Yanxin Li,1 Ke Ma,2 Qi Xie,3 Xianwei Zhang,3 Xiulei Zhang,4 Kui Chen,1 Lingfei Kong,3 Rongjun Qian1 1Department of Neurosurgery, Henan Provincial Peopleâs Hospital, Peopleâs Hospital of Zhengzhou University, Peopleâs Hospital of Henan University, Zhengzhou, Henan, 450003, Peopleâs Republic of China; 2Department of Medical Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, Peopleâs Republic of China; 3Department of Pathology, Henan Provincial Peopleâs Hospital, Peopleâs Hospital of Zhengzhou University, Peopleâs Hospital of Henan University, Zhengzhou, Henan, 450003, Peopleâs Republic of China; 4Department of Microbiome Laboratory, Henan Provincial Peopleâs Hospital, Peopleâs Hospital of Zhengzhou University, Peopleâs Hospital of Henan University, Zhengzhou, Henan, 450003, Peopleâs Republic of ChinaCorrespondence: Rongjun QianDepartment of Neurosurgery, Henan Provincial Peopleâs Hospital, Peopleâs Hospital of Zhengzhou University, Peopleâs Hospital of Henan University, No. 7, Wei Wu Road, Zhengzhou, Henan, 450003, Peopleâs Republic of ChinaTel +86 15037138200Email qrjqqx@163.comLingfei KongDepartment of Pathology, Henan Provincial Peopleâs Hospital, Peopleâs Hospital of Zhengzhou University, Peopleâs Hospital of Henan University, No. 7, Wei Wu Road, Zhengzhou, Henan, 450003, Peopleâs Republic of ChinaTel +86 18538298216Email lfkong@zzu.edu.cnPurpose: HOXD10 is a tumor modulator that can either be a tumor-suppressor or a tumor-promoting gene. However, the role of HOXD10 in glioblastoma multiforme (GBM) remains unclear.Methods: Immunohistochemistry (IHC) was applied to detect protein expression of HOXD10 in GBM and normal brain tissue patients. Clinicopathological characteristics with GBM were recorded, and a KaplanâMeier curve was plotted. Additionally, the mRNA expression of HOXD10 and its effect on prognosis were analyzed using the online tool GEPIA and the Cancer Genome Atlas (TCGA), Chinese Glioma Genome Atlas (CGGA), and the Gene Expression Omnibus (GEO) databases. Based on the mRNA expression of HOXD10, GBM patients from TCGA database were divided into low- and high-HOXD10 expression groups to analyze the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways, and construct a lncRNA-miRNA-mRNA network and a proteinâprotein interaction (PPI) network.Results: The mRNA expression of HOXD10 was up-regulated in GBM according to GEPIA, while the protein expression of HOXD10 in GBM was down-regulated according to IHC analysis of samples from patients collected from our hospital. Correlation analysis showed that HOXD10 expression was significantly related to IDH1 status. Univariate analysis revealed that low HOXD10 expression, complete surgical resection, postoperative radiotherapy, postoperative temozolomide chemotherapy and IDH1 mutation were all beneficial prognostic factors. Further multivariate analysis revealed that only complete surgical resection and postoperative radiotherapy were independent prognostic factors. GO and KEGG enrichment analyses indicated that HOXD10 expression is mainly involved in cytokine-cytokine receptor interactions. In the ceRNA network, 89 nodes, containing 45 mRNAs, 39 miRNAs and five lncRNAs associated with prognosis were involved. The PPI network revealed a tight interaction between HOXD10 and HOXD8, HOXD9, HOXD11, HOXD13 and HOXB3.Conclusion: Based on our experimental data, although HOXD10 expression is low in GBM compared with normal brain tissue, GBM patients with high HOXD10 expression have a worse prognosis. HOXD10 may play different or even opposite roles in different stages of GBM occurrence and development. For patients with GBM, HOXD10 may be a valid predictor of prognosis.Keywords: HOXD10, GBM, prognosis, ceRNA, protein-protein interaction