Plasma biomarker ORAI1 as a dual prognostic value for survival and postoperative quality of life in glioma patients

Abstract

Abstract Gliomas represent one of the most common and highly malignant primary brain tumors, with overall prognosis remaining unsatisfactory to date. Although certain molecular biomarkers have been identified to stratify patients based on survival outcomes, non-invasive blood biomarkers capable of simultaneously predicting both survival prognosis and postoperative quality of life (QoL) are still lacking. This study provides substantial evidence for the potential of ORAI1 as a non-invasive biomarker across diverse ethnic clinical cohorts. This investigation employed a translational medicine-oriented exploratory approach, incorporating 309 glioma patients from the Chinese Glioma Genome Atlas (CGGA) and 563 patients from The Cancer Genome Atlas (TCGA). Additionally, preoperative plasma samples from 50 glioma patients were analyzed by ELISA, alongside postoperative QoL assessments within three days after surgery. The correlations between ORAI1 gene expression and patients’ survival outcomes as well as postoperative QoL were evaluated, with further exploration of potential underlying biological mechanisms. High ORAI1 expression was identified as an independent adverse prognostic factor in glioma patients, significantly enriched in those with higher WHO grades (III–IV). Patients in the high ORAI1 expression group exhibited increased postoperative pain scores and poorer sleep quality. Notably, ORAI1 expression was absent or minimal in glioma tissues but markedly elevated in patients’ preoperative plasma. Functional enrichment analyses including Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Gene Set Variation Analysis (GSVA) indicated the potential utility of ORAI1 as a peripheral blood biomarker. ORAI1 serves not only as an independent predictor of survival prognosis but also reflects postoperative QoL, representing a promising dual biomarker. The discordant expression of ORAI1 in tumor tissue versus plasma suggests a unique role in tumor–host system interactions. These findings suggest new directions for precise prognostic evaluation and personalized perioperative management in glioma patients.