A Novel Pyroptosis-related Prognostic Model for Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is the second most lethal malignant tumor because of its significant heterogeneity and complicated molecular pathogenesis. Novel prognostic biomarkers are urgently needed because no effective and reliable prognostic biomarkers currently exist for HCC patients. Increasing evidence has revealed that pyroptosis plays a role in the occurrence and progression of malignant tumors. However, the relationship between pyroptosis-related genes (PRGs) and HCC patient prognosis remains unclear. In this study, 57 PRGs were obtained from previous studies and GeneCards. The gene expression profiles and clinical data of HCC patients were acquired from public data portals. Least absolute shrinkage and selection operator (LASSO) Cox regression analysis was performed to establish a risk model using TCGA data. Additionally, the risk model was further validated in an independent ICGC dataset. Our results showed that 39 PRGs were significantly differentially expressed between tumor and normal liver tissues in the TCGA cohort. Functional analysis confirmed that these PRGs were enriched in pyroptosis-related pathways. According to univariate Cox regression analysis, 14 differentially expressed PRGs were correlated with the prognosis of HCC patients in the TCGA cohort. A risk model integrating two PRGs was constructed to classify the patients into different risk groups. Poor overall survival was observed in the high-risk group of both TCGA (p < 0.001) and ICGC (p < 0.001) patients. Receiver operating characteristic curves demonstrated the accuracy of the model. Furthermore, the risk score was confirmed as an independent prognostic indicator via multivariate Cox regression analysis (TCGA cohort: HR = 3.346, p < 0.001; ICGC cohort: HR = 3.699, p < 0.001). Moreover, the single-sample gene set enrichment analysis revealed different immune statuses between high- and low-risk groups. In conclusion, our new pyroptosis-related risk model has potential application in predicting the prognosis of HCC patients.

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Prognostic Value and Regulatory Network of Immune-Related Genes in Hepatocellular Carcinoma

10.21203/rs.3.rs-123214/v1 ◽

2020 ◽

Author(s):

Xiang Zhou ◽

Keying Zhang ◽

Fa Yang ◽

Chao Xu ◽

Jianhua Jiao ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Regression Analysis ◽

Differentially Expressed Genes ◽

Molecular Mechanisms ◽

Risk Model ◽

Cox Regression ◽

Wilcoxon Test ◽

Differentially Expressed ◽

Cox Regression Analysis ◽

Immune Related Genes

Abstract Background: Hepatocellular carcinoma (HCC) is a disease with higher morbidity, mortality, and poor prognosis in the whole world. Understanding the crosslink between HCC and the immune system is essential for people to uncover a few potential and valuable therapeutic strategies. This study aimed to reveal the correlation between HCC and immune-related genes and establish a clinical evaluation model. Methods: We had analyzed the clinical information consisted of 373 HCC and 49 normal samples from the cancer genome atlas (TCGA). The differentially expressed genes (DEGs) were selected by the Wilcoxon test and the immune-related differentially expressed genes (IRDEGs) in DEGs were identified by matching DEGs with immune-related genes downloaded from the ImmPort database. Furthermore, the univariate Cox regression analysis and multivariate Cox regression analysis were performed to construct a prognostic risk model. Then, twenty-two types of tumor immune-infiltrating cells (TIICs) were downloaded from Tumor Immune Estimation Resource (TIMER) and were used to construct the correlational graphs between the TIICs and risk score by the CIBERSORT. Subsequently, the transcription factors (TFs) were gained in the Cistrome website and the differentially expressed TFs (DETFs) were achieved. Finally, the KEGG pathway analysis and GO analysis were performed to further understand the molecular mechanisms between DETFs and PDIRGs.Results: In our study, 5839 DEGs, 326 IRDEGs, and 31 prognosis-related IRDEGs (PIRDEGs) were identified. And 8 optimal PIRDEGs were employed to construct a prognostic risk model by multivariate Cox regression analysis. The correlation between risk genes and clinical characterizations and TIICs has verified that the prognostic model was effective in predicting the prognosis of HCC patients. Finally, several important immune-related pathways and molecular functions of the eight PIRDEGs were significantly enriched and there was a distinct association between the risk IRDEGs and TFs. Conclusion: The prognostic risk model showed a more valuable predicting role for HCC patients, and produced many novel therapeutic targets and strategies for 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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Identification and validation of lncRNAs involved in m6A regulation for patients with ovarian cancer

Cancer Cell International ◽

10.1186/s12935-021-02076-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jianfeng Zheng ◽

Jialu Guo ◽

Benben Cao ◽

Ying Zhou ◽

Jinyi Tong

Keyword(s):

Ovarian Cancer ◽

Regression Analysis ◽

Prognostic Value ◽

Risk Model ◽

Cox Regression ◽

Risk Groups ◽

Clinicopathological Characteristics ◽

Gene Set Enrichment Analysis ◽

Prognostic Signature ◽

Cox Regression Analysis

Abstract Background Both N6-methyladenosine (m6A) modification and lncRNAs play an important role in the carcinogenesis and cancer inhibition of ovarian cancer (OC). However, lncRNAs involved in m6A regulation (LI-m6As) have never been reported in OC. Herein, we aimed to identify and validate a signature based on LI-m6A for OC. Methods RNA sequencing profiles with corresponding clinical information associated with OC and 23 m6A regulators were extracted from TCGA. The Pearson correlation coefficient (PCC) between lncRNAs and 23 m6A regulators (|PCC|> 0.4 and p < 0.01) was calculated to identify LI-m6As. The LI-m6As with significant prognostic value were screened based on univariate Cox regression analysis to construct a risk model by LASSO Cox regression. Gene Set Enrichment Analysis (GSEA) was implemented to survey the biological functions of the risk groups. Several clinicopathological characteristics were utilized to evaluate their ability to predict prognosis, and a nomogram was constructed to evaluate the accuracy of survival prediction. Besides, immune microenvironment, checkpoint, and drug sensitivity in the two risk groups were compared using comprehensive algorithms. Finally, real-time qPCR analysis and cell counting kit-8 assays were performed on an alternative lncRNA, CACNA1G-AS1. Results The training cohort involving 258 OC patients and the validation cohort involving 111 OC patients were downloaded from TCGA. According to the PCC between the m6A regulators and lncRNAs, 129 LI-m6As were obtained to perform univariate Cox regression analysis and then 10 significant prognostic LI-m6As were identified. A prognostic signature containing four LI-m6As (AC010894.3, ACAP2-IT1, CACNA1G-AS1, and UBA6-AS1) was constructed according to the LASSO Cox regression analysis of the 10 LI-m6As. The prognostic signature was validated to show completely opposite prognostic value in the two risk groups and adverse overall survival (OS) in several clinicopathological characteristics. GSEA indicated that differentially expressed genes in disparate risk groups were enriched in several tumor-related pathways. At the same time, we found significant differences in some immune cells and chemotherapeutic agents between the two groups. An alternative lncRNA, CACNA1G-AS1, was proven to be upregulated in 30 OC specimens and 3 OC cell lines relative to control. Furthermore, knockdown of CACNA1G‐AS1 was proven to restrain the multiplication capacity of OC cells. Conclusions Based on the four LI-m6As (AC010894.3, ACAP2-IT1, CACNA1G-AS1, and UBA6-AS1), the risk model we identified can independently predict the OS and therapeutic value of OC. CACNA1G‐AS1 was preliminarily proved to be a malignant lncRNA.

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Ferroptosis-Related lncRNAs Signature is a Prognostic Factor in Hepatocellular Carcinoma: A Study Based on TCGA Data

10.21203/rs.3.rs-847334/v1 ◽

2021 ◽

Author(s):

Xiangjin Hu ◽

Sailun Wang ◽

Jia Guo ◽

Fang Xiong ◽

Jun Lv

Keyword(s):

Hepatocellular Carcinoma ◽

Regression Analysis ◽

Signaling Pathway ◽

Cox Regression ◽

Pearson Correlation ◽

Risk Groups ◽

Gene Set Enrichment Analysis ◽

Sphingolipid Metabolism ◽

Immune Microenvironment ◽

Cox Regression Analysis

Abstract Background Hepatocellular carcinoma (HCC) is the most common type of liver cancer and is the fourth leading cause of cancer-related death worldwide. Ferroptosis is a form of iron-dependent programmed cell death, and is characterized by intracellular accumulation of reactive oxygen species (ROS). Long non-coding RNAs (lncRNAs), as valuable prognostic factors for HCC patients, play a vital role in regulating ferroptosis. Methods RNA-sequencing datasets and ferroptosis-related genes were retrieved from The Cancer Genome Atlas (TCGA) database and the Molecular Signature Database. we performed Pearson correlation analysis between the lncRNAs and ferroptosis-related genes, and subsequently used regression analysis (univariate Cox analysis, multivariate Cox regression analysis, and Lasso regression analysis) to screen the ferroptosis-related lncRNAs with prognostic value in HCC, the prognostic ferroptosis-related lncRNAs signature (FRLS) was finally constructed. In addition, we reevaluated the model in terms of survival, clinical characteristics, and immune microenvironment. Results Univariate Cox regression analysis revealed 34 differently expressed ferroptosis-related lncRNAs related to the prognosis of HCC. Among them, 12 ferroptosis-related lncRNAs (LUCAT1, LINC01224, THUMPD3-AS1, AC116025.2, LINC00942, SNHG10, AC131009.1, POLH-AS1, MKLN1-AS, LINC01138, LNCSRLR, AL031985.3) were regarded as independent prognosis predictors of HCC, and were incorporated into the construction of the prognostic FRLS. Patients were divided into two groups based on the prognostic FRLS. Kaplan–Meier survival plot showed that patients in the high-risk groups exhibited shorter overall survival (OS) than those in low-risk groups (P < 0.001). Compared with clinical data, the area under curve (AUC) values of the risk factors, decision curve analysis (DCA), the AUC values of different years and multivariate Cox regression suggested that the signature had better predictive power. Gene set enrichment analysis (GSEA) revealed the potential pathways of 12 ferroptosis-related lncRNAs, including sphingolipid-metabolism, mTOR signaling pathway, notch signaling pathway, homologous recombination, endocytosis, cell cycle, etc. Immune microenvironment including tumor-infiltrating immune cells, immune-related functions, checkpoint-related genes and N6-methyladenosine (m6A)-related mRNA were also significantly different between the two risk groups. Conclusions This study constructed 12 FRLS for HCC patients to predict survival, which may provide promising targets for the therapy of HCC.

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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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Construction and Validation of a Prognostic Risk Model Based on Autophagy-Related Genes in Hepatocellular Carcinoma Cells

10.21203/rs.3.rs-714025/v1 ◽

2021 ◽

Author(s):

Rui Feng ◽

Jian Li ◽

Weiling Xuan ◽

Hanbo Liu ◽

Dexin Cheng ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Regression Analysis ◽

Differential Expression ◽

Prognostic Model ◽

Risk Model ◽

Cox Regression ◽

Univariate Analysis ◽

Differential Expression Analysis ◽

Cox Regression Analysis ◽

Dismal Prognosis

Abstract Background Hepatocellular carcinoma (HCC) is a prevalent primary liver cancer and the main cause of cancer mortality. Its high complexity and dismal prognosis bring dramatic difficulty to treatment. Due to the disclosed dual functions of autophagy in cancer development, understanding autophagy-related genes devotes into seeking novel biomarkers for HCC. Methods Differential expression of genes in normal and tumor groups was analyzed to acquire autophagy-related genes in HCC. GO and KEGG pathway analyses were conducted on these genes. Genes were then screened by univariate regression analysis. The screened genes were subjected to multivariate Cox regression analysis to build a prognostic model. The model was validated by ICGC validation set. Results Altogether, 42 autophagy-related differential genes were screened by differential expression analysis. Enrichment analysis showed that they were mainly enriched in pathways including regulation of autophagy and cell apoptosis. Genes were screened by univariate analysis and multivariate Cox regression analysis to build a prognostic model. The model was constituted by 6 feature genes: EIF2S1, BIRC5, SQSTM1, ATG7, HDAC1, FKBP1A. Validation confirmed the accuracy and independence of this model in predicting HCC patient’s prognosis. Conclusion A total of 6 feature genes were identified to build a prognostic risk model. This model is conducive to investigating interplay between autophagy-related genes and HCC prognosis.

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AC099850.3 Promotes Cell Proliferation and is One of Five Costimulatory Molecule-Related LncRNAs That Predict Overall Survival of Liver Hepatocellular Carcinoma

10.21203/rs.3.rs-1069383/v1 ◽

2021 ◽

Author(s):

Meimei Liu ◽

Qiong Fang ◽

Yanping Huang ◽

Jin Zhou ◽

Qi Wang

Keyword(s):

Hepatocellular Carcinoma ◽

Cell Proliferation ◽

Risk Model ◽

Cox Regression ◽

Costimulatory Molecule ◽

Costimulatory Molecules ◽

Gene Set Enrichment Analysis ◽

The Cancer Genome Atlas ◽

Cox Regression Analysis ◽

Liver Hepatocellular Carcinoma

Abstract Background: Extensive research has revealed that costimulatory molecules play central roles in mounting anti-tumor immune responses and long non‐coding RNA (lncRNA) is an important regulatory factor in the development of various cancers. However, their roles in liver hepatocellular carcinoma (HCC) remain unexplored. In this study, we aimed to explore costimulatory molecule-related lncRNAs in HCC and construct a prognostic signature to predict prognosis and improve clinical outcomes with HCC patients.Methods: The data we used for bioinformatics analysis were downloaded from The Cancer Genome Atlas database. Costimulatory molecules were obtained from the known literature. The R software, SPSS and GraphPad Prism were used for mapping and statistical analysis.Results: A five costimulatory molecule-related lncRNAs based risk model was initially constructed through lasso and Cox regression analysis. Moreover, multivariate regression suggested that the risk score was a significant prognostic risk factor in HCC. Samples in high- and low-risk groups exhibited significantly different in gene set enrichment analysis and immune infiltration analysis. Importantly, we found that the AC099850.3 were significantly related to cell proliferation in HCC according to the colony formation and CCK8 assays.Conclusion: In summary, we first identified and validated a novel costimulatory molecule-related survival model and we found that AC099850.3 is closely associated with clinical stage and could remarkably facilitate cell proliferation in HCC, making it potential to be a novel therapeutic target.

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Development and validation of a robust immune-related risk signature for hepatocellular carcinoma

10.21203/rs.3.rs-16346/v1 ◽

2020 ◽

Author(s):

Zaoqu Liu ◽

Dechao Jiao ◽

Xueliang Zhou ◽

Yuan Yao ◽

Zhaonan Li ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Regression Analysis ◽

Cox Regression ◽

Risk Group ◽

Low Risk ◽

Functional Enrichment ◽

Differentially Expressed ◽

Risk Genes ◽

Cox Regression Analysis ◽

Related Risk

Abstract Background: A growing amount of evidence has suggested immune-related genes (IRGs) play a key role in the development of hepatocellular carcinoma (HCC). However, there have been no investigations proposing a reliable prognostic signature in terms of tumor immunology. This study aimed to develop a robust signature based on IRGs in HCC.Methods: A total of 597 HCC patients were enrolled. The TCGA database was utilized for discovery, and the ICGC database was utilized for validation. Multiple algorithms (including univariate Cox, LASSO, and multivariate Cox regression) were performed to identify key prognostic IRGs and establish an immune-related risk signature. Bioinformatics analysis and R soft tools were utilized to annotate underlying biological functions. Results: A total of 1416 differentially expressed mRNAs (DEMs) were screened in the TCGA cohort, of which 90 were differentially expressed IRGs (DEIRGs). Using univariate Cox regression analysis, we identified 33 prognostically relevant DEIRGs. Using LASSO regression and multivariate Cox regression analysis, we extracted 8 optimal DEIRGs (APLN, CDK4, CXCL2, ESR1, IL1RN, PSMD2, SEMA3F, and SPP1) to construct a risk signature with the ability to distinguish cases as having a high or low risk of unfavorable prognosis in the TCGA cohort, and the signature was verified in the ICGC cohort. The signature was prognostically significant in all stratified cohorts and was deemed an independent prognostic factor for HCC. We also built a nomogram with good performance by combining the signature with clinicopathological factors to increase the accuracy of predicting HCC prognosis. By investigating the relationship of the risk score and 8 risk genes from our signature with clinical traits, we found that the aberrant expression of the immune-related risk genes is correlated with the development of HCC. Moreover, the high-risk group was higher than the low-risk group in terms of tumor mutation burden (TMB), immune cell infiltration, and the expression of immune checkpoints (PD-1, PD-L1, and CTLA-4), and functional enrichment analysis indicated the signature enriched an intensive immune phenotype.Conclusions: This study developed a robust immune-related risk signature and built a predictive nomogram that reliably predict overall survival in HCC, which may be helpful for clinical management and personalized immunotherapy decisions.

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A prognostic model for hepatocellular carcinoma based on apoptosis-related genes

10.21203/rs.3.rs-141169/v2 ◽

2021 ◽

Author(s):

Renjie Liu ◽

Guifu Wang ◽

Chi Zhang ◽

Dousheng Bai

Keyword(s):

Hepatocellular Carcinoma ◽

Prognostic Model ◽

Molecular Mechanisms ◽

Risk Model ◽

Cox Regression ◽

Risk Groups ◽

Low Risk ◽

The Cancer Genome Atlas ◽

Differentially Expressed ◽

Risk Scores

Abstract Background: Dysregulation of the balance between proliferation and apoptosis is the basis for human hepatocarcinogenesis. In many malignant tumors, such as hepatocellular carcinoma (HCC), there is a correlation between apoptotic dysregulation and poor prognosis. However, the prognostic values of apoptosis-related genes (ARGs) in HCC have not been elucidated. Methods: To screen for differentially expressed ARGs, the expression levels of 161 ARGs from The Cancer Genome Atlas (TCGA) database(https://cancergenome.nih.gov/) were analyzed. Gene Ontology (GO) enrichment and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed to evaluate the underlying molecular mechanisms of differentially expressed ARGs in HCC. The prognostic values of ARGs were established using Cox regression, and subsequently, a prognostic risk model for scoring patients was developed. Kaplan-Meier (K-M) and receiver operating characteristic (ROC) curves were plotted to determine the prognostic value of the model. Results: Compared to normal tissues, 43 highly up-regulated and 8 down-regulated ARGs in HCC tissues were screened. GO analysis results revealed that these 51 genes are indeed related to the apoptosis function. KEGG analysis revealed that these 51 genes were correlated with MAPK, P53, TNF, and PI3K-AKT signaling pathways, while Cox regression revealed that 5 ARGs (PPP2R5B, SQSTM1, TOP2A, BMF, and LGALS3) were associated with prognosis and were, therefore, obtained to develop the prognostic model. Based on the median risk scores, patients were categorized into high-risk and low-risk groups. Patients in the low-risk groups exhibited significantly elevated two-year or five-year survival probabilities (p < 0.0001). The risk model had a better clinical potency than the other clinical characteristics, with the area under the ROC curve (AUC = 0.741). The prognosis of HCC patients was established from a plotted nomogram. Conclusion: Based on the differential expression of ARGs, we established a novel risk model for predicting HCC prognosis. This model can also be used to inform the individualized treatment of HCC patients.

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Elevated CDK5R1 predicts worse prognosis in hepatocellular carcinoma based on TCGA data

Bioscience Reports ◽

10.1042/bsr20203594 ◽

2020 ◽

Author(s):

Zhili Zeng ◽

Zebiao Cao ◽

Enxin Zhang ◽

Haifu Huang ◽

Ying Tang

Keyword(s):

Hepatocellular Carcinoma ◽

Regression Analysis ◽

Cox Regression ◽

Hazard Ratio ◽

Gene Set Enrichment Analysis ◽

High Expression ◽

Rapid Progression ◽

Raw Data ◽

Cox Regression Analysis ◽

Free Interval

Background: Hepatocellular carcinoma (HCC) is a malignant tumor with rapid progression, high recurrence rate and poor prognosis. The objective of our investigation was to explore the prognostic value of CDK5R1 in HCC. Methods: The raw data of HCC raw data were downloaded from The Cancer Genome Atlas (TCGA) database. The Wilcoxon signed-rank test, Kruskal-Wallis test and logistic regression were applied to investigate the relevance between the CDK5R1 expression and clinicopathologic characteristics in HCC. Kaplan-Meier and Cox regression analysis were employed to examine the association between clinicopathologic features and survival. Gene set enrichment analysis (GSEA) was applied to annotate the biological function of CDK5R1. Results: CDK5R1 was highly expressed in HCC tissues. The high expression of CDK5R1 in HCC tissues was significantly associated with tumor status (P=0.00), new tumor event (P=0.00), clinical stage (P=0.00), topography (P=0.00). Elevated CDK5R1 had significant correlation with worse overall survival (OS) (P=7.414e−04), disease-specific survival (DSS) (P=5.642e−04), disease-free interval (DFI) (P=1.785e−05), and progression-free interval (PFI) (P=2.512e−06). Besides, univariate and multivariate Cox regression analysis uncovered that increased CDK5R1 can independently predict adverse OS (P=0.037, hazard ratio [HR]=1.7 (95% CI [1.0-2.7])), DFI (P=0.007, hazard ratio [HR]=3.0 (95% CI [1.4-6.7])), PFI (P=0.007, hazard ratio [HR]=2.8 (95% CI [1.3-5.9])). GSEA disclosed that notch signaling pathway and non-small cell lung cancer were prominently enriched in CDK5R1 high expression phenotype. Conclusions: Increased CDK5R1 may act as a promising independent prognostic factor of poor survival in HCC.

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