Abstract:ObjectiveTo explore the role of CD200 in Ewing's sarcoma and its possible pathological mechanisms, and to search for potential drugs that can improve the survival prognosis of Ewing's sarcoma patients. MethodsThe RNA seq and clinical data of Ewing's sarcoma patients were obtained from the International Cancer Genome Consortium database. The survival analysis was used to explore the impact of CD200 on the survival prognosis of Ewing's sarcoma patients. The gene set enrichment analysis (GSEA) and Lincx analysis were carried out to find the molecular mechanism of CD200 promoting the malignant process of Ewing's sarcoma and the anti-Ewing's sarcoma drugs that may target CD200. The expression level of CD200 was verified by RT qPCR. ResultsCD200 was significantly overexpressed in Ewing's sarcoma cells (P<0.05). The survival time of Ewing's sarcoma patients with low expression of CD200 was longer than high expression (P<0.05). The areas under the receiver operating characteristic curve in the 3-year and 5-year survival analysis were both greater than 0.70. CD200 expression level was an independent risk factor affecting the prognosis of Ewing's sarcoma patients. CD200 was involved in the malignant progression of Ewing's sarcoma through Focal adhesion, Cytokine-cytokine receptor interaction, ECM receptor interaction, Epithelial mesenchymal transition, and TNF-α signaling via NF-κB. Cabergoline, curcumin, elesclomol, and enzastaurin had potential significance in the development and clinical application of drugs targeting CD200. ConclusionCD200 is an independent risk factor affecting the survival prognosis of Ewing's sarcoma patients, and it can be used as a biomarker for the prevention, diagnosis, and treatment of Ewing's sarcoma.