The role of SPP1 in evaluating the prognosis, immune infiltration, and drug sensitivity of hepatocellular carcinoma.

BACKGROUND

Secretory phosphoprotein 1 (SPP1) has been linked to tumor progression and immune regulation, but its prognostic value, impact on the tumor immune microenvironment (TIME), and drug sensitivity in HCC remain unclear.

METHODS

We performed a pan-cancer analysis using TIMER and validated SPP1 upregulation in six GEO datasets (GSE45436, GSE54236, GSE121248, GSE76427, GSE64041, and GSE60502) and HPA protein data. In TCGA-LIHC, we assessed overall survival (OS) and progression-free survival (PFS) using univariate/multivariate Cox analyses, ROC analysis, and a calibrated nomogram. We identified differentially expressed genes (DEGs) and performed GO/KEGG and GSEA analyses. Immune infiltration was estimated with CIBERSORT and TIMER, and relationships with immune checkpoints were explored. Drug sensitivity was predicted with pRRophetic using GDSC data. In vitro, SPP1 was knocked down or overexpressed in HCC cell lines to evaluate effects on proliferation, migration, invasion, and apoptosis via qRT-PCR, Western blot, CCK-8, colony formation, wound healing, Transwell invasion, and TUNEL assays.

RESULTS

SPP1 was significantly upregulated in HCC at mRNA and protein levels. High SPP1 predicted poorer OS and PFS and was associated with higher histological grade, advanced stage, and greater T stage. The nomogram showed good calibration and discrimination. DEGs and enrichment analyses implicated cytokine receptor interaction, fatty acid metabolism, and PI3K-Akt signaling; GSEA confirmed immune- and metabolism-related pathways. High SPP1 correlated with higher immune/ESTIMATE scores, increased M0/M2 macrophages and dendritic cells, reduced CD8 + T cells, and upregulation of multiple immune checkpoints. Drug-sensitivity predictions showed high-SPP1 tumors were more sensitive to several anti-cancer drugs (e.g., sorafenib), while resistance to others was suggested. Functionally, SPP1 knockdown inhibited, while overexpression promoted, proliferation, migration, and invasion; knockdown increased apoptosis.

CONCLUSIONS

SPP1 acts as an oncogenic driver in HCC, associated with poor prognosis, an immunosuppressive TIME, and distinct drug-response patterns.