The Development and Validation of a Novel 71-Gene Signature for Risk Stratification and Prognosis in Lower Grade Glioma
Abstract Background: Lower-grade gliomas (LGG) are a diverse group of primary brain tumors with relatively poor overall survival in young adults. In this study, we aimed to establish novel method that are effectively predictive of prognosis of LGG patients. Methods: We detected and validated prognosis-associated genes using gene expression and c`Clinical data of LGG patients from The Cancer Genome Atlas (TCGA) and Chinese Glioma Genome Atlas (CGGA) databases. We then established a novel prognostic 71-gene score and 17-gene nomograms and analyzed their relationship with overall survival (OS) and relapse-free survival (RFS) in LGG patients. We also performed Gene Set Enrichment Analysis to investigate the altered signalling pathways associated with the 71-gene score phenotype and hierarchical clustering analysis of 71 genes to detect subgroups of LGG patients with distinct clinical characteristics. Results: We identified 1489 genes significantly correlated with patients’ prognosis in LGG. The 71-gene score was predictive of favourable OS and RFS in LGG patients independently of clinicopathological characteristics. The wnt signalling pathway, glutathione metabolism, primary immunodeficiency, galactose metabolism were the potential pathways involved in the prognostication of the 71-gene score. Hierarchical clustering analysis of the 71 genes revealed three subgroups of LGG patients in the TCGA dataset. The cluster2 LGG tumours were associated with higher grade, more frequent radiation therapy, poorer OS and RFS than cluster1 and cluster3 tumours. The 71-gene nomogram incorporating the survival‐related clinical factors showed good prediction accuracies for overall survival, 3-year and 5‐year survival (area under curve [AUC] = 0.79, 0.67 and 0.75 respectively). Conclusions: The 71-gene nomogram may turn out to be a useful and robust method to remarkably ameliorate the prognostic prediction in LGG.