Identification and Validation a Costimulatory Molecule Gene Signature to Predict the Prognosis and Immunotherapy Response for Hepatocellular Carcinoma

Abstract Background: Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. Costimulatory molecules have been proven to be the foundation of immunotherapy. However, the potential roles of costimulatory molecule genes (CMGs) in HCC remain unclear. Our study is aimed to develop a costimulatory molecule-related gene signature that could evaluate the prognosis of HCC patients.Methods: Based on The Cancer Gene Atlas (TCGA) database, univariate Cox regression analysis was applied in CMGs to identify prognosis-related CMGs. Consensus clustering analysis was performed to stratify HCC patients into different subtypes and compared them in OS. Subsequently, the LASSO Cox regression analysis was performed to construct the CMGs-related prognostic signature and Kaplan–Meier survival curves as well as ROC curve were used to validate the predictive capability. Then we explored the correlations of the risk signature with tumor-infiltrating immune cells, tumor mutation burden (TMB) and response to immunotherapy. The expression levels of prognosis-related CMGs were validated in HCC using qRT-PCR method.Results: All HCC patients were classified into two clusters based on 11 CMGs with prognosis values and cluster 2 correlated with a poorer prognosis. Next, a prognostic signature of six CMGs was constructed, which was an independent risk factor for HCC patients. Patients with low-risk score were associated with better prognosis. The correlation analysis showed that the risk signature could predict the infiltration of immune cells and immune status of the immune microenvironment in HCC. The qRT-PCR indicated six CMGs with significantly differential expression in HCC tissues and normal tissues.Conclusion: In conclusion, our CMGs-related risk signature could be used as a prediction tool in survival assessment and immunotherapy for HCC patients.

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Identification of Prognostic Gene Signature Associated with Tumor Microenvironment of Cholangiocarcinoma

10.21203/rs.3.rs-524410/v1 ◽

2021 ◽

Author(s):

Jixiang Cao ◽

Xi Chen ◽

Guang Lu ◽

Haowei Wang ◽

Xinyu Zhang ◽

...

Keyword(s):

Regression Analysis ◽

Tumor Microenvironment ◽

Immune Cells ◽

Prognostic Model ◽

Cox Regression ◽

Gene Signature ◽

Risk Scores ◽

Tumor Infiltration ◽

Prognostic Signature ◽

Cox Regression Analysis

Abstract Background: Cholangiocarcinoma (CCA) is the most common malignancy of the biliary tract with a dismal prognosis. Increasing evidence suggests that tumor microenvironment (TME) is closely associated with cancer prognosis. However, the prognostic signature for CCA based on TME has not yet been reported. This study aimed to develop a TME-related prognostic signature for accurately predicting the prognosis of patients with CCA. Methods: Based on the TCGA database, we calculated the stromal and immune scores using the ESTIMATE algorithm to assess TME in stromal and immune cells derived from CCA. TME-related differentially expressed genes were identified, followed by functional enrichment analysis and PPI network analysis. Univariate Cox regression analysis, Lasso Cox regression model and multivariable Cox regression analysis were performed to identify and construct the TME-related prognostic gene signature. Gene Set Enrichment Analyses (GSEA) was performed to further investigate the potential molecular mechanisms. The correlations between the risk scores and tumor infiltration immune cells were analyzed using Tumor Immune Estimation Resource (TIMER) database. Results: A total of 784 TME-related differentially expressed genes (DEGs) were identified, which were mainly enriched in immune-related processes and pathways. Among these TME-related DEGs, A novel two‑gene signature (including GAD1 and KLRB1) was constructed for CCA prognosis prediction. The AUC of the prognostic model for predicting the survival of patients at 1-, 2-, and 3- years was 0.811, 0.772, and 0.844, respectively. Cox regression analysis showed that the two‑gene signature was an independent prognostic factor. Based on the risk scores of the prognostic model, CCA patients were divided into high- and low-risk groups, and patients with high-risk score had shorter survival time than those with low-risk score. Furthermore, we found that the risk scores were negatively correlated with TME-scores and the number of several tumor infiltration immune cells, including B cells and CD4+ T cells. Conclusion: Our study established a novel TME-related gene signature to predict the prognosis of patients with CCA. This might provide a new understanding of the potential relationship between TME and CCA prognosis, and serve as a prognosis stratification tool for guiding personalized treatment of CCA patients.

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Identification of Immune-Related Prognostic mRNA and lncRNA in Patients with Hepatocellular Carcinoma

Journal of Oncology ◽

10.1155/2022/5313149 ◽

2022 ◽

Vol 2022 ◽

pp. 1-16

Author(s):

Dan Chen ◽

Xiaoting Li ◽

Hui Li ◽

Kai Wang ◽

Xianghua Tian

Keyword(s):

Hepatocellular Carcinoma ◽

Flow Cytometry ◽

T Cells ◽

Regression Analysis ◽

Survival Analysis ◽

Immune Cells ◽

Cox Regression ◽

Differentially Expressed ◽

Cox Regression Analysis ◽

Immune Related Genes

Background. As the most common hepatic malignancy, hepatocellular carcinoma (HCC) has a high incidence; therefore, in this paper, the immune-related genes were sought as biomarkers in liver cancer. Methods. In this study, a differential expression analysis of lncRNA and mRNA in The Cancer Genome Atlas (TCGA) dataset between the HCC group and the normal control group was performed. Enrichment analysis was used to screen immune-related differentially expressed genes. Cox regression analysis and survival analysis were used to determine prognostic genes of HCC, whose expression was detected by molecular experiments. Finally, important immune cells were identified by immune cell infiltration and detected by flow cytometry. Results. Compared with the normal group, 1613 differentially expressed mRNAs (DEmRs) and 1237 differentially expressed lncRNAs (DElncRs) were found in HCC. Among them, 143 immune-related DEmRs and 39 immune-related DElncRs were screened out. These genes were mainly related to MAPK cascade, PI3K-AKT signaling pathway, and TGF-beta. Through Cox regression analysis and survival analysis, MMP9, SPP1, HAGLR, LINC02202, and RP11-598F7.3 were finally determined as the potential diagnostic biomarkers for HCC. The gene expression was verified by RT-qPCR and western blot. In addition, CD4 + memory resting T cells and CD8 + T cells were identified as protective factors for overall survival of HCC, and they were found highly expressed in HCC through flow cytometry. Conclusion. The study explored the dysregulation mechanism and potential biomarkers of immune-related genes and further identified the influence of immune cells on the prognosis of HCC, providing a theoretical basis for the prognosis prediction and immunotherapy in HCC patients.

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Identification of a Liver Progenitor Cell-Related Genes Signature Predicting Overall Survival for Hepatocellular Carcinoma

Technology in Cancer Research & Treatment ◽

10.1177/15330338211041425 ◽

2021 ◽

Vol 20 ◽

pp. 153303382110414

Author(s):

Xiaoyong Li ◽

Jiaqong Lin ◽

Yuguo pan ◽

Peng Cui ◽

Jintang Xia

Keyword(s):

Hepatocellular Carcinoma ◽

Overall Survival ◽

Regression Analysis ◽

Prognostic Model ◽

Cox Regression ◽

Risk Group ◽

Gene Signature ◽

Regression Analyses ◽

Related Gene ◽

Cox Regression Analysis

Background: Liver progenitor cells (LPCs) play significant roles in the development and progression of hepatocellular carcinoma (HCC). However, no studies on the value of LPC-related genes for evaluating HCC prognosis exist. We developed a gene signature of LPC-related genes for prognostication in HCC. Methods: To identify LPC-related genes, we analyzed mRNA expression arrays from a dataset (GSE57812 & GSE 37071) containing LPCs, mature hepatocytes, and embryonic stem cell samples. HCC RNA-Seq data from The Cancer Genome Atlas (TCGA) were used to explore the differentially expressed genes (DEGs) related to prognosis through DEG analysis and univariate Cox regression analysis. Lasso and multivariate Cox regression analyses were performed to construct the LPC-related gene prognostic model in the TCGA training dataset. This model was validated in the TCGA testing set and an external dataset (International Cancer Genome Consortium [ICGC] dataset). Finally, we investigated the relationship between this prognostic model with tumor-node-metastasis stage, tumor grade, and vascular invasion of HCC. Results: Overall, 1770 genes were identified as LPC-related genes, of which 92 genes were identified as DEGs in HCC tissues compared with normal tissues. Furthermore, we randomly assigned patients from the TCGA dataset to the training and testing cohorts. Twenty-six DEGs correlated with overall survival (OS) in the univariate Cox regression analysis. Lasso and multivariate Cox regression analyses were performed in the TCGA training set, and a 3-gene signature was constructed to stratify patients into 2 risk groups: high-risk and low-risk. Patients in the high-risk group had significantly lower OS than those in the low-risk group. Receiver operating characteristic curve analysis confirmed the signature's predictive capacity. Moreover, the risk score was confirmed to be an independent predictor for patients with HCC. Conclusion: We demonstrated that the LPC-related gene signature can be used for prognostication in HCC. Thus, targeting LPCs may serve as a therapeutic alternative for HCC.

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A novel comprehensive immune-related gene signature as a promising survival predictor for head and neck squamous cell carcinoma

10.21203/rs.3.rs-26402/v1 ◽

2020 ◽

Author(s):

Ruihua Fang ◽

Lin Chen ◽

Jing Liao ◽

Jierong Luo ◽

Chenchen Zhang ◽

...

Keyword(s):

Regression Analysis ◽

Head And Neck ◽

Cox Regression ◽

Gene Signature ◽

Related Gene ◽

Prognostic Signature ◽

Immune Microenvironment ◽

Cox Regression Analysis ◽

Immune Genes ◽

Immune Related Gene

Abstract Background: Head and neck squamous cell carcinoma (HNSCC), the most frequent subtype of head and neck cancer, continues to have a poor prognosis with no improvement. Growing evidence has demonstrated that the immune system plays a crucial role in the development and progression of HNSCC. The goal of our study was to develop an immune-related signature for accurately predicting the survival of HNSCC patients. Methods: Gene expression profiles were established from a total of 546 HNSCC and normal tissues to establish a training set and 83 HNSCC tissues for a validation set. Differentially expressed prognostic immune genes were identified by univariate Cox regression analysis and a corresponding network of differentially expressed transcription factors (TFs) were identified using Cytoscape. The immune-related gene signature was established and validated by univariate Cox regression analysis, least absolute shrinkage and selector operation (LASSO), and multivariate Cox regression analyses. In addition, the prognostic value of the immune-related signature was analyzed by survival and Cox regression analysis. Finally, the correlation between the immune-related signature and the immune microenvironment was established.Results: In this study, the TF-mediated network revealed that Foxp3 plays a central role in the regulatory mechanism of most immune genes. A prognostic signature based on 10 immune-related genes, which divided patients into high and low risk groups, was developed and successfully validated using two independent databases. Our prognostic signature was significantly related to worse survival and predicted prognosis in patients with different clinicopathological factors. A nomogram including clinical characteristics was also constructed for accurate prediction. Furthermore, it was determined that our prognostic signature may act as an independent factor for predicting the survival of HNSCC patients. ROC analysis also revealed that our signature had superior predictive value compared with TNM stage. As for the immune microenvironment, our signature showed a positive correlation with activated mast cells and M0 macrophages, a negative correlation with Tregs, and immune checkpoint molecules PD-1 and CLTA-4. Conclusions: Our study established an immune-related gene signature, which not only provides a promising biomarker for survival prediction, but may be evaluated as an indicator for personalized immunotherapy in patients with HNSCC.

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Prognostic Nomogram Based on Circular RNA-Associated Competing Endogenous RNA Network for Patients with Lung Adenocarcinoma

Oxidative Medicine and Cellular Longevity ◽

10.1155/2021/9978206 ◽

2021 ◽

Vol 2021 ◽

pp. 1-13

Author(s):

Yang Li ◽

Rongrong Sun ◽

Rui Li ◽

Yonggang Chen ◽

He Du

Keyword(s):

Overall Survival ◽

Regression Analysis ◽

Lung Adenocarcinoma ◽

Regulatory Mechanism ◽

Cox Regression ◽

Gene Signature ◽

Differentially Expressed ◽

Prognostic Signature ◽

Cox Regression Analysis ◽

Cerna Network

Evidence is increasingly indicating that circular RNAs (circRNAs) are closely involved in tumorigenesis and cancer progression. However, the function and application of circRNAs in lung adenocarcinoma (LUAD) are still unknown. In this study, we constructed a circRNA-associated competitive endogenous RNA (ceRNA) network to investigate the regulatory mechanism of LUAD procession and further constructed a prognostic signature to predict overall survival for LUAD patients. Differentially expressed circRNAs (DEcircRNAs), differentially expressed miRNAs (DEmiRNAs), and differentially expressed mRNAs (DEmRNAs) were selected to construct the ceRNA network. Based on the TargetScan prediction tool and Pearson correlation coefficient, we constructed a circRNA-associated ceRNA network including 11 DEcircRNAs, 8 DEmiRNAs, and 49 DEmRNAs. GO and KEGG enrichment indicated that the ceRNA network might be involved in the regulation of GTPase activity and endothelial cell differentiation. After removing the discrete points, a PPI network containing 12 DEmRNAs was constructed. Univariate Cox regression analysis showed that three DEmRNAs were significantly associated with overall survival. Therefore, we constructed a three-gene prognostic signature for LUAD patients using the LASSO method in the TCGA-LUAD training cohort. By applying the signature, patients could be categorized into the high-risk or low-risk subgroups with significant survival differences (HR: 1.62, 95% CI: 1.12-2.35, log-rank p = 0.009 ). The prognostic performance was confirmed in an independent GEO cohort (GSE42127, HR: 2.59, 95% CI: 1.32-5.10, log-rank p = 0.004 ). Multivariate Cox regression analysis proved that the three-gene signature was an independent prognostic factor. Combining the three-gene signature with clinical characters, a nomogram was constructed. The primary and external verification C -indexes were 0.717 and 0.716, respectively. The calibration curves for the probability of 3- and 5-year OS showed significant agreement between nomogram predictions and actual observations. Our findings provided a deeper understanding of the circRNA-associated ceRNA regulatory mechanism in LUAD pathogenesis and further constructed a useful prognostic signature to guide personalized treatment of LUAD patients.

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Identification and validation of an immune-related prognostic signature for hepatocellular carcinoma

10.21203/rs.3.rs-25879/v1 ◽

2020 ◽

Author(s):

Xinxin Xia ◽

Hui Liu ◽

Yuejun Li

Keyword(s):

Hepatocellular Carcinoma ◽

Regression Analysis ◽

Cox Regression ◽

Cancer Genome ◽

The Cancer Genome Atlas ◽

Immune Gene ◽

Regression Analyses ◽

Prognostic Signature ◽

Biological Mechanisms ◽

Cox Regression Analysis

Abstract Background: Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality. The immune system plays vital roles in HCC initiation and progression. The present study aimed to construct an immune-gene related prognostic signature (IRPS) for predicting the prognosis of HCC patients. Methods: Gene expression data were retrieved from The Cancer Genome Atlas database. Univariate Cox regression analysis was carried out to identify differentially expressed genes that associated with overall survival. The IRPS was established via Lasso and multivariate Cox regression analysis. Both Cox regression analyses were conducted to determine the independent prognostic factors for HCC. Next, the association between the IRPS and clinical-related factors were evaluated. The prognostic values of the IRPS were further validated using the International Cancer Genome Consortium (ICGC) dataset. Gene set enrichment analyses (GSEA) were conducted to understand the biological mechanisms of the IRPS. Results: A total of 62 genes were identified to be candidate immune-related prognostic genes. Transcription factors-immunogenes network was generated to explore the interactions among these candidate genes. According to the results of Lasso and multivariate Cox regression analysis, we established an IRPS and confirmed its stability and reliability in ICGC dataset. The IRPS was significantly associated with advanced clinicopathological characteristics. Both Cox regression analyses revealed that the IRPS could be an independent risk factor influencing the prognosis of HCC patients. The relationships between the IRPS and infiltration immune cells demonstrated that the IRPS was associated with immune cell infiltration. GSEA identified significantly enriched pathways, which might assist in elucidating the biological mechanisms of the IRPS. Furthermore, a nomogram was constructed to estimate the survival probability of HCC patients.Conclusions: The IRPS was effective for predicting prognosis of HCC patients, which might serve as novel prognostic and therapeutic biomarkers for HCC.

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Identification and Validation of a Novel Metabolism‑Related Prognostic Signature in Hepatocellular Carcinoma

10.21203/rs.3.rs-50552/v1 ◽

2020 ◽

Author(s):

Zhihao Wang ◽

Kidane Siele Embaye ◽

Qing Yang ◽

Lingzhi Qin ◽

Chao Zhang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Overall Survival ◽

Regression Analysis ◽

Prognostic Value ◽

Cox Regression ◽

Cancer Genome ◽

Regression Analyses ◽

Prognostic Signature ◽

Cox Regression Analysis ◽

Tcga Dataset

Abstract Background: Given that metabolic reprogramming has been recognized as an essential hallmark of cancer cells, this study sought to investigate the potential prognostic values of metabolism-related genes(MRGs) for hepatocellular carcinoma (HCC) diagnosis and treatment. Methods: The metabolism-related genes sequencing data of HCC samples with clinical information were obtained from the International Cancer Genome Consortium(ICGC) and The Cancer Genome Atlas (TCGA). The differentially expressed MRGs were identified by Wilcoxon rank sum test. Then, univariate Cox regression analysis were performed to identify metabolism-related DEGs that related to overall survival(OS). A novel metabolism-related prognostic signature was developed using the least absolute shrinkage and selection operator (Lasso) and multivariate Cox regression analyses . Furthermore, the signature was validated in the TCGA dataset. Finally, cox regression analysis was applied to identify the prognostic value and clinical relationship of the signature in HCC. Results: A total of 178 differentially expressed MRGs were detected between the ICGA dataset and the TCGA dataset. We found that 17 MRGs were most significantly associated with OS by using the univariate Cox proportional hazards regression analysis in HCC. Then, the Lasso and multivariate Cox regression analyses were applied to construct the novel metabolism-relevant prognostic signature, which consisted of six MRGs. The prognostic value of this prognostic model was further successfully validated in the TCGA dataset. Further analysis indicated that this signature could be an independent prognostic indicator after adjusting to other clinical factors. Six MRGs (FLVCR1, MOGAT2, SLC5A11, RRM2, COX7B2, and SCN4A) showed high prognostic performance in predicting HCC outcomes, and were further associated with tumor TNM stage, gender, age, and pathological stage. Finally, the signature was found to be associated with various clinicopathological features. Conclusions: In summary, our data provided evidence that the metabolism-based signature could serve as a reliable prognostic and predictive tool for overall survival in patients with HCC.

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Development of a prognostic signature based on six immune related lncRNAs for hepatocellular carcinoma.

10.21203/rs.3.rs-16348/v1 ◽

2020 ◽

Author(s):

Ze-bing Song ◽

Guo-pei Zhang ◽

shaoqiang li

Keyword(s):

Hepatocellular Carcinoma ◽

Regression Analysis ◽

Cox Regression ◽

Enrichment Analysis ◽

Gene Set Enrichment Analysis ◽

The Cancer Genome Atlas ◽

Differentially Expressed ◽

Prognostic Signature ◽

Cox Regression Analysis ◽

Cerna Network

Abstract Background: Hepatocellular carcinoma (HCC) is one of the most common malignant tumor in the world which prognosis is poor. Therefore, a precise biomarker is needed to guide treatment and improve prognosis. More and more studies have shown that lncRNAs and immune response are closely related to the prognosis of hepatocellular carcinoma. The aim of this study was to establish a prognostic signature based on immune related lncRNAs for HCC.Methods: Univariate cox regression analysis was performed to identify immune related lncRNAs, which had negative correlation with overall survival (OS) of 370 HCC patients from The Cancer Genome Atlas (TCGA). A prognostic signature based on OS related lncRNAs was identified by using multivariate cox regression analysis. Gene set enrichment analysis (GSEA) and a competing endogenous RNA (ceRNA) network were performed to clarify the potential mechanism of lncRNAs included in prognostic signature. Results: A prognostic signature based on OS related lncRNAs (AC145207.5, AL365203.2, AC009779.2, ZFPM2-AS1, PCAT6, LINC00942) showed moderately in prognosis prediction, and related with pathologic stage (Stage I&II VS Stage III&IV), distant metastasis status (M0 VS M1) and tumor stage (T1-2 VS T3-4). CeRNA network constructed 15 aixs among differentially expressed immune related genes, lncRNAs included in prognostic signature and differentially expressed miRNA. GSEA indicated that these lncRNAs were involved in cancer-related pathways. Conclusion: We constructed a prognostic signature based on immune related lncRNAs which can predict prognosis and guide therapies for HCC.

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A Novel Five-gene Signature Predicts Overall Survival in Hepatocellular Carcinoma

10.21203/rs.3.rs-32144/v1 ◽

2020 ◽

Author(s):

Zhigang Wang ◽

Leyu Pan ◽

Deliang Guo ◽

Xiaofeng Luo ◽

Jie Tang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Overall Survival ◽

Regression Analysis ◽

Cox Regression ◽

Gene Signature ◽

Tnm Stage ◽

Time Dependent ◽

Quantitative Real Time Pcr ◽

Cox Regression Analysis ◽

Normal Tissues

Abstract Background: Hepatocellular carcinoma (HCC) is one of the most common challenges for public health worldwide. Due to its complex molecular and great heterogeneity, the effectiveness of existing HCC risk prediction models is unsatisfactory. Hence, more accurate prognostic models are pressingly needed. Materials and methods: Differentially expressed mRNAs (DEMs) between HCC and normal tissues were identified after downloading GSE1450 from gene omnibus (GEO) database. We randomly divided all patients into training and testing sets. Univariate Cox regression, lasso Cox regression and multivariable Cox regression analysis were used to constructed the prognostic gene signature in training set. Our study utilized Kaplan-Meier plot, time-dependent receiver operating characteristic (ROC), multivariable Cox regression analysis with clinical information, nomogram and decision curve analysis (DCA) to evaluate the predictive ability for overall survival of the novel gene signature in training, testing and whole sets. We also validated the prognostic capacity of the five-gene signature in an external validation set. The information of mutation of each gene was explored on cBioPortal online website. We performed gene set enrichment analysis (GSEA) to explore underlying mechanisms in the high and low risk group. Finally, quantitative real-time PCR was conducted to validate the expression tendency between 12 paired HCC and adjacent normal tissues. Results: Our study constructed a novel five-gene signature (CNIH4, SOX4, SPP1, SORBS2 and CCL19) for predicting overall survival of HCC. Time-dependent ROC curve indicated admirable ability in survival prediction in two datasets. Multivariable Cox regression analysis indicated that both this five-gene signature and TNM stage were two independent prognostic factors for overall survival of HCC patients. Combined with TNM stage clinical pathological parameters, the predictive capacity of nomogram had a decent improvement. The mutation of the five genes had no obvious variation. Plenty pathways were enriched by GSEA, including cell cycle and various metabolism. Furthermore, the mRNA levels of these five genes had signiﬁcantly diﬀerent expressions between HCC tissues and adjacent normal tissues by quantitative real-time PCR. Conclusions: A five-gene prognostic model and nomogram were constructed and validated for predicting prognostic of HCC patients. And the five-gene risk score with TNM stage models might help various HCC patients to customize individual therapies.

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Construction and Validation of a Reliable Six-Gene Prognostic Signature Based on the TP53 Alteration for Hepatocellular Carcinoma

Frontiers in Oncology ◽

10.3389/fonc.2021.618976 ◽

2021 ◽

Vol 11 ◽

Author(s):

Junyu Huo ◽

Liqun Wu ◽

Yunjin Zang

Keyword(s):

Gene Expression ◽

Hepatocellular Carcinoma ◽

Regression Analysis ◽

Cox Regression ◽

Enrichment Analysis ◽

Gene Set Enrichment Analysis ◽

Prognostic Signature ◽

Gene Set Enrichment ◽

Cox Regression Analysis ◽

Gene Set

BackgroundThe high mutation rate of TP53 in hepatocellular carcinoma (HCC) makes it an attractive potential therapeutic target. However, the mechanism by which TP53 mutation affects the prognosis of HCC is not fully understood.Material and ApproachThis study downloaded a gene expression profile and clinical-related information from The Cancer Genome Atlas (TCGA) database and the international genome consortium (ICGC) database. We used Gene Set Enrichment Analysis (GSEA) to determine the difference in gene expression patterns between HCC samples with wild-type TP53 (n=258) and mutant TP53 (n=116) in the TCGA cohort. We screened prognosis-related genes by univariate Cox regression analysis and Kaplan–Meier (KM) survival analysis. We constructed a six-gene prognostic signature in the TCGA training group (n=184) by Lasso and multivariate Cox regression analysis. To assess the predictive capability and applicability of the signature in HCC, we conducted internal validation, external validation, integrated analysis and subgroup analysis.ResultsA prognostic signature consisting of six genes (EIF2S1, SEC61A1, CDC42EP2, SRM, GRM8, and TBCD) showed good performance in predicting the prognosis of HCC. The area under the curve (AUC) values of the ROC curve of 1-, 2-, and 3-year survival of the model were all greater than 0.7 in each independent cohort (internal testing cohort, n = 181; TCGA cohort, n = 365; ICGC cohort, n = 229; whole cohort, n = 594; subgroup, n = 9). Importantly, by gene set variation analysis (GSVA) and the single sample gene set enrichment analysis (ssGSEA) method, we found three possible causes that may lead to poor prognosis of HCC: high proliferative activity, low metabolic activity and immunosuppression.ConclusionOur study provides a reliable method for the prognostic risk assessment of HCC and has great potential for clinical transformation.

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