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Placenta-specific protein 1 (PLAC1) is inversely associated with survival in several types of cancer. However, whether PLAC1 is involved in the progression of cervical cancer (CC) remains to be elucidated. Therefore, the present study aimed to evaluate the prognostic role of PLAC1 in CC by determining the relationship between clinicopathological factors, PLAC1 gene expression and survival prognosis using univariate and multivariate Cox proportional-hazards regression analyses. Similarly, Kaplan-Meier curves were evaluated with the log-rank test. Subsequently, gene set enrichment analysis was performed to compare the highand low-PLAC1 expression phenotypes. Functional studies were further conducted in PLAC1-overexpressing HeLa cells and PLAC1-silenced MS751 cells, and western blotting was performed to determine whether PLAC1 promoted CC progression via epithelial-mesenchymal transition (EMT). The findings demonstrated that high expression of PLAC1 was associated with American Joint Committee on Cancer metastasis pathological score and suggested a poor overall survival. 'mTOR complex 1 signaling', 'interferon α response' and 'hypoxia' were differentially enriched in the high-PLAC1 phenotype. Furthermore, PLAC1 promoted the invasion of CC cells in vitro. E-cadherin expression was decreased in the PLAC1-overexpressing cells, accompanied by increased expression of the mesenchymal markers, Vimentin, MMP2 and Slug, and the opposite effects were observed in PLAC1-silenced cells. Taken together, the present results indicated that high expression of PLAC1 was associated with poor survival and PLAC1 promoted metastasis via EMT in CC.

BackgroundThe enhanced recovery after surgery (ERAS) protocol is widely implemented in surgeries, and this study aims to reveal the characteristics of the 100 most-cited original articles in the field of ERAS research.MethodsThe literature was retrieved in the Web of Science database, the 100 most-cited original articles were identified, and their characteristics were analyzed, including the trends of publications and citations; contributions from countries, institutions, and authors; co-cited authors and journals in the references; served surgeries, research endpoints, keywords; and the level of evidence.ResultsThere was a rising trend in the yearly publications and citations. Denmark and the USA contributed the largest number of highly cited papers. The University of Copenhagen was the most influential institution. Kehlet, Henrik was the most influential author. The British Journal of Surgery was the most often published and cited journal. ERAS protocols were overwhelmingly implemented in colorectal surgeries. The most focused endpoints were “length of stay”, “complications”, and “readmission”. The most frequently used keywords were “fast track”, “length of stay”, and “laparoscopy”. The keyword “enhanced recovery after surgery” burst since 2012. More than half of the highly cited articles presented level IV evidence, but there was no correlation between citations (densities) and the levels of evidence.ConclusionsThe highly cited research overwhelming implemented ERAS in colorectal surgeries, the “length of stay” was the most focused element, and Kehlet, Henrik was the most influential researcher. Most of the highly cited ERAS had low levels of evidence, and the total number of citations was not relevant to the level of evidence. Therefore, studies with high levels of evidence are still required in the future.