Objective To investigate the expression of chromosome 6 open reading frame 15 (C6orf15) in colon cancer and its effects on clinicopathological features and prognosis. Methods Using the transcriptome and clinical data of colon cancer and normal tissues in The Cancer Genome Atlas (TCGA) database, the expression of C6orf15 mRNA in colon cancer samples and its relationship with clinicopathological characteristics and prognosis were explored. The expression level of C6orf15 protein in 23 colon

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... tissues was detected by immunohistochemistry (IHC). The possible mechanism of C6orf15 involved in the occurrence and development of colon cancer was explored by gene set enrichment analysis (GSEA). Results Compared with normal tissues, C6orf15 was highly expressed in colon cancer (1.207±0.694 vs. 0.276±0.166, t=8.281, P<0.01). The expression level of C6orf15 was associated with tumor invasion depth (χ2=8.30, P=0.04), lymph node metastasis (χ2=36.97, P<0.001), distant metastasis (χ2=8.69, P=0.003), pathological stage (χ2=34.17, P<0.001). High expression of C6orf15 was associated with poor prognosis (χ2=6.43, P<0.05). The results of GSEA showed that C6orf15 promotes the occurrence and development of colon cancer by promoting the ECM receptor interaction pathway, Hedgehog signaling pathway and Wnt signaling pathway. Immunohistochemical results showed that the expression of C6orf15 protein in colon cancer tissues was correlated with the depth of invasion (P=0.023) and lymph node metastasis (P=0.048). Conclusion C6orf15 is highly expressed in colon cancer tissue and is related to adverse pathological features and poor prognosis of colon cancer. It is involved in multiple oncogenic signaling pathways and may serve as a prognostic marker of colon cancer.