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Purpose:  This study was conducted in order to analyze the prognostic effects of epidermal growth factor receptor (EGFR) and CDKN2A alterations and determine the prognostic significance of EGFR and CDKN2A alterations on regulated genes in patients with glioblastoma (GBM) or lower grade glioma (LGG).   Methods:  The alteration frequencies of EGFR and CDKN2A across 32 tumor types were derived from cBioPortal based on The Cancer Genome Atlas (TCGA) datasets. The Kaplan–Meier analysis was used to determine the prognostic significance of EGFR and CDKN2A alterations. EGFR and CDKN2A alterations on regulated expression signatures were identified from RNA-seq data in the TCGA GBM datasets. The prognostic significance of EGFR and CDKN2A alterations on regulated genes in patients with glioma was determined using the TCGA and the Chinese Glioma Genome Atlas (CGGA) datasets.   Results:  Compared with the other 31 tumor types, EGFR amplification and CDKN2A deletion particularly occurred in patients with GBM. GBM patients with EGFR amplification or CDKN2A deletion demonstrated poor prognosis. Statistical analysis showed the coexistence of EGFR alteration and CDKN2A deletion in GBM patients. We identified 864 genes which were commonly regulated by EGFR amplification and CDKN2A deletion, and those genes were highly expressed in brain tissues and associated with the cell cycle, EBRR2, and MAPK signaling pathways.  Spermatogenesis-associated serine-rich 2-like gene  ( SPATS2L ) was upregulated in GBM patients with EGFR amplification or CDKN2A alteration. Higher expression levels of  SPATS2L  were associated with worse prognosis in patients with GBM in both TCGA and CGGA datasets. Moreover, the expression levels of  SPATS2L  were higher in patients with a mesenchymal subtype of GBM. Statistical analysis also showed that the coexistence of EGFR alteration and CDKN2A deletion was significant in patients with LGG.  SPATS2L  was upregulated in LGG patients with EGFR amplification or CDKN2A alteration. Furthermore, higher expression levels of  SPATS2L  were associated with worse prognosis in patients with LGG in both TCGA and CGGA datasets. The expression levels of  SPATS2L  were higher in patients with an astrocytoma subtype of LGG. Finally, the coexistence and unfavorable prognostic effects of EGFR amplification and CDKN2A alteration were validated using the Memorial Sloan Kettering Cancer Center (MSKCC) glioma datasets.   Conclusions:  EGFR amplification and CDKN2A deletion of the regulated gene  SPATS2L  have significant prognostic effects in patients with GBM or LGG.

frontiers in oncology

Analysis of the EGFR Amplification and CDKN2A Deletion Regulated Transcriptomic Signatures Reveals the Prognostic Significance of SPATS2L in Patients With Glioma