Objective To investigate the expression of the nucleolar spindle-associated protein 1 (NUSAP1) gene in hepatocellular carcinoma (HCC) and its effect on clinical prognosis.Methods HCC microarray datasets GSE57957, GSE14520, GSE22058, GSE46444, GSE54236, GSE36376, GSE64041, GSE76297, GSE76427, and GSE102079 were downloaded from the Gene Expression Omnibus (GEO) database, and HCC RNA-Seq data were downloaded from The Cancer Genome Atlas (TCGA). R software 4.0 was used to investigate the difference in the expression of NUSAP1 between HCC tissue and adjacent tissue. The t-distributed stochastic neighbour embedding (t-SNE) method was used to perform dimensionality reduction of single-cell sequencing data and analyze the difference in the expression of NUSAP1 between HCC tissue and adjacent tissue. HCC tissue samples and adjacent tissue samples were collected from 42 patients with hepatitis B-related HCC who underwent liver transplantation in The Affiliated Hospital of Qingdao University from January 2018 to November 2019, and related clinical and pathological data were collected to analyze their correlation with the expression of the NUSAP1 gene. The chi-square test was used for comparison of paired data. The Kaplan-Meier method was used to analyze the correlation of the expression level of NUSAP1 with overall survival rate and disease-free survival, and the log-rank test was used for survival difference analysis; the results were visualized using Graphpad prim 7.Results NUSAP1 was highly expressed in HCC tissue in GEO and TCGA datasets (P < 0.001). The cells from HCC tissue had a significantly higher proportion of cells with high NUSAP1 expression than those from adjacent tissue. NUSAP1 showed high expression in HCC tissue of 29 patients and low expression in HCC tissue of 13 patients, and there were significant differences in Child-Pugh class, TNM stage, and Okuda stage between the high-expression group and the low-expression group (χ2=5.469, 6.836 and 4.617, all P < 0.05). The HCC patients with high expression of NUSAP1 had significantly lower overall survival rate and disease-free survival rate than those with low expression; compared with the patients with high expression, the patients with low expression had significantly higher 1-, 3-, and 5-year survival rates (92.96%/83.80%/76.76% vs 76.76%/67.60%/64.78%, P < 0.05), and the patients with high expression had a significantly shorter median survival time than those with low expression (61.7 months vs 108.6 months, P < 0.05).Conclusion NUSAP1 is highly expressed in cells from HCC tissue and may be used as a potential marker for poor prognosis of patients with hepatitis B-related HCC.
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