AccScience Publishing / EJMO / Online First / DOI: 10.36922/EJMO026090101
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ORIGINAL RESEARCH ARTICLE

Integrated identification, functional characterization, and clinical significance of key genes during cervical cancer progression

Shengyi Gu1 ,  Meiqin Yang1*
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1 Department of Gynecology, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, School of Life Science and Technology, Tongji University, Shanghai, China
EJMO, 026090101 https://doi.org/10.36922/EJMO026090101
Received: 26 February 2026 | Revised: 12 June 2026 | Accepted: 1 July 2026 | Published online: 13 July 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Introduction: Cervical cancer evolves from normal cervical epithelium through a multifaceted pathway, first to high-grade squamous intraepithelial lesions (HSILs) and subsequently culminating in invasive cancer, yet the specific molecular mechanisms driving this progression remain poorly understood.

Objective: To identify genes persistently dysregulated during cervical lesion progression and to evaluate their clinical relevance with respect to prognosis, immune infiltration, and therapeutic response.

Methods: Two independent gene expression datasets (GSE7803 and GSE64217) were analyzed to screen persistently differentially expressed genes (DEGs) across normal cervix, HSIL, and cervical cancer. Public databases and clinical samples were used to validate the hub genes initially identified through functional enrichment and protein–protein interaction analyses. Associations with patient survival, immune infiltration, and drug sensitivity were further analyzed using integrated bioinformatics platforms.

Results: Eighteen common persistent DEGs were identified, primarily enriched in cell cycle regulation and epithelial differentiation. Four hub genes (AURKA, ECT2, RFC4, and PCNA) showed progressive upregulation as cervical lesions progressed and were associated with clinicopathological features. Elevated RFC4 and PCNA levels were significantly associated with improved survival. Immune analysis revealed distinct correlation patterns for RFC4 and PCNA expression: positive with B cells and effector memory immune cells, and negative with regulatory T cells. Drug sensitivity analysis showed that elevated RFC4 and PCNA expression were associated with lower IC50 values, whereas AURKA and ECT2 were linked to potential drug resistance.

Conclusion: AURKA, ECT2, RFC4, and PCNA are key regulators of cervical lesion progression, among which RFC4 and PCNA are promising prognostic biomarkers and potential therapeutic targets.

Keywords
Cervical cancer
High-grade squamous intraepithelial lesions
Bioinformatics analysis
Hub genes
Immune infiltration
Funding
This study was supported by a grant from the National Science Foundation of China (No. 82403164).
Conflict of interest
The authors have no conflicts of interest.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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