A Lipid Metabolism-Related Genes Prognosis Biomarker Associated With The Tumor Immune Microenvironment in Colorectal Carcinoma

Abstract Background: Lipid metabolic reprogramming was considered as a new hallmark of malignant tumors. It has been reported to play a crucial biological role in cell proliferation, energy homeostasis and signal-transduction. However, the important value of lipid metabolism-related genes(LMRGs) in prognostic prediction and the tumor immune microenvironment has not been explored by large sample studies in colorectal cancer(CRC). Methods: In this study, the lipid metabolism status of 1086 CRC samples was analyzed using RNA expression profiles and clinical data from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases, of which the former was determined as training set and the latter as validation set. The risk signature was constructed by the univariate Cox regression and Least Absolute Shrinkage and Selection Operator(LASSO) COX regression. The patients were stratified into high- and low-risk groups according to the median value of the risk score. Immune and mutation landscape between low- and high-risk CRC patients were also explored. Additionally, we established a nomogram integrating the risk signature and clinical factors to improve risk assessment of CRC patients. Results: A four LMRGs signature, including PROCA1, CCKBR, CPT2 and FDFT1, was constructed to predict the prognosis of CRC. The risk signature as an independent prognostic factor for CRC was associated with a variety of parameters. Survival analysis showed that patients with low risk score had a better prognosis. There were different immune landscapes between low and high-risk CRC patients, especially in monocytes, dendritic cells, M0 and M2-like macrophages. Patients in the low-risk group were more likely to have higher tumor mutation burden, stem cell characteristics and level of PD-L1 expression. In addition, it was found that genes that played crucial biological functions in tumorigenesis (including TP53, PI3K and MUC16) had significant differences in mutation frequency between two groups. Conclusion: A lipid metabolism-related risk signature for predicting the prognosis of CRC was identified in this study. Furthermore, this prognostic signature may be a potential biomarker for predicting the efficacy of chemotherapy and anti-PD-L1 therapy in CRC.

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A lipid metabolism-related genes prognosis biomarker associated with the tumor immune microenvironment in colorectal carcinoma

BMC Cancer ◽

10.1186/s12885-021-08902-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chao Yang ◽

Shuoyang Huang ◽

Fengyu Cao ◽

Yongbin Zheng

Keyword(s):

Lipid Metabolism ◽

Cox Regression ◽

Malignant Tumors ◽

Expression Profiles ◽

Risk Groups ◽

Clinical Parameter ◽

Gene Expression Omnibus ◽

Metabolic Reprogramming ◽

The Cancer Genome Atlas ◽

Immune Microenvironment

Abstract Background and aim Lipid metabolic reprogramming is considered to be a new hallmark of malignant tumors. The purpose of this study was to explore the expression profiles of lipid metabolism-related genes (LMRG) in colorectal cancer (CRC). Methods The lipid metabolism statuses of 500 CRC patients from the Cancer Genome Atlas (TCGA) and 523 from the Gene Expression Omnibus (GEO GSE39582) database were analyzed. The risk signature was constructed by univariate Cox regression and least absolute shrinkage and selection operator (LASSO) Cox regression. Results A novel four-LMRG signature (PROCA1, CCKBR, CPT2, and FDFT1) was constructed to predict clinical outcomes in CRC patients. The risk signature was shown to be an independent prognostic factor for CRC and was associated with tumour malignancy. Principal components analysis demonstrated that the risk signature could distinguish between low- and high-risk patients. There were significantly differences in abundances of tumor-infiltrating immune cells and mutational landscape between the two risk groups. Patients in the low-risk group were more likely to have higher tumor mutational burden, stem cell characteristics, and higher PD-L1 expression levels. Furthermore, a genomic-clinicopathologic nomogram was established and shown to be a more effective risk stratification tool than any clinical parameter alone. Conclusions This study demonstrated the prognostic value of LMRG and showed that they may be partially involved in the suppressive immune microenvironment formation.

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Prognostic Modeling of Patients with Metastatic Melanoma Based on Tumor Immune Microenvironment Characteristics

10.21203/rs.3.rs-730205/v1 ◽

2021 ◽

Author(s):

Jing Liu ◽

Ting Ye ◽

Xue fang Zhang ◽

Yong jian Dong ◽

Wen feng Zhang ◽

...

Keyword(s):

High Risk ◽

Metastatic Melanoma ◽

Prognostic Model ◽

Cox Regression ◽

Risk Group ◽

Low Risk ◽

Risk Scores ◽

Immune Microenvironment ◽

Immune Infiltration ◽

Tumor Immune Microenvironment

Abstract Most of the malignant melanomas are already in the middle and advanced stages when they are diagnosed, which is often accompanied by the metastasis and spread of other organs.Besides, the prognosis of patients is bleak. The characteristics of the local immune microenvironment in metastatic melanoma have important implications for both tumor progression and tumor treatment. In this study, data on patients with metastatic melanoma from the TCGA and GEO datasets were selected for immune, stromal, and estimate scores, and overlapping differentially expressed genes (DEGs) were screened. A nine-IRGs prognostic model (ALOX5AP, ARHGAP15, CCL8, FCER1G, GBP4, HCK, MMP9, RARRES2 and TRIM22) was established by univariate COX regression, LASSO and multivariate COX regression. Receiver operating characteristic (ROC) curves were used to test the predictive accuracy of the model. Immune infiltration was analyzed by using CIBERSORT, Xcell and ssGSEA in high-risk and low-risk groups. The immune infiltration of the high-risk group was significantly lower than that of the low-risk group. Immune checkpoint analysis revealed that the expression of PDCD1, CTLA4, TIGIT, CD274, HAVR2 and LAG3 were significantly different in groups with different levels of risk scores. WGCNA analysis found that the yellow-green module contained seven genes (ALOX5AP, FCER1G, GBP4, HCK, MMP9, RARRES2 and TRIM22) from the nine-IRG prognostic model, of which the yellow-green module had the highest correlation with risk scores. The results of GO and KEGG suggested that the genes in the yellow-green module were mainly enriched in immune-related biological processes. Finally, we analyzed the prognostic ability and expression characteristics of ALOX5AP, ARHGAP15, CCL8, FCER1G, GBP4, HCK, MMP9, RARRES2 and TRIM22 in metastatic melanoma. Overall, a prognostic model for metastatic melanoma based on the characteristics of the tumor immune microenvironment was established, which was helpful for further studies.It could function well in helping people to understand the characteristics of the immune microenvironment in metastatic melanoma and to find possible therapeutic targets.

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A Ferroptosis-Related Signature Robustly Predicts Clinical Outcomes and Associates With Immune Microenvironment for Thyroid Cancer

Frontiers in Medicine ◽

10.3389/fmed.2021.637743 ◽

2021 ◽

Vol 8 ◽

Author(s):

Mingqin Ge ◽

Jie Niu ◽

Ping Hu ◽

Aihua Tong ◽

Yan Dai ◽

...

Keyword(s):

Thyroid Cancer ◽

High Risk ◽

Risk Score ◽

Immune Cell ◽

Cox Regression ◽

Low Risk ◽

Cell Infiltration ◽

Immune Cell Infiltration ◽

Immune Microenvironment ◽

Cox Regression Analysis

Objective: This study aimed to construct a prognostic ferroptosis-related signature for thyroid cancer and probe into the association with tumor immune microenvironment.Methods: Based on the expression profiles of ferroptosis-related genes, a LASSO cox regression model was established for thyroid cancer. Kaplan-Meier survival analysis was presented between high and low risk groups. The predictive performance was assessed by ROC. The predictive independency was validated via multivariate cox regression analysis and stratified analysis. A nomogram was established and verified by calibration curves. The enriched signaling pathways were predicted via GSEA. The association between the signature and immune cell infiltration was analyzed by CIBERSORT. The ferroptosis-related genes were validated in thyroid cancer tissues by immunohistochemistry and RT-qPCR.Results: A ferroptosis-related eight gene model was established for predicting the prognosis of thyroid cancer. Patients with high risk score indicated a poorer prognosis than those with low risk score (p = 1.186e-03). The AUCs for 1-, 2-, and 3-year survival were 0.887, 0.890, and 0.840, respectively. Following adjusting other prognostic factors, the model could independently predict the prognosis (p = 0.015, HR: 1.870, 95%CI: 1.132–3.090). A nomogram combining the signature and age was constructed. The nomogram-predicted probability of 1-, 3-, and 5-year survival approached the actual survival time. Several ferroptosis-related pathways were enriched in the high-risk group. The signature was distinctly associated with the immune cell infiltration. After validation, the eight genes were abnormally expressed between thyroid cancer and control tissues.Conclusion: Our findings established a prognostic ferroptosis-related signature that was associated with the immune microenvironment for thyroid cancer.

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Identification and Clinical Validation of Genes Signatures With Grade and Survival in Head and Neck Carcinomas

10.21203/rs.3.rs-95746/v1 ◽

2020 ◽

Author(s):

Wei Ma ◽

Qing Cao ◽

Wandong She

Keyword(s):

High Risk ◽

Head And Neck ◽

Risk Score ◽

Cox Regression ◽

Expression Profiles ◽

Low Risk ◽

Low Grade ◽

High Grade ◽

Head And Neck Carcinomas ◽

Risk Patients

Abstract Background: The mechanism of transition from low-grade to high-grade head and neck carcinomas (HNC) still remains unclear. The aim of this study was to explore the genes expression profiles that drive malignancy from low to high-grade HNC, as well as analyze their correlations with the survival.Methods: Gene expressions and clinical data of HNC were downloaded from the Gene Expression Omnibus (GEO) repository. The significantly differential genes (SDGs) between low and high-grade HNC were screened by GEO2R and R software. Bioinformatics functions of SDGs were investigated by the enrichment analyses. Univariate and multivariate cox regressions were performed to identify prognostic SDGs of progression free survival (PFS) and disease specific survival (DSS). ROC curve was established to evaluate the ability to predict the prognosis. Then, the correlations between SDGs and clinical features were evaluated. The genes were experimentally validated by RT-PCR in clinical specimens’ tissues at last.Results: Thirty-five SDGs were identified in 47 low-grade and 30 high-grade HNC samples. Enrichment analysis showed these SDGs were mainly enriched in the DNA repair pathway and the regulation of I−kappaB kinase/NF−kappaB signaling pathway. Cox regression analyses showed that CXCL14, SLC44A1 and UBD were significantly associated with DSS, and PPP2R2C and SLC44A1 were associated with PFS. Patients at a high-risk or low-risk for prognosis were established based on genes signatures. High-risk patients had significantly shorter DSS and PFS than low-risk patients (P=0.033, 0.010 respectively). Multivariate cox regression showed HPV (P=0.033), lymph node status (P=0.032) and residual status (P＜0.044) were independent risk factors for PFS. ROC curves showed the risk score had better efficacy to predict survival both for DSS and PFS (AUC=0.858, 0.901 respectively). In addition, we found UBD, PPP2R2C and risk score were significantly associated with HPV status (all P＜0.05). The experiment results showed CXCL14 and SLC44A1 were significantly overexpressed in the HNC grade I/II tissues and the UBD were overexpressed in the HNC grade III/IV tissues.Conclusions: Our results suggested that SDGs had different expression profiles between the low-grade and high-grade HNC, and these genes may serve as prognostic biomarker to predict the survival.

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Identification of a Nine Immune-Related lncRNA Signature as a Novel Diagnostic Biomarker for Hepatocellular Carcinoma

BioMed Research International ◽

10.1155/2021/9798231 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Mengqin Yuan ◽

Yanqing Wang ◽

Qinqian Sun ◽

Shiyi Liu ◽

Shu Xian ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

High Risk ◽

Risk Score ◽

Prognostic Value ◽

Expression Profiles ◽

Risk Groups ◽

Low Risk ◽

Gene Set Enrichment Analysis ◽

Potential Biomarker ◽

Increased Risk

Hepatocellular carcinoma (HCC) ranks fifth among common cancers and is the second most common cause of cancer-related mortality worldwide. This study is aimed at identifying an immune-related long noncoding RNA (lncRNA) signature as a potential biomarker with prognostic value to improve early diagnosis and provide potential therapeutic targets for HCC patients. The subjects of this study were HCC samples with complete transcriptome data and clinical information downloaded from The Cancer Genome Atlas (TCGA) database. We then extracted the immune-related mRNA and lncRNA expression profiles. Based on the expression profiles of immune-related lncRNAs, we identified a nine-lncRNA signature that was related to the progression of HCC. The risk score was calculated based on the expression level of the nine lncRNAs of each sample, which divided patients into high-risk and low-risk groups. We found that the increased risk score was associated with a poor prognosis of HCC patients. To assess the accuracy of the survival model, we calculated a receiver operating characteristic (ROC) for validation. The curve showed that the area under the curve (AUC) for the risk score was 0.792. Besides, both principal component analysis (PCA) and gene set enrichment analysis (GSEA) were further used for functional annotation. We found that the distribution patterns were different between the low-risk and high-risk groups in PCA, and the underlying mechanism by which the nine lncRNAs promoted the progression of HCC involved an abnormal immune status. Finally, we analyzed the infiltration of twenty-nine kinds of immune cells and the activation of immune function in HCC using the ssGSEA algorithm. The results showed that aDCs, iDCs, macrophages, Tfh, Th1, Treg, and NK cells were correlated with the progress of HCC patients. And the immune functions including APC costimulation, CCR, check point, HLA, MHC class I, and Type II IFN responses were also significantly different between the high-risk and low-risk groups. In conclusion, our study identified a nine-lncRNA signature with potential prognostic value for patients with HCC, which could be used as a new biomarker for the diagnosis and immunotherapy of HCC.

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Prognostic modeling of patients with metastatic melanoma based on tumor immune microenvironment characteristics

Mathematical Biosciences and Engineering ◽

10.3934/mbe.2022067 ◽

2021 ◽

Vol 19 (2) ◽

pp. 1448-1470

Author(s):

Jing Liu ◽

◽

Xuefang Zhang ◽

Ting Ye ◽

Yongjian Dong ◽

...

Keyword(s):

High Risk ◽

Metastatic Melanoma ◽

Prognostic Model ◽

Cox Regression ◽

Risk Group ◽

Low Risk ◽

Risk Scores ◽

Immune Microenvironment ◽

Immune Infiltration ◽

Tumor Immune Microenvironment

<abstract> <p>Most of the malignant melanomas are already in the middle and advanced stages when they are diagnosed, which is often accompanied by the metastasis and spread of other organs. Besides, the prognosis of patients is bleak. The characteristics of the local immune microenvironment in metastatic melanoma have important implications for both tumor progression and tumor treatment. In this study, data on patients with metastatic melanoma from the TCGA and GEO datasets were selected for immune, stromal, and estimate scores, and overlapping differentially expressed genes were screened. A nine-IRGs prognostic model (ALOX5AP, ARHGAP15, CCL8, FCER1G, GBP4, HCK, MMP9, RARRES2 and TRIM22) was established by univariate COX regression, LASSO and multivariate COX regression. Receiver operating characteristic curves were used to test the predictive accuracy of the model. Immune infiltration was analyzed by using CIBERSORT and Xcell in high-risk and low-risk groups. The immune infiltration of the high-risk group was significantly lower than that of the low-risk group. Immune checkpoint analysis revealed that the expression of PDCD1, CTLA4, TIGIT, CD274, HAVR2 and LAG3 demonstrated the visible difference in groups with different levels of risk scores. WGCNA analysis found that the yellow-green module contained seven genes from the nine-IRG prognostic model, and the yellow-green module had the highest correlation with risk scores. The results of GO and KEGG suggested that the genes in the yellow-green module were mainly enriched in immune-related biological processes. Finally, the expression characteristics of ALOX5AP, ARHGAP15, CCL8, FCER1G, GBP4, HCK, MMP9, RARRES2 and TRIM22 were analyzed between metastatic melanoma and normal samples. Overall, a prognostic model for metastatic melanoma based on the tumor immune microenvironment characteristics was established, which left plenty of space for further studies. It could function well in helping people to understand characteristics of the immune microenvironment in metastatic melanoma.</p> </abstract>

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Immune-Related LncRNAs Affect the Prognosis of Osteosarcoma, Which Are Related to the Tumor Immune Microenvironment

Frontiers in Cell and Developmental Biology ◽

10.3389/fcell.2021.731311 ◽

2021 ◽

Vol 9 ◽

Author(s):

Qingshan Huang ◽

Yilin Lin ◽

Chenglong Chen ◽

Jingbing Lou ◽

Tingting Ren ◽

...

Keyword(s):

High Risk ◽

Risk Score ◽

Immune Escape ◽

Risk Group ◽

High Risk Group ◽

Low Risk ◽

Gene Set Enrichment Analysis ◽

Immune Microenvironment ◽

Tumor Immune Microenvironment

Background: Abnormal expression of lncRNA is closely related to the occurrence and metastasis of osteosarcoma. The tumor immune microenvironment (TIM) is considered to be an important factor affecting the prognosis and treatment of osteosarcoma. This study aims to explore the effect of immune-related lncRNAs (IRLs) on the prognosis of osteosarcoma and its relationship with the TIM.Methods: Ninety-five osteosarcoma samples from the TARGET database were included. Iterative LASSO regression and multivariate Cox regression analysis were used to screen the IRLs signature with the optimal AUC. The predict function was used to calculate the risk score and divide osteosarcoma into a high-risk group and low-risk group based on the optimal cut-off value of the risk score. The lncRNAs in IRLs signature that affect metastasis were screened for in vitro validation. Single sample gene set enrichment analysis (ssGSEA) and ESTIMATE algorithms were used to evaluate the role of TIM in the influence of IRLs on osteosarcoma prognosis.Results: Ten IRLs constituted the IRLs signature, with an AUC of 0.96. The recurrence and metastasis rates of osteosarcoma in the high-risk group were higher than those in the low-risk group. In vitro experiments showed that knockdown of lncRNA (AC006033.2) could increase the proliferation, migration, and invasion of osteosarcoma. ssGSEA and ESTIMATE results showed that the immune cell content and immune score in the low-risk group were generally higher than those in the high-risk group. In addition, the expression levels of immune escape-related genes were higher in the high-risk group.Conclusion: The IRLs signature is a reliable biomarker for the prognosis of osteosarcoma, and they alter the prognosis of osteosarcoma. In addition, IRLs signature and patient prognosis may be related to TIM in osteosarcoma. The higher the content of immune cells in the TIM of osteosarcoma, the lower the risk score of patients and the better the prognosis. The higher the expression of immune escape-related genes, the lower the risk score of patients and the better the prognosis.

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The role of m6A RNA methylation-related lncRNAs in the prognosis and tumor immune microenvironment of papillary thyroid carcinoma

10.21203/rs.3.rs-903297/v1 ◽

2021 ◽

Author(s):

WenLong Wang ◽

Cong Shen ◽

Yunzhe Zhao ◽

Botao Sun ◽

Xiangyuan Qiu ◽

...

Keyword(s):

High Risk ◽

Risk Score ◽

Cox Regression ◽

Consensus Clustering ◽

Papillary Thyroid ◽

Immune Microenvironment ◽

Rna Methylation ◽

Tumor Immune Microenvironment ◽

M6a Rna Methylation

Abstract Background: Emerging evidence has indicated that N6-methylandenosine (m6A) RNA methylation plays a critical role in cancer development. However, the function of m6A RNA methylation-related long noncoding RNAs (m6A-lncRNAs) in papillary thyroid carcinoma (PTC) has never been reported. This study aimed to investigate the role of m6A-lncRNAs in the prognosis and tumor immune microenvironment of PTC.Methods: The gene expression data of lncRNAs and 20 m6A methylation regulators with corresponding clinicopathological information download from the Cancer Genome Atlas database. Based on consensus clustering analysis, LASSO Cox regression, nivariate and multivariate Cox regression analysis were used to determine the role of m6A-lncRNA in the prognosis and tumor immune microenvironment of PTC.Results: Three subgroups (clusters 1, 2, and 3) were identified by consensus clustering of 19 prognosis-related m6A-lncRNA regulators，of which cluster 1 preferentially related with unfavorable prognosis, lower immune scores, and distinct immune infiltrate level. A risk-score model was established based on 8 prognosis-related m6A-lncRNAs. Patients with a high-risk score had a worse prognosis and the ROC indicated a reliable prediction performance for patients with PTC (AUC=0.802). As expected, the immune scores, infiltration levels of immune cells and ESTIMATE scores in the low-risk subgroups were notably higher (p < 0.001) compared with those of high-risk subgroups. Furthermore, GSEA analysis showed that tumor associated pathways, hallmarks, and biological processes were remarkably enriched in the high-risk subgroup. Further analysis indicated that the risk score and age were independent prognostic factors for PTC. An integrated nomogram was constructed that accurately predicted the survival status (AUC = 0.963). Moreover, a lncRNA–miRNA–mRNA regulated network was established based on seven prognosis-related m6A-lncRNAs. Additional, 30 clinical samples and different PTC cells were validated. Conclusions: This is the first study to reveal that m6A-lncRNAs play a vital role in the prognosis and TME of PTC. To a certain degree, m6A-lncRNAs can be considered as new, promising prognostic biomarkers and treatment targets.

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Prognostic value of an autophagy-related gene expression signature for endometrial cancer patients

10.21203/rs.3.rs-24691/v3 ◽

2020 ◽

Author(s):

Hui Wang ◽

Xiaoling Ma ◽

Jinhui Liu ◽

Yicong Wan ◽

Yi Jiang ◽

...

Keyword(s):

Endometrial Cancer ◽

High Risk ◽

Risk Score ◽

Cox Regression ◽

Risk Group ◽

Expression Profiles ◽

Gene Expression Signature ◽

Low Risk ◽

Prognostic Signature ◽

Test Set

Abstract Background: Autophagy is associated with cancer development. Autophagy-related genes play significant roles in endometrial cancer (EC), a major gynecological malignancy worldwide, but little was known about their value as prognostic markers. Here we evaluated the value of a prognostic signature based on autophagy-related genes for EC. Methods: First, various autophagy-related genes were obtained via the Human Autophagy Database and their expression profiles were downloaded from The Cancer Genome Atlas. Second, key prognostic autophagy-related genes were identified via univariat, LASSO and multivariate Cox regression analyses. Finally, a risk score to predict the prognosis of EC was calculated and validated by using the test and the entire data sets. Besides, the key genes mRNA expression were validated using quantitative real-time PCR in clinical tissue samples. Results: A total of 40 differentially expressed autophagy-related genes in EC were screened and five of them were prognosis-related (CDKN1B, DLC1, EIF4EBP1, ERBB2 and GRID1). A prognostic signature was constructed based on these five genes using the train set, which stratified EC patients into high-risk and low-risk groups (P<0.05). In terms of overall survival, the analyses of the test set and the entire set yielded consistent results (test set: p < 0.05; entire set: p < 0.05). Time-dependent ROC analysis suggested that the risk score predicted EC prognosis accurately and independently (0.674 at 1 year, 0.712 at 3 years and 0.659 at 5 years). A nomogram with clinical utility was built. Patients in the high-risk group displayed distinct mutation signatures compared with those in the low-risk group. For clinical sample validation, we found that EIF4EBP1and ERBB2 had higher level in EC than that in normal tissues while CDKN1B, DLC1 and GRID1 had lower level, which was consistent with the results predicted. Conclusions: Based on five autophagy-related genes (CDKN1B, DLC1, EIF4EBP1, ERBB2 and GRID1), our model can independently predict the OS of EC patients by combining molecular signature and clinical characteristics.

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Identification of Metastasis-Related Signature For Predicting Survival In Osteosarcoma

10.21203/rs.3.rs-683582/v1 ◽

2021 ◽

Author(s):

Song Shi ◽

Shuaijie Yang ◽

Zhenyu Zhou ◽

Kai Sun ◽

Ran Tao ◽

...

Keyword(s):

High Risk ◽

Risk Score ◽

Immune Cell ◽

Cox Regression ◽

Risk Group ◽

Expression Profiles ◽

Gene Signature ◽

Low Risk ◽

Risk Scores ◽

Activation Markers

Abstract BackgroundRNA sequencing has become a powerful tool for exploring tumor recurrence or metastasis mechanisms. In this study, we aimed to develop a signature to improve the prognostic predictions of osteosarcoma.Materials and methodsBy comparing the expression profiles between metastatic and non-metastatic samples, we obtained 57 metastatic-related gene signatures. Then we constructed a 3‐gene signature to predict the prognostic risk of osteosarcoma patients by the Cox proportional hazards regression model. The risk score derived from this signature could successfully stratify osteosarcoma patients into subgroups with different survival outcomes.ResultsPatients in the low-risk group showed more prolonged overall survival than those in the high-risk group. And the performance was validated with another independent dataset. Multivariate cox regression revealed that the risk score served as an independent risk factor. Besides, we found that patients with low-risk scores had higher expression levels of immune-related signatures, suggesting an active immune status in those patients. Using the CIBERSORT database, we further systematically analyzed the relationships between the risk score and immune cell infiltration levels, as well as the immune activation markers. Higher infiltration of immune cells (CD8 T cells, monocytes, M2 macrophages, and memory B cells) and higher levels of immune cytotoxic markers (GZMA, GMZB, IFNG, and TNF) were observed in patients in the low-risk group.ConclusionsIn summary, this 3-gene signature could be a reliable marker for prognostic evaluation and help clinicians identify high‐risk patients.

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