Pan-Cancer Profiling of FZD2 as a Prognostic Biomarker: Integrative Multi-Omics Analysis with Experimental Validation and Functional Characterization in Gastric Cancer

SIJIANG ZHOU¹Da Li¹Chao Quan²Zhu Yu¹Yue Feng¹Shengyu Wang¹Yong Li¹Tongtong Qi¹Junqiang Chen^1*

• ¹First Affiliated Hospital, Guangxi Medical University, Nanning, China
• ²Department of Surgery, University of Michigan Medical School, Ann Arbor, Michigan, United States

Background: FZD2 is a critical protein in the Wnt signaling pathway, which plays significant roles in various cancers. However, its role in cancer progression, prognosis, and diagnosis remains largely unexplored. This study investigates the correlation between FZD2 expression and clinical outcomes, as well as its underlying molecular mechanisms in pan-cancer.Methods: A comprehensive bioinformatic analysis was performed using pan-cancer data from The Cancer Genome Atlas (TCGA), which included 33 cancer types. GSEA was conducted to explore functional pathways, while a protein-protein interaction (PPI) network was constructed to further elucidate the role of FZD2 in tumor biology. The relationship between FZD2 expression and immune cell infiltration across 22 categories was assessed using CIBERSORT. Additionally, single-cell analysis was employed to examine FZD2 expression levels across different cell types. To investigate the functional impact of FZD2, loss-of-function experiments were carried out in gastric cancer cell lines using siRNA-mediated knockdown. Subsequent assays, including PCR, Western blotting, CCK8, Flow Cytometry, wound healing, and transwell migration and invasion assays, were performed to assess cellular responses. A subcutaneous gastric cancer xenograft model was established to investigate the effect of FZD2 knockdown on tumor growth in vivo.Results: Our analysis revealed significant upregulation of FZD2 in multiple malignancies, including STAD, BLCA, and CHOL. FZD2 expression was correlated with various cancer characteristics, including stemness score, matrix score, immune score, TMB, MSI, RNA modification genes, and drug sensitivity. Notably, FZD2 was associated with altered sensitivity to several anticancer agents, suggesting its role in modulating treatment responses. FZD2 knockdown was demonstrated by both in vitro and in vivo experiments to suppress tumor cell proliferation, migration, and invasion in gastric cancer cell lines, indicating its critical role in tumor progression. Furthermore, FZD2 exhibited significant correlations with other Wnt pathway genes, indicating a complex interaction network contributing to tumorigenesis.Conclusion: FZD2 is widely upregulated in various tumor types, with its expression closely associated with key clinical outcomes, including overall survival, disease-specific survival, disease-free interval, as well as tumor mutations, drug sensitivity, immune cell infiltration, and immunotherapy-related biomarkers such as TMB and MSI. These findings highlight the pivotal role of FZD2 in cancer prognosis and treatment.