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Introduction
The mortality rate of malignant tumors in China surpasses the global average, posing a serious threat to human health. As of 2020, prostate cancer holds the highest incidence rate among male cancers in 112 countries globally. It accounts for about 1.4 million new cases annually, leading to around 375,000 deaths each year. Prostate cancer is the second most common cancer among males in 2020, with a mortality rate ranking fifth [1, 2]. Prostate cancer incidence exhibits considerable variation across regions and ethnic groups. It is most prevalent in Northern and Western Europe, the Caribbean, Australia/New Zealand, North America, and southern Africa, while Asia and North Africa experience comparatively lower rates [3, 4]. In China, the incidence of prostate cancer has markedly risen due to population aging and shifts in lifestyle habits [5, 6]. Consequently, prostate cancer is poised to impose a substantial health burden on men worldwide [2]. Notwithstanding its clinical utility as a biomarker for diagnosing and prognosticating PCa, prostate-specific antigen (PSA) exhibits inherent limitations [7]. For instance, it exhibits variations in sensitivity across different ethnic and racial groups and has poor specificity [7, 8–9]. Given these limitations, there is a critical need to identify novel biomarkers that can aid in the diagnosis, development, and recurrence monitoring of PCa.
Apoptosis inhibitors, known as IAPs and encoded by BIRC genes, play a critical role in conferring apoptosis resistance in various cancer cells [10, 11, 12, 13, 14–15]. These IAP proteins share significant structural and functional similarities. They exhibit two unique characteristics: first, they target both the initiating and executing caspases, resulting in a range of effects from anti-apoptotic to pro-apoptotic [10]. Secondly, IAPs exert influence over various cellular processes, including cell cycle regulation, immune system modulation, and DNA damage repair [16]. Furthermore, there is a significant link between IAPs and the NF-κB signaling pathway, underscoring their role in crucial cellular signaling cascades. IAPs exercise their function by counteracting proapoptotic signals, especially through interaction with the inhibitor of apoptosis-binding protein, thus aiding in cellular survival [17, 18]. In the BIRC family, different genes perform distinct biological functions, with both connections and differences among them. The genes BIRC2 and BIRC3 encode the cIAP1 and cIAP2 proteins, respectively, both of which are essential regulators of the...