Cervical cancer is the leading cause of death with gynecological
malignancies. We aimed to explore the molecular mechanism of
carcinogenesis and
biomarkers for
cervical cancer by integrated bioinformatic analysis. We employed
RNA-sequencing details of 254 cervical
squamous cell carcinomas and 3 normal samples from The
Cancer Genome Atlas. To explore the distinct pathways,
messenger RNA expression was submitted to a Gene Set Enrichment Analysis. Kyoto Encyclopedia of Genes and Genomes and protein-protein interaction network analysis of differentially expressed genes were performed. Then, we conducted pathway enrichment analysis for modules acquired in
protein-
protein interaction analysis and obtained a list of pathways in every module. After intersecting the results from the 3 approaches, we evaluated the survival rates of both mutual pathways and genes in the pathway, and 5 survival-related genes were obtained. Finally, Cox hazards ratio analysis of these 5 genes was performed. DNA replication pathway ( P < .001; 12 genes included) was suggested to have the strongest association with the prognosis of cervical squamous
cancer. In total, 5 of the 12 genes, namely, minichromosome maintenance 2, minichromosome maintenance 4, minichromosome maintenance 5,
proliferating cell nuclear antigen, and
ribonuclease H2 subunit A were significantly correlated with survival. Minichromosome maintenance 5 was shown as an independent prognostic
biomarker for patients with
cervical cancer. This study identified a distinct pathway (DNA replication). Five genes which may be prognostic
biomarkers and minichromosome maintenance 5 were identified as independent prognostic
biomarkers for patients with
cervical cancer.