WOFAPS 2025 8th World Congress of Pediatric Surgery

Jizhen Cen, Cheng Su

The First Affiliated Hospital of Guangxi Medical University

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Objectives:

Wilms’ tumour (WT), a common childhood kidney cancer, has treatment strategies combining surgery, radiotherapy, and chemotherapy. However, the optimal sequence of chemotherapy and surgery is debated. This study aimed to explore RNF34’s role as a prognostic biomarker and chemotherapy sensitivity indicator in WT using multidimensional transcriptomics.

Materials and methods:

Our study integrated bulk RNA sequencing data from 136 WT samples with single-nucleus RNA sequencing and spatial transcriptomics data from 32 WT specimens. We assessed RNF34 expression levels and their correlation with prognostic outcomes and chemotherapy sensitivity. Using the Genomics of Drug Sensitivity in Cancer (GDSC) database, we analyzed the chemotherapeutic responses associated with RNF34. Additionally, immunohistochemistry was performed to validate RNF34 expression at the protein level, ensuring a comprehensive validation of our findings.

Results:

RNF34 expression was significantly elevated in WT samples compared to normal tissues and strongly linked to unfavorable prognostic outcomes. Notably, patients exhibiting high RNF34 expression demonstrated enhanced sensitivity to conventional chemotherapy drugs. Furthermore, following chemotherapy, a marked decrease in RNF34 expression within cancer cells was observed. In the spatial transcriptomics data, high RNF34 expression in cancer cells was significantly associated with anaplastic histology and tumour recurrence. Additionally, RNF34 expression was closely related to a suppressed tumour immune microenvironment, which may have important implications for understanding the tumour's response to treatment and its progression.

Conclusions:

Our findings highlight RNF34’s significance in predicting prognosis and treatment sensitivity in WT. This comprehensive analysis could enhance clinical decision-making for WT patients and guide future research toward developing optimized therapeutic strategies, though further in vitro and clinical experiments are needed to confirm our result.