PURPOSE:To explore the core driving genes and related pathways of pleomorphic adenoma(PA)transforma tion into carcinoma ex pleomorphic adenoma(Ca-ex-PA)based on high-throughput transcriptome sequencing and WGCNA.METHODS:The mRNA expression of 5 cases of PA and salivary gland and 5 cases of Ca-ex-PA and salivary gland was detected by RNA-Seq.The differentially expressed genes(DEGs)of PA group and Ca-ex-PA group were screened and the intersection of DEGs of them were taken.WGCNA was used to analyze the intersection of DEGs,in order to identify the hub genes associated with malignant transformation of PA.RESULTS:Totally 426 DEGs between PA and Ca-ex-PA were detected.Through WGCNA,78 genes were considered to be highly associated with malignant transformation of PA.The highest correlation score gene was EFNA3(P<0.05).CONCLUSIONS:The malignant transformation of PA may be highly associated with EFNA3 and other hub genes.Whether EFNA3 can be used as an independent predictor in the prognosis assessment of Ca-ex-PA needs to be studied further.