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Searching for the gene ‘BRCA1’ in the lung cancer dataset reveals it to be most strongly associated with CorEx factor 26 (Figure 2). GO term enrichment for this factor is seen to be extremely high, with DNA repair exhibiting an FDR of only 1 x 10-19. The selection also draws attention to the second level cluster L2_8 that has six closely related factors as children. Selecting ‘DNA repair’ in either the GO term annotations or the factor graph's GO enriched dropdown highlights associated genes in each of the factors, with the factor 26 having by far the most, as expected11. The protein-protein interaction network is strongly connected, further supporting the tightly linked functionality of the genes in factor 26. The associated survival graph suggests a possible association with patient survival, but this would have to be confirmed in a larger dataset.
Starting with survival can allow dissection of reasons for improved survival associated with particular gene expression groups. As an example, the top factor influencing survival for ovarian cancer is seen to be number 39, which is strongly enriched for genes associated with the immune system (Figure 3). Five other factors associated with the same level 2 node are also indicated to be immune-related, however the survival impact appears to be strongly variable among them, with 39 being the highest and 52 being the lowest. Adding a protein-protein interaction window for a factor shows the immediate interaction network and allows for link out to the StringDB12 website to query various enrichments for the PPI network genes. By doing this for each of the L2_14 factors in turn, one finds that StringDB enrichments for the PPI network genes suggest the following possible explanation for the associations with survival. Factor 32 contains genes that make up the major histocompatibility complex (MHC) class I protein complex, which is recognized by cytotoxic T lymphocytes. Factor 39 corresponds to cytokine signaling and CXCR3 receptor binding, related to CD8+ T lymphocytes. Both of these factors appear to confer a significant survival advantage for patients exhibiting relatively high expression of the corresponding genes. Cytotoxic CD8+ T lymphocytes are primarily responsible for anti-tumor immunity. Factor 52, on the other hand, is comprised of genes coding for proteins in the MHC class II complex which are recognized primarily by CD4+ T helper cells rather than directly by cytotoxic T lymphocytes. The remaining L2_14 factors reflect generalized immune system activation that doesn't differentiate the two types of lymphocyte populations. A survival association specific to cytotoxic T lymphocyte recognition of MCH class I cellular antigens is consistent with our understanding of antitumor immunity in general and from other cancers such as melanoma13,14.
The web portal supports the discovery of pairs of factors with complementary functions that may suggest effective tumor-specific combination therapies. The dataset overview can be scanned for factors that show a correlation with survival yet have distinct GO enrichments. For melanoma (TCGA_SKCM; Figure 4), it is seen that the top survival factor 171 is immune related, while factor 88 down the list shows enrichment for genes related to mitochondrion organization. Indeed, this has been suggested as a target in melanoma15. Adding survival windows to the CorExplorer page allows comparison of stratification using the factor pair to that of each factor individually, showing that favorable gene expression patterns from both groups exhibits a trend of survival better than that for either factor alone. The top stratum does not appear to be improved however, suggesting immunotherapy only may be the best option for some patients.
Commonalities and differences among tumors can be seen by searching across datasets for genes or GO terms (Figure 5). As an example, FLT1 (aka VEGFR1) is a well-studied pro-angiogenic marker16,17. When it is put into the search bar, all of the tumors have factors in which FLT1 plays a major role. Conversely, when the GO term ‘angiogenesis’ is input on the search page, 5 out of 6 of the FLT1 groups appear with that enrichment. All FLT1 factors, with the exception of SKCM-195, are listed as statistically enriched for ‘angiogenesis’ genes. The sixth factor does, in fact, have the annotation, but below the default 10-8 threshold. When the weighting within the factor list is utilized in an alternative enrichment calculator, e.g., Gene Set Enrichment Analysis (GSEA)18, the sixth factor is found to be significantly enriched for ‘angiogenesis’ genes as well.
It is important to check the heatmaps to ensure the gene expression pattern is of adequate quality to support biological interpretations. Heatmaps that show strong clear variation may exhibit either coordinated expression of the factor genes ranging from low to high or more complex patterns with some genes having low expression correlated with others having high (Figure 6). A key marker of a high-quality grouping is the presence of several genes with a smooth variation in expression as a function of factor score. The factor heatmaps show samples ordered according to factor score, thus there should be a smooth gradient moving from left to right. However, this can fail to happen in at least two different ways. Most commonly, the correlations may be extremely noisy (Figure 5C), calling into question the robustness and utility of any inferences regarding survival and/or biological function. Also, patterns that happen only in a small minority of samples may not conform to the model of three expression states assumed by the CorEx algorithm, resulting in a misleading classification of the samples (right side of Figure 5D).

Figure 1: CorExplorer front page. After clicking on + next to Ovarian Cancer under Quick Links, factor graph details are shown. The CorEx hierarchical model is made up of input variables (gene expression in this case) on the bottom layer and inferred latent factors in the higher layers. Please click here to view a larger version of this figure.

Figure 2: Using a gene name to guide exploration. The figure shows a series of screenshots illustrating exploration of CorEx lung cancer factors strongly related to BRCA1. First, selecting ‘BRCA1’ in the Gene dropdown box for the factor graph causes the graph view to zoom in on the factor for which BRCA1 has greatest weight. Zooming out a bit frames the layer two node L2_8 connecting that factor to other related ones. Survival and annotations can be compared: clicking on the GO term DNA repair highlights annotated genes. A PPI window is added to show the network interactions for genes in the factor. Using the Add Window button to add a heat map shows association of expression patterns with survival, suggesting increased expression of DNA repair genes may be associated with decreased survival. Please click here to view a larger version of this figure.

Figure 3: Using clinical data (survival) to guide exploration. Exploring the top survival-associated factor (39) for ovarian cancer reveals interesting relationships among neighboring factors. After selecting factor 39 in the factor graph and zooming out a bit, the layer two factor linked to factor 39 is seen to have five other associated factors. An additional survival window allows direct comparison of the associated survival differentials. Factors 39 and 32 both show a positive survival correlation, in contrast to factor 52, which does not. The protein-protein interaction networks are all well-defined. Linking out to StringDB allows comparison of the GO annotations (not shown): Factor 39 is associated with a cytokine signaling network related to cytotoxic CD8+ T lymphocyte activation and factor 32 is dominated by MHC class I antigen presenting proteins that trigger recognition by such lymphocytes; the neighboring factors, however, are dominated by other immune system components such as CD4+ helper T cells and show no survival correlation. Please click here to view a larger version of this figure.

Figure 4: Exploring top survival factors suggests potential therapeutic combinations. The ‘Datasets’ link on the home page menu bar leads to a concise table of survival factors ordered by p-value, along with the top GO annotation (not shown). Using this information for melanoma, the combination of factor 171 for immune function with factor 88 for mitochondrion organization appears complementary. The figure shows annotation windows for each of the factors side-by-side to contrast them. Survival curves for patients stratified by the two factors individually or together indicate that the combination increases the survival differential compared to either factor alone. Please click here to view a larger version of this figure.

Figure 5: The Search page facilitates pan-cancer analysis. Genes or GO biological process terms can be searched for across all datasets using the Search link from the home page. The figure shows search results for the gene FLT1 and the GO term ‘angiogenesis’. The results show the presence of FLT1 in factors annotated with the term ‘angiogenesis’ across cancers. Please click here to view a larger version of this figure.

Figure 6: Heatmaps can be used to qualitatively assess correlations among genes and samples according to factor score. High quality gene expression relationships are shown by smooth gradation when patients are ordered by factor score in the heatmaps. The leftmost heatmap for factor 18 is one example. The patterns may also encompass complex signatures of up and down expression as in the middle large heatmap for factor 11. Lower quality patterns sometimes show abrupt changes in expression for a subgroup of patients as in the factor 9 heatmap on the right or simple very noisy correlations as in the factor 161 heatmap at the lower right. Please click here to view a larger version of this figure.