Understanding Colon Cancer in Athletes: The Expression and Prognostic Value of REG4 Based on Advanced Bioinformatics and Tissue Microarray Technology

Abstract

Objective: To investigate the differential expression of the REG4 gene in colon cancer compared to normal tissue, using bioinformatics, and to analyze its relationship with clinicopathological features and prognosis in athletes diagnosed with colon cancer. The study aims to identify whether REG4 can serve as a biomarker for early detection and prognosis in this specific population. Methods: The GEO database was utilized to download the colon cancer gene expression datasets, while the UALCAN and GEPIA databases verified the differential expression and prognostic significance of REG4. A cohort of 94 athletes with colon cancer who underwent surgical treatment at our hospital was examined. REG4 expression was assessed using tissue microarrays and immunohistochemistry from paraffin-embedded specimens to determine its correlation with clinicopathological features and five-year survival rates. Results: Both UALCAN and GEPIA databases indicated that REG4 expression was significantly lower in colon cancer tissues compared to adjacent normal tissues. Higher REG4 expression levels were associated with better overall survival rates. Immunohistochemical analysis confirmed lower REG4 protein levels in colon cancer tissues than in adjacent normal tissues. The five-year overall survival rate was higher in patients with elevated REG4 expression, suggesting a positive correlation. Cox regression analysis identified REG4 expression as a potential independent prognostic factor for colon cancer in athletes. Conclusion: REG4 is markedly downregulated in colon cancer tissues of athletes, correlating with pathological grade and age. High REG4 expression is linked to favorable outcomes, suggesting its utility as a prognostic marker. These findings underscore the importance of targeted molecular testing in enhancing the management and prognosis of colon cancer in athletes, supporting the integration of such biomarkers in sports medicine for better health care strategies.