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LB2

Cervical squamous cell carcinoma and endocervical adenocarcinoma CESC

Of 60,498 genes, 2,574 are higher in the tumor than in normal uterus and in whole blood, and are not made by blood immune cells. 1,119 are protein-coding, and 1,105 of those have supporting plasma Cell-free RNA (cfRNA)RNA fragments that circulate in blood plasma outside cells. Most come from blood cells; a small share comes from other tissues, including tumors. evidence; the rest are mostly non-coding genes the plasma sources cannot check.

Samples compared

Tumor
304
TCGA primary tumors
Normal tissue
81
3 TCGA tumor-adjacent, 78 GTEx uterus
Whole blood
337
GTEx samples from 328 donors
Survival
291
patients, 71 events (Survival endpointsCurated TCGA outcomes (Liu et al. 2018): OS is overall survival, PFI the progression-free interval and DSS disease-specific survival. LB2 uses whichever has the most events in each cancer type.)

Results in brief

2,574
candidate genes: 1,105 with plasma cfRNA evidence, 24 protein-coding without, 1,445 non-coding
73
genes in the tissue panel, Held-out AUCHow well an elastic-net model separates tumor from normal tissue, measured with nested cross-validation on samples the model did not train on. It describes tissue, not the accuracy of a blood test. 1.000
0
genes associated with overall survival (FDR < 0.05, 150 tested)

Candidates

Filter by plasma evidence or discrimination, find a gene, and select any point or row for its full record. The table holds all 2,574 candidates.

Loading candidates…

How the candidates were selected

60,498 genes tested; 7,653 higher in tumor than in normal uterus; 4,179 also higher than in whole blood; 2,574 remain after removing genes expressed in blood immune cells; 1,105 of these have plasma cfRNA evidence, 24 protein-coding candidates have none, and 1,445 are non-coding genes the plasma sources cannot list.

Figure 2. Genes remaining after each step in cervical squamous cell carcinoma and endocervical adenocarcinoma.

Each comparison uses a two-sided Wilcoxon rank-sum test. A gene passes when its q-value is below 0.05, its log2 fold change is at least 1, and the lower bound of the 95% confidence interval for its AUC is at least 0.70.

Genes made by any of 18 sorted blood immune cell types above 1 nTPM are then removed, because blood cells supply most plasma RNA. Genes missing from that reference, mostly non-coding, are kept.

Plasma evidence only reorders the list. A candidate not yet seen in plasma stays in, because every dataset misses genes. Read the full methods.

Tissue classifier panel

Geneweight toward tumorCoef.
  1. PITX1+0.17
  2. EXO1+0.14
  3. TFAP2A+0.13
  4. SKA1+0.10
  5. BAIAP2L1+0.10
  6. RECQL4+0.10
  7. CDC45+0.10
  8. MTFR2+0.09
  9. FOXM1+0.09
  10. C1orf106+0.08
  11. BRIP1+0.08
  12. FAM83H+0.07
  13. E2F1+0.07
  14. DEPDC4+0.07
  15. C16orf59+0.07
  16. ANLN+0.07
  17. SLC25A10+0.06
  18. ZIC2+0.06
  19. CDC25A+0.06
  20. NCAPG+0.06
Show the other 53 genes
  1. ZYG11A+0.05
  2. CCDC150+0.05
  3. FAM72D+0.05
  4. FOXA1+0.05
  5. ECE2+0.05
  6. CDT1+0.05
  7. MAL2+0.05
  8. ANKRD18B+0.05
  9. FXYD3+0.04
  10. ASPM+0.04
  11. KRT80+0.04
  12. C17orf53+0.04
  13. PIF1+0.04
  14. DIAPH3+0.04
  15. KIF15+0.04
  16. SKA3+0.03
  17. CASC5+0.03
  18. KIF4A+0.03
  19. STIL+0.03
  20. MCM10+0.03
  21. KIAA1522+0.03
  22. GRIN2D+0.03
  23. PKP3+0.03
  24. ESPL1+0.03
  25. TICRR+0.03
  26. GPRIN1+0.03
  27. WWC1+0.03
  28. LAD1+0.03
  29. POLQ+0.02
  30. GTSE1+0.02
  31. DNAH3+0.02
  32. ESRP1+0.02
  33. ERBB3+0.02
  34. ESRP2+0.02
  35. LIPH+0.02
  36. PVRL4+0.02
  37. CNKSR1+0.01
  38. C1orf116+0.01
  39. PPP1R13L+0.01
  40. TTC6+0.01
  41. TMEM184A+0.01
  42. IGSF9+0.01
  43. OVOL1+0.01
  44. GSG2+0.01
  45. GINS1+0.01
  46. TERT+0.01
  47. KIF14+0.00
  48. DQX1+0.00
  49. CDC42BPG+0.00
  50. S100A14+0.00
  51. ARHGEF39+0.00
  52. ELMO3+0.00
  53. ARHGAP11A+0.00
Figure 3. Standardized elastic-net coefficients of the 73 genes selected to separate cervical squamous cell carcinoma and endocervical adenocarcinoma from normal uterus, largest first.

An elastic-net logistic regression was trained on the 300 top-ranked candidates to tell tumor from normal tissue. Its Held-out AUCHow well an elastic-net model separates tumor from normal tissue, measured with nested cross-validation on samples the model did not train on. It describes tissue, not the accuracy of a blood test. is 1.000, from nested five-fold cross-validation.

Before training, the TCGA-versus-GTEx offset was removed from the expression matrix with the tumor/normal contrast protected, as in the tissue comparison. That correction is fitted once on all samples, so the held-out AUC is not fully independent of it.

This number describes tumor and normal tissue, where separation is expected to be near perfect. It is not the accuracy of a blood test: that has to be measured in plasma from patients and controls.

Association with survival

None of the 150 top-ranked candidates is associated with overall survival at FDR < 0.05 (291 patients, 71 events). A null result here is informative: these genes mark the presence of the cancer, not necessarily its course.

For the 150 top-ranked candidates, a Cox model relates tumor expression, as a continuous value, to overall survival in 291 patients (71 events). No high/low cutpoint is searched for, since optimized cutpoints inflate false positives.

A Hazard ratio per SDFrom a Cox model with the gene’s tumor expression as a continuous variable: the change in hazard for each one-standard-deviation increase. Above 1, higher expression goes with a shorter time to the event; below 1, with a longer one. above 1 means higher expression goes with a shorter overall survival. These are associations in tissue, not evidence that a blood level predicts outcome.

Caveats for CESC

  • Normal uterus stands in for cervix in this release.
  • Only 3 TCGA adjacent samples anchor the correction for study differences between TCGA and GTEx normals.
  • With only 81 normal samples, confidence intervals are wide; treat close ranks as ties.
  • The blood comparison sets TCGA tumors against GTEx blood. Study and biology cannot be separated there, which is why genes made by blood immune cells are removed as well.

Limitations that apply to every cancer type