scholarly journals The Immune Heterogeneity Between Pulmonary Adenocarcinoma and Squamous Cell Carcinoma: A Comprehensive Analysis Based on lncRNA Model

2021 ◽  
Vol 12 ◽  
Author(s):  
Tao Yan ◽  
Guoyuan Ma ◽  
Kai Wang ◽  
Weidong Liu ◽  
Weiqing Zhong ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Squamous Cell Carcinoma ◽  
T Cell ◽  
High Risk ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Risk Group ◽  
Low Risk ◽  
Gene Set Enrichment Analysis ◽  
Risk Scores

Adenocarcinoma (AD) and squamous cell carcinoma (SCC) are both classified as major forms of non-small cell lung cancer, but differences in clinical prognoses and molecular mechanisms are remarkable. Recent studies have supported the importance of understanding immune status in that it influences clinical outcomes of cancer, and immunotherapies based on the theory of “immune editing” have had notable clinical success. Our study aimed to identify specific long non-coding (lnc) RNAs that control key immune-related genes and to use them to construct risk models for AD and SCC. Risk scores were used to separate patients into high- and low-risk groups, and we validated the prognostic significance of both risk scores with our own cohorts. A Gene Set Enrichment Analysis suggested that the immune responses of patients in the AD high-risk group and the SCC low-risk group tended to be weakened. Evaluation of immune infiltration revealed that the degree of infiltration of dendritic cells is of particular importance in AD. In addition, prediction of responses to immune checkpoint inhibitor (ICI) treatments, based on the T Cell Immune Dysfunction and Exclusion and immunophenoscore models, indicated that deterioration of the immune microenvironment is due mainly to T cell exclusion in AD patients and T cell dysfunction in SCC patients and that high-risk patients with SCC might benefit from ICI treatment. The prediction of downstream targets via The Cancer Proteome Atlas and RNA-seq analyses of a transfected lung cancer cell line indicated that the lncRNA LINC00996 is a potential therapeutic target in AD.

A Four-gene Autophagy-related Prognostic Signature and Its Association With Immune Landscape in Lung Squamous Cell Carcinoma

2020 ◽  
Author(s):  
Lumeng Luo ◽  
Minghe Lv ◽  
Xuan Li ◽  
Tiankui Qiao ◽  
Kuaile Zhao ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
High Risk ◽  
Cell Carcinoma ◽  
Risk Score ◽  
Squamous Cell ◽  
Immune Suppression ◽  
Risk Group ◽  
Lung Squamous Cell Carcinoma ◽  
High Risk Group ◽  
Low Risk

Abstract Background: Recent advances in immune checkpoint inhibitors (ICIs) have dramatically changed the therapeutic strategy against lung squamous cell carcinoma (LUSC). In the era of immunotherapy, effective biomarkers to better predict outcomes and inform treatment decisions for patients diagnosed with LUSC are urgently needed. We hypothesized that immune contexture of LUSC is potentially dictated by tumor intrinsic events, such as autophagy. Thus, we attempted to construct an autophagy-related risk signature and examine its prediction value for immune phenotype in LUSC.Method: The expression profile of LUSC was obtained from the cancer genome atlas (TCGA) database and the profile of autophagy-related genes (ARGs) was extracted. The survival‑related ARGs (sARGs) was screened out through survival analyses. Random forest was performed to select the sARGs and construct a prognostic risk signature based on these sARGs. The signature was further validated by receiver operating characteristic (ROC) analysis and Cox regression. GEO dataset was used as an independent testing dataset. Patients were divided into high-risk and low-risk group based on the risk score. Then, gene set enrichment analysis (GSEA) was conducted between the two groups. The Single-Sample GSEA (ssGSEA) was introduced to quantify the relative infiltration of immune cells. The correlations between risk score and several main immune checkpoints were examined. And the ESTIMATE algorithm was used to calculate the estimate/immune/stromal scores of the LUSC. Results: Four ARGs (CFLAR, RGS19, PINK1 and CTSD) with the most significant prognostic values were enrolled to construct the risk signature. Patients in high-risk group had better prognosis than the low-risk group (P < 0.0001 in TCGA; P < 0.01 in GEO) and considered as an independent prognosis factor. We also found that high-risk group indicated an immune-suppression status and had higher levels of infiltrating regulatory T cells and macrophages, which are correlated with worse outcome. Besides, risk score showed a significantly positive correlation with the expression of PD-1 and CTLA4, as well as estimate score and immune score.Conclusion: This study established a novel autophagy-related four-gene prognostic risk signature, and the autophagy-related scores are associated with immune landscape of LUSC, with higher score indicating a stronger immune-suppression status.

scholarly journals Novel Autophagy-Related Gene Signature Investigation for Patients With Oral Squamous Cell Carcinoma

2021 ◽  
Vol 12 ◽  
Author(s):  
Lihong Huang ◽  
Xinghao Yu ◽  
Zhou Jiang ◽  
Ping Zeng
Keyword(s):  
Squamous Cell Carcinoma ◽  
High Risk ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Risk Score ◽  
Squamous Cell ◽  
Cox Regression ◽  
Risk Group ◽  
Low Risk ◽  
Related Gene

The correlation between autophagy defects and oral squamous cell carcinoma (OSCC) has been previously studied, but only based on a limited number of autophagy-related genes in cell lines or animal models. The aim of the present study was to analyze differentially expressed autophagy-related genes through The Cancer Genome Atlas (TCGA) database to explore enriched pathways and potential biological function. Based on TCGA database, a signature composed of four autophagy-related genes (CDKN2A, NKX2-3, NRG3, and FADD) was established by using multivariate Cox regression models and two Gene Expression Omnibus datasets were applied for external validation. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed to study the function of autophagy-related genes and their pathways. The most significant GO and KEGG pathways were enriched in several key pathways that were related to the progression of autophagy and OSCC. Furthermore, a prognostic risk score was constructed based on the four genes; patients were then divided into two groups (i.e., high risk and low risk) in terms of the median of risk score. Prognosis of the two groups and results showed that patients at the low-risk group had a much better prognosis than those at the high-risk group, regardless of whether they were in the training datasets or validation datasets. Multivariate Cox regression results indicated that the risk score of the autophagy-related gene signatures could greatly predict the prognosis of patients after controlling for several clinical covariates. The findings of the present study revealed that autophagy-related gene signatures play an important role in OSCC and are potential prognostic biomarkers and therapeutic targets.

scholarly journals Identification and Validation of a Hypoxia-Immune-Based Prognostic mRNA Signature for Oral Squamous Cell Carcinoma

2021 ◽  
Author(s):  
Shaohua Lv ◽  
Jianhao Li ◽  
Songlin Piao ◽  
jichen Li
Keyword(s):  
Squamous Cell Carcinoma ◽  
High Risk ◽  
Oral Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Immune Status ◽  
Cox Regression ◽  
Risk Group ◽  
Gene Signature ◽  
Low Risk

Abstract Background: Oral squamous cell carcinoma (OSCC) is a frequently encountered head and neck malignancy. Increasing evidence points towards an aberrant immune response and chronic cell hypoxia in the development of OSCC. However, there is a lack of a reliable hypoxia-immune-based gene signature that may serve to accurately prognosticate OSCC. Methods: The mRNA expression data of OSCC patients was extracted from the TCGA database. Hypoxia status was identified using the t-distributed Stochastic Neighbor Embedding (t-SNE) algorithm. Both ESTIMATE and single-sample gene-set enrichment analysis (ssGSEA) was used for further evaluation of immune status. The DEGs in different hypoxia and immune status were determined. A Machine learning method-Least Absolute Shrinkage and Selection operator (LASSO) Cox regression analysis allowed us to select prognostically significant hypoxia- and immune-related mRNAs in order to construct prognostic gene signature to predict the overall survival (OS) of OSCC patients. Results: A total of 773 DEGs were classified into either Hypoxia_High and Hypoxia_Low groups. Immune-associated DEG expressions were used to divide individuals into Immune_High, Immune_ Medium and Immune_Low groups. A total of 193 mRNAs which were significant in both immune function and hypoxia status were identified. With the Lasso Cox regression model, 8 signature mRNAs (FAM122C, RNF157, RANBP17, SOWAHA, KIAA1211, RIPPLY2, INSL3, and DNAH1) associated with OS were selected for further calculation of their respective risk scores. The risk score showed a significant association with age, perineural and lymphovascular invasion. In the GEO validation cohort, a better OS was observed in patients from the low-risk group in comparison to those in the high-risk group. High-risk patients also demonstrated different immune infiltration characteristics from the low-risk group. All individuals from the TCGA OSCC cohort showed similar trends in all 6 immune checkpoints, with those of the low-risk group yielding higher immune indicator scores in contrast to their high-risk counterparts. Conclusion: The hypoxia-immune-based gene signature has prognostic potential in OSCC.

Identification of a novel CpG methylation signature to predict prognosis in lung squamous cell carcinoma

2020 ◽  
pp. 1-11
Author(s):  
Nan Lee ◽  
Xuelian Xia ◽  
Hui Meng ◽  
Weiliang Zhu ◽  
Xiankai Wang ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Regression Analysis ◽  
High Risk ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Risk Group ◽  
Lung Squamous Cell Carcinoma ◽  
High Risk Group ◽  
Low Risk ◽  
Risk Patients

BACKGROUND: DNA methylation plays a vital role in modulating genomic function and warrants evaluation as a biomarker for the diagnosis and treatment of lung squamous cell carcinoma (LUSC). OBJECTIVE: In this study, we aimed to identify effective potential biomarkers for predicting prognosis and drug sensitivity in LUSC. METHODS: A univariate Cox proportional hazards regression analysis, a random survival forests-variable hunting (RSFVH) algorithm, and a multivariate Cox regression analysis were adopted to analyze the methylation profile of patients with LUSC included in public databases: The Cancer Genome Atlas (TCGA), and the Gene Expression Omnibus (GEO). RESULTS: A methylated region consisting of 3 sites (cg06675147, cg07064331, cg20429172) was selected. Patients were divided into a high-risk group and a low-risk group in the training dataset. High-risk patients had shorter overall survival (OS) (hazard ratio [HR]: 2.72, 95% confidence interval [CI]: 1.82–4.07, P< 0.001) compared with low-risk patients. The accuracy of the prognostic signature was validated in the test and validation cohorts (TCGA, n= 94; GSE56044, n= 23). Gene set variation analysis (GSVA) showed that activity in the cell cycle/mitotic, ERBB, and ERK/MAPK pathways was higher in the high-risk compared with the low-risk group, which may lead to differences in OS.Interestingly, we observed that patients in the high-risk group were more sensitive to gemcitabine and docetaxel than the low-risk group, which is consistent with results of the GSVA. CONCLUSION: We report novel methylation sites that could be used as powerful tools for predicting risk factors for poorer survival in patients with LUSC.

scholarly journals An Immune-associated lncRNA Signature Predicts the Survival of Patients With Head and Neck Squamous Cell Carcinoma

2021 ◽  
Author(s):  
Jian Wang ◽  
Qinjiang Bian ◽  
Jialin Liu ◽  
Lijuan Du ◽  
Adili Moming
Keyword(s):  
Squamous Cell Carcinoma ◽  
High Risk ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Operating Characteristic ◽  
Low Risk ◽  
Neck Squamous Cell Carcinoma ◽  
Differentially Expressed ◽  
Risk Scores

Abstract BackgroundThe malignant progression and treatment resistance of head and neck squamous cell carcinoma are closely related to the tumor immune microenvironment. Long non-coding RNA (lncRNA) plays a regulatory role in this process and may be exploited as new signatures for head and neck squamous cell carcinoma(HNSCC) diagnosis, prognosis, and treatment.MethodsHNSCC transcriptome data was abstracted from the Cancer Genome Atlas (TCGA) data resource, and uncovered immune-linked lncRNA through co-expression analysis. Besides, univariate along with Lasso penalty regression were employed to determine immune-linked lncRNA pairs with different expressions. We then compared area under the curve, calculated the Akaike information criterion (AIC) value of the receiver operating characteristic curve for 5 years, determined cutoff points, and established an optimal predictive model for identifying high- and low-risk HNSCC patients. Then, we evaluated these patients with high- and low-risk HNSCC in terms of survival, clinic-pathological characteristics, tumor-infiltrating immune cells, chemotherapeutic efficacy, and immunosuppressed biomarkers.ResultsThis study included 545 samples. By co-expression analysis of known immune-linked genes and lncRNAs, a total of 809 immune-related lncRNAs were collected. 77 differentially expressed immune-related lncRNAs were identified (logFC>2,FDR<0.01). The identified differentially-expressed immune-linked lncRNAs were used to develop differential immune-linked lncRNA pairs. Univariate and modified Lasso regression analysis identified 40 differentially expressed immune linked lncRNAs pairs, 17 of which were incorporated in the Cox proportional hazard model by a stepwise approach. The signature could well predict the survival of patients, and the area under the receiver operating characteristic (ROC) of 17 lncRNA pairs predicted 1, 3, and 5-year survival rates (AUC) were all greater than 0.74. Kaplan-Meier analysis found that patients at low risk had longer survival than those in the high-risk group (p<.001). In addition, T stage, survival status, N stage, and clinical stage, were remarkably linked to the risk. The high- and low risk groups were correlated with tumor invading immune cells like macrophages, CD8+ T-cells, monocytes, along with CD4+ T-cells. ICI-related biomarker correlation analysis showed high risk scores were positively linked to high CDK8 expression (p<0.001) and negatively correlated with BTLA , LAG3 and PDCD1 (p<0.001). High-risk scores were correlated with lower IC50 for chemotherapeutics like Docetaxel (p<0.01), indicating that this model can predict chemotherapeutic efficacy.ConclusionsOur results offer promising prospects for identifying innovative molecular targets of immunotherapy and to improve therapeutic approaches for head and neck squamous cell carcinoma patients.

scholarly journals Comprehensive profiling of genomic and transcriptomic differences between risk groups of lung adenocarcinoma and lung squamous cell carcinoma

2021 ◽  
Author(s):  
Talip Zengin ◽  
Tuğba Önal-Süzek
Keyword(s):  
Lung Cancer ◽  
Squamous Cell Carcinoma ◽  
High Risk ◽  
Lung Adenocarcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cox Model ◽  
Lung Squamous Cell Carcinoma ◽  
Risk Groups ◽  
Low Risk

AbstractLung cancer is the second frequently diagnosed cancer type and responsible for the highest number of cancer deaths worldwide. Lung adenocarcinoma and lung squamous cell carcinoma are subtypes of non-small cell lung cancer which has the highest frequency of lung cancer cases. We aimed to analyze genomic and transcriptomic variations including simple nucleotide variations (SNVs), copy number variations (CNVs) and differential expressed genes (DEGs) in order to find key genes and pathways for diagnostic and prognostic prediction for lung adenocarcinoma and lung squamous cell carcinoma. We performed univariate cox model and then lasso regularized cox model with leave-one-out cross-validation using TCGA gene expression data in tumor samples. We generated a 35-gene signature and a 33-gene signature for prognostic risk prediction based on the overall survival time of the patients with LUAD and LUSC, respectively. When we clustered patients into high-risk and low-risk groups, the survival analysis showed highly significant results with high prediction power for both training and test datasets. Then we characterized the differences including significant SNVs, CNVs, DEGs, active subnetworks, and the pathways. We described the results for the risk groups and cancer subtypes separately to identify specific genomic alterations between both high-risk groups and cancer subtypes. Both LUAD and LUSC high-risk groups have more down-regulated immune pathways and upregulated metabolic pathways. On the other hand, low-risk groups have both upregulated and downregulated genes on cancer-related pathways. Both LUAD and LUSC have important gene alterations such as CDKN2A and CDKN2B deletions with different frequencies. SOX2 amplification occurs in LUSC and PSMD4 amplification in LUAD. EGFR and KRAS mutations are mutually exclusive in LUAD samples. EGFR, MGA, SMARCA4, ATM, RBM10, and KDM5C genes are mutated only in LUAD but not in LUSC. CDKN2A, PTEN, and HRAS genes are mutated only in LUSC samples. Low-risk groups of both LUAD and LUSC, tend to have a higher number of SNVs, CNVs, and DEGs. The signature genes and altered genes have the potential to be used as diagnostic and prognostic biomarkers for personalized oncology.

scholarly journals Constructing A Novel Signature Based on Immune-Related Lncrna to Improve Prognosis Prediction of Cervical Squamous Cell Carcinoma Patients

2021 ◽  
Author(s):  
Dongchun Qin ◽  
Xuefeng Lv ◽  
Lu Liu ◽  
Pengxiang Li ◽  
Yingying Yuan ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
High Risk ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Risk Model ◽  
Cervical Squamous Cell Carcinoma ◽  
Low Risk ◽  
Risk Scores ◽  
Expression Levels ◽  
M1 Macrophage

Abstract We downloaded gene expression data, clinical data, and somatic mutation data of cervical squamous cell carcinoma (CSCC) patients from The Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx) databases. Predictive lncRNAs were screened using univariate analysis and lasso regression, and risk score of each patient were calculated according to the expression levels of lncRNAs and regression coefficients to establish a risk model that could be a novel signature. We assessed the correlation between immune infiltration status, chemotherapeutics sensitivity, immune checkpoint proteins (ICP) and the signature. Therefore, we selected 11 immune-related lncRNAs (WWC2,AS2, STXBP5.AS1, ERICH6.AS1, USP30.AS1, LINC02073, RBAKDN, IL21R.AS1, LINC02078, DLEU1, LINC00426, BOLA3.AS1) to construct the risk model. Patients with high risk had a shorter survival time than those with low risk. Risk scores in the signature were negatively correlated with macrophage M1, macrophage M2, and T cell CD8+. The expression levels of ICP such as PD-1 were substantially higher in the low-risk group. For chemotherapeutic agents, high-risk scores were associated with higher half-inhibitory concentrations (IC50) of cisplatin. These findings suggested that the risk model can be a novel signature for predicting CSCC patients’ prognosis, and it also can be used to formulate clinical treatment plans for CSCC patients.

scholarly journals A Ferroptosis-Related Long Non-Coding RNA Signature Predicts Prognosis and Immune Microenvironment for Lung Squamous Cell Carcinoma

2021 ◽  
Author(s):  
Zhiyang Liu ◽  
Zhongcheng Xie ◽  
Chenxi Zhi ◽  
Xiaoyan Lin ◽  
Wentao Ma ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
High Risk ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Prognostic Value ◽  
Risk Group ◽  
Lung Squamous Cell Carcinoma ◽  
High Risk Group ◽  
Low Risk ◽  
Immune Checkpoints

Abstract Background: Ferroptosis-related lncRNAs (FerLncRNAs) were developed to play a significant role in cancer treatment and prognosis. However, the relationship between FerLncRNAs and Lung squamous cell carcinoma (LUSC) remains unclear.Method: Based on ferroptosis-related differentially expressed lncRNAs in LUSC, we established a prognostic 8-lncRNA signature.Results: 8 Ferroptosis-related lncRNAs (LUCAT1, AL161431.1, AL122125.1, AC104248.1, AC016924.1, MIR3945HG, C10orf55 and AP006545.2) had prognostic value for LUSC by multivariate COX analysis (P<0.05), and possessed significant association with patient outcomes. Kaplan–Meier curves showed an obvious difference in OS that the high-risk group patients exhibited poorer survival than the low-risk group patients. The clinical receiver operating characteristic (ROC) curve and decision curve analysis (DCA) revealed that the ferroptosis-related lncRNAs prognostic signature can (FerRLSig) emerged more outstanding performance than clinical features in predicting the prognosis of LUSC. GSEA revealed that the majority of the novel Ferroptosis-related lncRNAs signature-regulated immune responses and the immune system processes were enriched in the high-risk group. 34 immune checkpoints (ICs) were detected significantly different expression between high-risk and low-risk groups.Conclusion: A novel FerRLSig based on 8 Ferroptosis-related lncRNAs provided important prognostic value for LUSC patients and developed new insights about ferroptosis-related immunotherapy targets in clinic.

Development and Validation of a Hypoxia-Related Gene Pairs Signature to Predict Overall Survival in Head and Neck Squamous Cell Carcinoma

2020 ◽  
Author(s):  
Zhao Ding ◽  
Hefeng Li ◽  
Deshun Yu
Keyword(s):  
Squamous Cell Carcinoma ◽  
T Cells ◽  
High Risk ◽  
Gene Silencing ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Poor Prognosis ◽  
Risk Group ◽  
Low Risk

Abstract Objective Head and neck squamous cell carcinoma (HNSCC) are a highly aggressive tumor with an extremely poor prognosis. Thus, we aimed to develop and validate a robust prognostic signature that can estimate the prognosis for HNSCC.Methods Data on gene expressions and clinical were downloaded from TCGA and GEO database. To develop the best prognosis signature, a LASSO Cox Regression model was employed. Time-dependent receiver-operating characteristic (ROC) was used to determine the best cut-off value. Patients were divided into high-risk and low-risk hypoxia groups according to cut-off value. Survival differences were evaluated by log-rank test, while multivariate analysis was performed by a Cox proportional hazards model.Results A 17-HRGPs composed of 24 unique genes was constructed, which was significantly related to OS. In the TCGA and GEO datasets, patients in the high hypoxia risk group have a poor prognosis (TCGA: P < 0.001, GEO: P < 0.05). After adjusting for other clinicopathological parameters, the 17-HRGP signature was independent prognostic factors in patients with HNSCC (P < 0.05). Functional analysis revealed that mRNA binding, gene silencing by RNA, RNA binding involved in posttranscriptional gene silencing signaling pathway were enriched in the low-risk groups. For this model, C-index was 0.684, which was higher than that of many established risk models. Macrophages M0, Mast cells activated, NK cells resting, and T cells CD4 memory resting, etc. were significantly higher in the high-risk group, and B cells memory, Plasma cells, T cells follicular helper, T cells gamma delta, and T cells CD8, etc. were significantly higher in the low-risk group.Conclusion In summary, our study constructed a robust HRGPs signature as molecular markers for predicting the outcome of HNSCC patients.

scholarly journals A Novel Clinical Six-Flavoprotein-Gene Signature Predicts Prognosis in Esophageal Squamous Cell Carcinoma

2019 ◽  
Vol 2019 ◽  
pp. 1-13
Author(s):  
Liu Peng ◽  
Jin-Cheng Guo ◽  
Lin Long ◽  
Feng Pan ◽  
Jian-Mei Zhao ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
High Risk ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Clinical Significance ◽  
Squamous Cell ◽  
Risk Group ◽  
Gene Signature ◽  
High Risk Group ◽  
Low Risk

Flavoproteins and their interacting proteins play important roles in mitochondrial electron transport, fatty acid degradation, and redox regulation. However, their clinical significance and function in esophageal squamous cell carcinoma (ESCC) are little known. Here, using survival analysis and machine learning, we mined 179 patient expression profiles with ESCC in GSE53625 from the Gene Expression Omnibus (GEO) database and constructed a signature consisting of two flavoprotein genes (GPD2 and PYROXD2) and four flavoprotein interacting protein genes (CTTN, GGH, SRC, and SYNJ2BP). Kaplan–Meier analysis revealed the signature was significantly associated with the survival of ESCC patients (mean survival time: 26.77 months in the high-risk group vs. 54.97 months in the low-risk group, P<0.001, n = 179), and time-dependent ROC analysis demonstrated that the six-gene signature had good predictive ability for six-year survival for ESCC (AUC = 0.86, 95% CI: 0.81–0.90). We then validated its prediction performance in an independent set by RT-PCR (mean survival: 15.73 months in the high-risk group vs. 21.1 months in the low-risk group, P=0.032, n = 121). Furthermore, RNAi-mediated knockdown of genes in the flavoprotein signature led to decreased proliferation and migration of ESCC cells. Taken together, CTTN, GGH, GPD2, PYROXD2, SRC, and SYNJ2BP have an important clinical significance for prognosis of ESCC patients, suggesting they are efficient prognostic markers and potential targets for ESCC therapy.

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