Fig. 6
Combination treatment of RC48 and CM affected signaling pathways and unique OC-associated prognostic genes. GSEA was performed using the 50 HALLMARK gene set database in MSigDB to analyze the most common DEGs in A2780 and OVCAR-3 cells treated with the combination therapy. A Positively and negatively enriched gene sets responsive to RC48 plus CM were identified using GSEA. B GSEA revealed strong positive enrichment of cell death-related pathways, such as ferroptosis and lysosomes, in A2780 and OVCAR-3 cells under combination treatment. C Negative enrichment was observed in cellular senescence, GAP junction, the hippo signaling pathway, and TGF-β signaling pathway, which are related to cell growth and adhesion pathways. NES, Normalised Enrichment Score; FDR, false discovery rate. D, E The relationship between different expressed genes enriched by GSEA and overall survival rate was evaluated using Kaplan-Meier analysis. Lower expression of CDKN2B and WNT11 was found to be beneficial to the overall survival rate of patients with OC (p < 0.01), while high expression of SMAD3, ZFYVE16, BMP6, LEFTY1, and DVL2 significantly improved the overall survival of OC patients (p < 0.05). Significance was determined using the log-rank (Mantel-Cox) test, and p < 0.05 was considered significant. F, G GEPIA was used to analyze the differential expression of genes enriched by GSEA in OC tissues and adjacent tissues