CD99 is a potential diagnostic and immunological biomarker in pan-cancer

Background As a cell adhesion factor, cluster of differentiation 99 (CD99) mainly plays a role in regulating cell differentiation. Recent studies have revealed an important role for CD99 in the initiation and progression of several cancers. However, a comprehensive pan-cancer analysis of CD99 has not been performed. Methods In this study, we utilized advanced bioinformatics techniques to conduct an in-depth investigation of CD99 expression across diverse tumors, its prognostic and diagnostic implications, the predominant modes of genetic alteration, correlations with immune cell infiltration and immune checkpoints, enrichment analyses of related gene expression, and mechanisms of drug resistance. Results Our findings revealed that CD99 was significantly upregulated in numerous common cancers and was associated with both diagnostic and prognostic outcomes. Notably, genetic alterations of CD99 predominantly manifested as deletions. Furthermore, CD99 exhibited strong correlations with nearly all infiltrating immune cells and their corresponding checkpoints. Enrichment analyses further emphasized the potential role of CD99 in epithelial-mesenchymal transition (EMT) pathways and leukocyte migration. Additionally, our investigations into drug resistance indicated that CD99 expression was primarily linked to resistance against antitumor agents such as 5-fluorouracil and belinostat. Conclusions Through this comprehensive pan-cancer analysis, we elucidated novel roles for CD99 in various cancer types, providing important insights for clinical treatment strategies and drug development.