></sup></td>
</tr>
<tr>
<td align="left" valign="top">Esophageal adenocarcinoma</td>
<td align="center" valign="top">0.0965<sup><xref rid="tfn3-ol-0-0-11266" ref-type="table-fn">a</xref></sup></td>
<td align="center" valign="top">N/A</td>
</tr>
<tr>
<td align="left" valign="top">Lung cancer</td>
<td align="center" valign="top">0.3010<sup><xref rid="tfn3-ol-0-0-11266" ref-type="table-fn">a</xref></sup></td>
<td align="center" valign="top">0.0002<sup><xref rid="tfn3-ol-0-0-11266" ref-type="table-fn">a</xref></sup></td>
</tr>
<tr>
<td align="left" valign="top">Gastric cancer</td>
<td align="center" valign="top">0.0068<sup><xref rid="tfn3-ol-0-0-11266" ref-type="table-fn">a</xref></sup></td>
<td align="center" valign="top">1.3&#x00D7;10<sup>&#x2212;10a</sup></td>
</tr>
<tr>
<td align="left" valign="top">Ovarian cancer</td>
<td align="center" valign="top">0.0093<sup><xref rid="tfn3-ol-0-0-11266" ref-type="table-fn">a</xref></sup></td>
<td align="center" valign="top">0.0004<sup><xref rid="tfn3-ol-0-0-11266" ref-type="table-fn">a</xref></sup></td>
</tr>
<tr>
<td align="left" valign="top">Bladder cancer</td>
<td align="center" valign="top">0.0025<sup><xref rid="tfn3-ol-0-0-11266" ref-type="table-fn">a</xref></sup></td>
<td align="center" valign="top">N/A</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="tfn2-ol-0-0-11266"><p>Calculated using</p></fn>
<fn id="tfn3-ol-0-0-11266"><label>a</label><p>Kaplan-Meier Plotter databases with RNA-seq data and gene chip data. BGN, biglycan; N/A, not applicable.</p></fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="tIII-ol-0-0-11266" position="float">
<label>Table III.</label>
<caption><p>Overall survival of patients with different subtypes of cancer with overexpressed <italic>BGN</italic> gene.</p></caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="bottom">Cancer subtype</th>
<th align="center" valign="bottom">RNA-seq P-value (database)</th>
<th align="center" valign="bottom">gene chip P-value (database)</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top">Lung squamous cell carcinoma</td>
<td align="center" valign="top">0.0111<sup><xref rid="tfn5-ol-0-0-11266" ref-type="table-fn">a</xref></sup></td>
<td align="center" valign="top">N/A</td>
</tr>
<tr>
<td align="left" valign="top">Ovarian serous cystadenocarcinoma</td>
<td align="center" valign="top">0.0290<sup><xref rid="tfn7-ol-0-0-11266" ref-type="table-fn">c</xref></sup></td>
<td align="center" valign="top">N/A</td>
</tr>
<tr>
<td align="left" valign="top">Breast invasive carcinoma</td>
<td align="center" valign="top">0.9400<sup><xref rid="tfn7-ol-0-0-11266" ref-type="table-fn">c</xref></sup></td>
<td align="center" valign="top">N/A</td>
</tr>
<tr>
<td align="left" valign="top">Colon adenocarcinoma</td>
<td align="center" valign="top">0.0963<sup><xref rid="tfn6-ol-0-0-11266" ref-type="table-fn">b</xref></sup></td>
<td align="center" valign="top">N/A</td>
</tr>
<tr>
<td align="left" valign="top">Rectum adenocarcinoma</td>
<td align="center" valign="top">0.1776<sup><xref rid="tfn5-ol-0-0-11266" ref-type="table-fn">a</xref></sup></td>
<td align="center" valign="top">N/A</td>
</tr>
<tr>
<td align="left" valign="top">Esophageal Squamous</td>
<td align="center" valign="top">0.2707<sup><xref rid="tfn5-ol-0-0-11266" ref-type="table-fn">a</xref></sup></td>
<td align="center" valign="top">N/A</td>
</tr>
<tr>
<td align="left" valign="top">Cell Carcinoma</td>
<td/>
<td/>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="tfn4-ol-0-0-11266"><p>Calculated using</p></fn>
<fn id="tfn5-ol-0-0-11266"><label>a</label><p>Kaplan-Meier Plotter databases</p></fn>
<fn id="tfn6-ol-0-0-11266"><label>b</label><p>OncoLnc</p></fn>
<fn id="tfn7-ol-0-0-11266"><label>c</label><p>UALCAN with RNA-seq data. BGN, biglycan; N/A, not applicable.</p></fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</article>
