An Integrated Fibrosis Signature for Predicting Survival and Immunotherapy Efficacy of Patients With Hepatocellular Carcinoma

Introduction: Fibrosis, a primary cause of hepatocellular carcinoma (HCC), is intimately associated with inflammation, the tumor microenvironment (TME), and multiple carcinogenic pathways. Currently, due to widespread inter- and intra-tumoral heterogeneity of HCC, the efficacy of immunotherapy is limited. Seeking a stable and novel tool to predict prognosis and immunotherapy response is imperative.Methods: Using stepwise Cox regression, least absolute shrinkage and selection operator (LASSO), and random survival forest algorithms, the fibrosis-associated signature (FAIS) was developed and further validated. Subsequently, comprehensive exploration was conducted to identify distinct genomic alterations, clinical features, biological functions, and immune landscapes of HCC patients.Results: The FAIS was an independent prognostic predictor of overall survival and recurrence-free survival in HCC. In parallel, the FAIS exhibited stable and accurate performance at predicting prognosis based on the evaluation of Kaplan–Meier survival curves, receiver operator characteristic curves, decision curve analysis, and Harrell’s C-index. Further investigation elucidated that the high-risk group presented an inferior prognosis with advanced clinical traits and a high mutation frequency of TP53, whereas the low-risk group was characterized by superior CD8+ T cell infiltration, a higher TIS score, and a lower TIDE score. Additionally, patients in the low-risk group might yield more benefits from immunotherapy.Conclusion: The FAIS was an excellent scoring system that could stratify HCC patients and might serve as a promising tool to guide surveillance, improve prognosis, and facilitate clinical management.

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Identification of Novel Tumor Microenvironment-Related Long Non-coding RNAs to Predict the Prognosis for Hepatocellular Carcinoma

10.21203/rs.3.rs-877901/v1 ◽

2021 ◽

Author(s):

Shenglan Huang ◽

Jian Zhang ◽

Dan Li ◽

Xiaolan Lai ◽

Lingling Zhuang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

High Risk ◽

Tumor Microenvironment ◽

Cox Regression ◽

Risk Group ◽

High Risk Group ◽

Low Risk ◽

Clinicopathological Parameters ◽

Kaplan Meier ◽

The Impact

Abstract Introduction: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors with poor prognosis. Tumor microenvironment (TME) plays a vital role in the tumor progression of HCC. Thus, we aimed to analyze the association of TME with HCC prognosis, and construct an TME-related lncRNAs signature for predicting the prognosis of HCC patients.Methods: We firstly assessed the stromal/immune /Estimate scores within the HCC microenvironment using the ESTIMATE algorithm based on TCGA database, and its associations with survival and clinicopathological parameters were also analyzed. Then, different expression lncRNAs were filtered out according to immune/stromal scores. Cox regression was performed to built an TME-related lncRNAs risk signature. Kaplan–Meier analysis was carried out to explored the prognostic values of the risk signature. Furthermore, we explored the biological functions and immune microenvironment feathers in high- and low risk groups. Lastly, we probed the association of the risk signature with the treatment responses to immune checkpoint inhibitors (ICIs) in HCC by comparing the immunophenoscore (IPS).Results: Stromal/immune /Estimate scores of HCC patients were obtained based on the ESTIMATE algorithm. The Kaplan-Meier curve analysis showed the high stromal/immune/ Estimate scores were significantly associated with better prognosis of the HCC patients. Then, six TME-related lncRNAs were screened for constructing the prognosis model. Kaplan-Meier survival curves suggested that HCC patients in high-risk group had worse prognosis than those with low-risk. ROC curve and Cox regression analyses demonstrated the signature could predict HCC survival exactly and independently. Function enrichment analysis revealed that some tumor- and immune-related pathways associated with HCC tumorigenesis and progression might be activated in high-risk group. We also discovered that some immune cells, which were beneficial to enhance immune responses towards cancer, were remarkably upregulated in low-risk group. Besides, there was closely correlation of immune checkmate inhibitors (ICIs) with the risk signature and the signature can be used to predict treatment response of ICIs.Conclusions: We analyzed the impact of the tumor microenvironment scores on the prognosis of patients with HCC. A novel TME-related prognostic risk signature was established, which may improve prognostic predictive accuracy and guide individualized immunotherapy for HCC patients.

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Discovery and validation of immune- related long non-coding RNA biomarkers associated with prognosis in hepatocellular carcinoma

10.21203/rs.3.rs-17851/v1 ◽

2020 ◽

Author(s):

Li Liu ◽

She Tian ◽

Zhu Li ◽

Yongjun Gong ◽

Hao Zhang

Keyword(s):

Hepatocellular Carcinoma ◽

High Risk ◽

Cox Regression ◽

Risk Group ◽

Survival Curve ◽

Principal Component ◽

High Risk Group ◽

Low Risk ◽

Cox Regression Analysis ◽

Immune Related Genes

Abstract Background : Hepatocellular carcinoma (HCC) is one of the most common clinical malignant tumors, resulting in high mortality and poor prognosis. Studies have found that LncRNA plays an important role in the onset, metastasis and recurrence of hepatocellular carcinoma. The immune system plays a vital role in the development, progression, metastasis and recurrence of cancer. Therefore, immune-related lncRNA can be used as a novel biomarker to predict the prognosis of hepatocellular carcinoma. Methods : The transcriptome data and clinical data of HCC patients were obtained by using The Cancer Genome Atlas-Liver Hepatocellular Carcinoma (TCGA‑LIHC), and immune-related genes were extracted from the Molecular Signatures Database (IMMUNE RESPONSE M19817 and IMMUNE SYSTEM PROCESS M13664). By constructing the co-expression network and Cox regression analysis, 13 immune-lncRNAs was identified to predict the prognosis of HCC patients. Patients were divided into high risk group and low risk group by using the risk score formula, and the difference in overall survival (OS) between the two groups was reflected by Kaplan-Meier survival curve. The time - dependent receiver operating characteristics (ROC) analysis and principal component analysis (PCA) were used to evaluate 13 immune -lncRNAs signature. Results : Through TCGA - LIHC extracted from 343 cases of patients with hepatocellular carcinoma RNA - Seq data and clinical data, 331 immune-related genes were extracted from the Molecular Signatures Database , co-expression networks and Cox regression analysis were constructed, 13 immune-lncRNAs signature was identified as biomarkers to predict the prognosis of patients. At the same time using the risk score median divided the patients into high risk and low risk groups, and through the Kaplan-Meier survival curve analysis found that high-risk group of patients' overall survival (OS) less low risk group of patients. The AUC value of the ROC curve is 0.828, and principal component analysis (PCA) results showed that patients could be clearly divided into two parts by immune-lncRNAs, which provided evidence for the use of 13 immune-lncRNAs signature as prognostic markers. Conclusion : Our study identified 13 immune-lncRNAs signature that can effectively predict the prognosis of HCC patients, which may be a new prognostic indicator for predicting clinical outcomes.

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Prognostic utility of neutrophil-to-lymphocyte ratio in patients with metastatic colorectal cancer treated using different modalities

Current Oncology ◽

10.3747/co.27.6573 ◽

2020 ◽

Vol 27 (5) ◽

Author(s):

G. Nogueira-Costa ◽

I. Fernandes ◽

R. Gameiro ◽

J. Gramaça ◽

A.T. Xavier ◽

...

Keyword(s):

Colorectal Cancer ◽

High Risk ◽

Metastatic Colorectal Cancer ◽

Real World ◽

Cox Regression ◽

Risk Group ◽

High Risk Group ◽

Low Risk ◽

First Line ◽

Kaplan Meier

Introduction Inflammation is a critical component in carcinogenesis. The neutrophil-to-lymphocyte ratio (nlr) has been retrospectively studied as a biomarker of prognosis in metastatic colorectal cancer (mcrc). Compared with a low nlr, a high nlr is associated with worse prognosis. In the present study, we compared real-world survival for patients with mcrc based on their nlr group, and we assessed the utility of the nlr in determining first-line chemotherapy and metastasectomy benefit. Methods In this retrospective and descriptive analysis of patients with mcrc undergoing first-line chemotherapy in a single centre, the last systemic absolute neutrophil and lymphocyte count before treatment was used for the nlr. A receiver operating characteristic curve was used to estimate the nlr cut-off value, dividing the patients into low and high nlr groups. Median overall survival (mos) was compared using Kaplan–Meier curves and the log-rank test. A multivariate analysis was performed using a Cox regression model. Results The 102 analyzed patients had a median follow-up of 15 months. Regardless of systemic therapy, approximately 20% of patients underwent metastasectomy. The nlr cut-off was established at 2.35, placing 45 patients in the low-risk group (nlr < 2.35) and 57 in the high-risk group (nlr ≥ 2.35). The Kaplan–Meier analysis showed a mos of 39.1 months in the low-risk group and 14.4 months in the high-risk group (p < 0.001). Multivariate Cox regression on the nlr estimated a hazard ratio of 3.08 (p = 0.01). Survival analysis in each risk subgroup, considering the history of metastasectomy, was also performed. In the low-risk group, mos was longer for patients undergoing metastasectomy than for those not undergoing the procedure (95.2 months vs. 22.6 months, p = 0.05). In the high-risk group, mos was not statistically different for patients undergoing or not undergoing metastasectomy (24.3 months vs. 12.7 months, p = 0.08). Conclusions Our real-world data analysis of nlr in patients with mcrc confirmed that this biomarker is useful in predicting survival. It also suggests that nlr is an effective tool to choose first-line treatment and to predict the benefit of metastasectomy.

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Identification of Novel Tumor Microenvironment-Related Long Noncoding RNAs to Determine the Prognosis and Response to Immunotherapy of Hepatocellular Carcinoma Patients

Frontiers in Molecular Biosciences ◽

10.3389/fmolb.2021.781307 ◽

2021 ◽

Vol 8 ◽

Author(s):

Shenglan Huang ◽

Jian Zhang ◽

Xiaolan Lai ◽

Lingling Zhuang ◽

Jianbing Wu

Keyword(s):

Hepatocellular Carcinoma ◽

High Risk ◽

Tumor Microenvironment ◽

Immune Cells ◽

Risk Model ◽

Cox Regression ◽

Risk Group ◽

Low Risk ◽

Kaplan Meier ◽

Treatment Responses

Introduction: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors with poor prognosis. The tumor microenvironment (TME) plays a vital role in HCC progression. Thus, this research was designed to analyze the correlation between the TME and the prognosis of HCC patients and to construct a TME-related long noncoding RNA (lncRNA) signature to determine HCC patients’ prognosis and response to immunotherapy.Methods: We assessed the stromal–immune–estimate scores within the HCC microenvironment using the ESTIMATE (Estimation of Stromal and Immune Cells in Malignant Tumor Tissues Using Expression Data) algorithm based on The Cancer Genome Atlas database, and their associations with survival and clinicopathological parameters were also analyzed. Thereafter, differentially expressed lncRNAs were filtered out according to the immune and stromal scores. Cox regression analysis was performed to build a TME-related lncRNA risk signature. Kaplan–Meier analysis was used to explore the prognostic value of the risk signature. Furthermore, we explored the biological functions and immune microenvironment features in the high- and low-risk groups. Lastly, we probed the association of the risk model with treatment responses to immune checkpoint inhibitors (ICIs) in HCC.Results: The stromal, immune, and estimate scores were obtained utilizing the ESTIMATE algorithm for patients with HCC. Kaplan–Meier analysis showed that high scores were significantly correlated with better prognosis in HCC patients. Six TME-related lncRNAs were screened to construct the prognostic model. The Kaplan–Meier curves suggested that HCC patients with low risk had better prognosis than those with high risk. Receiver operating characteristic (ROC) curve and Cox regression analyses indicated that the risk model could predict HCC survival exactly and independently. Functional enrichment analysis revealed that some tumor- and immune-related pathways were activated in the high-risk group. We also revealed that some immune cells, which were important in enhancing immune responses toward cancer, were significantly increased in the low-risk group. In addition, there was a close correlation between ICIs and the risk signature, which can be used to predict the treatment responses of HCC patients.Conclusion: We analyzed the influence of the stromal, immune, and estimate scores on the prognosis of HCC patients. A novel TME-related lncRNA risk model was established, which could be effectively applied as an independent prognostic biomarker and predictor of ICIs for HCC patients.

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Identification and Validation of Hypoxia-Related lncRNA Signature as a Prognostic Model for Hepatocellular Carcinoma

Frontiers in Genetics ◽

10.3389/fgene.2021.744113 ◽

2021 ◽

Vol 12 ◽

Author(s):

Chenghui Zhou ◽

Huajun Zhang ◽

Liqing Lu

Keyword(s):

Hepatocellular Carcinoma ◽

Survival Data ◽

Immune Cell ◽

Malignant Tumors ◽

Risk Group ◽

High Risk Group ◽

Low Risk ◽

Immune Checkpoints ◽

Kaplan Meier ◽

Clinical Characteristic

Hepatocellular carcinoma (HCC) is one of the most general malignant tumors. Hypoxia is a critical clinical characteristic and acts as a significant part in the development and cancers’ prognosis. The prognostic value and biological functions of hypoxia-related lncRNAs in hepatocellular carcinoma is little known. Thus, we aim to establish a hypoxia-related lncRNA signature to predict the HCC patients’ survival. First, we extracted the hypoxia-related genes and expression of lncRNAs from the MSigDB and TCGA database, respectively. The co-expression analysis among hypoxia-related mRNAs and lncRNAs was employed to identify hypoxia-related lncRNAs. Then, comprehensive analyses of lncRNAs expression level and survival data were applied to establish the signature. We built a prognostic signature on the foundation of the three differently expressed hypoxia-related lncRNAs. Kaplan-Meier curves indicated the low-risk group is associated with better survival. The 1−, 3−, and 5 years AUC values of the signature were 0.805, 0.672 and 0.63 respectively. The test set performed consistent outcomes. A nomogram was built grounded on the risk score and clinicopathological features. GSEA showed the immune-related pathways in high-risk group, while metabolism-related pathways in low-risk group. Besides, we found this model was correlated with the clinical features, tumor immune cell infiltration, immune checkpoints, and m6A-related genes. Finally, a novel signature based on hypoxia-related lncRNAs was established and validated for predicting HCC patients’ survival and may offer some useful information for immunotherapies.

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Stemness-related LncRNA pair signature for predicting therapy response in gastric cancer

BMC Cancer ◽

10.1186/s12885-021-08798-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Quan Jiang ◽

Hao Chen ◽

Zhaoqing Tang ◽

Jie Sun ◽

Yuanyuan Ruan ◽

...

Keyword(s):

Gastric Cancer ◽

Cox Regression ◽

Risk Group ◽

Therapy Response ◽

Risk Groups ◽

High Risk Group ◽

Low Risk ◽

Survival Prediction ◽

Critical Feature ◽

Kaplan Meier

Abstract Objective As a critical feature of cancers, stemness is acknowledged as a contributor to the development of drug resistance in gastric cancer (GC). LncRNAs have been revealed to participate in this process. In this study, we tried to develop a stemness-related lncRNA pair signature as guidance for clinical decisions. Methods The analysis was initiated by collecting stemness-related lncRNAs in TCGA cohort. The differentially expressed stemness-related lncRNAs between normal and tumor tissues in GC patients from TCGA datasets were further collected to establish the signature based on Lasso and Cox regression analyses. The predictive efficacy of the signature for chemotherapy and immunotherapy was also tested. The practicality of this signature was also validated by Zhongshan cohort. Results A 13-DEsrlncRNA pair-based signature was established. The cutoff point acquired by the AIC algorithm divided the TCGA cohort into high and low risk groups. We found that the low-risk group presented with better survival (Kaplan-Meier analysis, p < 0.001). Cox regression analyse was also conducted to confirm the signature as an independent risk factor for GC {p < 0.001, HR = 1.300, 95% CI (1.231–1.373)]}. As for the practicality of this signature, the IC50 of cytotoxic chemotherapeutics was significantly higher in the high-risk group. The low-risk group also presented with higher immunophenoscore (IPS) in both the “CTLA4+ PD1+” (Mann-Whitney U test, p = 0.019) and “CTLA4- PD1+” (Mann-Whitney U test, p = 0.013) groups, indicating higher sensitivity to immunotherapy. The efficacy of the signature was also validated by Zhongshan cohort. Conclusions This study could not only provide a stemness-related lncRNA signature for survival prediction in GC patients but also established a model with predictive potentials for GC patients’ sensitivity to chemotherapy and immunotherapy.

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Identification and validation of hub genes predicting prognosis of hepatocellular carcinoma

Digestive Surgery ◽

10.1159/000520893 ◽

2021 ◽

Author(s):

Ziyan Chen ◽

Haitao Yu ◽

Lijun Wu ◽

Sina Zhang ◽

Zhihui Lin ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Regression Model ◽

Risk Model ◽

Cox Regression ◽

Risk Group ◽

Histological Grade ◽

High Risk Group ◽

Low Risk ◽

Hub Genes ◽

Cox Regression Analysis

Introduction: Selecting the hub genes associated with hepatocellular carcinoma (HCC) to construct a COX regression model for predicting prognosis in HCC patients. Methods: Using HCC patient data from the ICGC and TCGA databases, screened for 40 core genes highly correlated with histological grade of HCC. Univariate and multivariate COX regression analysis were performed on the genes highly associated with HCC prognosis and the model was established. The expression of those genes was measured by immunohistochemistry in 110 HCC patients who underwent the surgery in The First Affiliated Hospital of Wenzhou Medical University. The survival of HCC patients was analyzed by the Kaplan-Meier method. Results: Eight genes (CDC45, CENPA, MCM10, MELK, CDC20, ASF1B, FANCD2 and NCAPH) were correlated with prognosis, and the same result was observed in 110 HCC patients. Using the regression model, the HCC patients in the training set were classified as high- and low-risk groups. The overall survival (OS) of patients in the high-risk group was shorter than that in the low-risk group, the same results were obtained in verification set. Conclusion: This study found that the risk model according to these eight genes can be used as a predictor of prognosis in HCC. These genes may become alternative biomarkers and therapeutic targets and provide new therapeutic strategies for HCC.

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Development of a Novel Autophagy-Related Prognostic Signature and Nomogram for Hepatocellular Carcinoma

Frontiers in Oncology ◽

10.3389/fonc.2020.591356 ◽

2020 ◽

Vol 10 ◽

Author(s):

Qiongxuan Fang ◽

Hongsong Chen

Keyword(s):

Gene Expression ◽

Hepatocellular Carcinoma ◽

High Risk ◽

Cox Regression ◽

Risk Group ◽

High Risk Group ◽

Low Risk ◽

Gene Set Enrichment Analysis ◽

Regression Analyses ◽

Gene Model

BackgroundHepatocellular carcinoma (HCC) is the seventh most common malignancy and the second most common cause of cancer-related deaths. Autophagy plays a crucial role in the development and progression of HCC.MethodsUnivariate and Lasso Cox regression analyses were performed to determine a gene model that was optimal for overall survival (OS) prediction. Patients in the GSE14520 and GSE54236 datasets of the Cancer Genome Atlas (TCGA) were divided into the high-risk and low-risk groups according to established ATG models. Univariate and multivariate Cox regression analyses were used to identify risk factors for OS for the purpose of constructing nomograms. Calibration and receiver operating characteristic (ROC) curves were used to evaluate model performance. Real-time PCR was used to validate the effects of the presence or absence of an autophagy inhibitor on gene expression in HepG2 and Huh7 cell lines.ResultsOS in the high-risk group was significantly shorter than that in the low-risk group. Gene set enrichment analysis (GSEA) indicated that the association between the low-risk group and autophagy- as well as immune-related pathways was significant. ULK2, PPP3CC, and NAFTC1 may play vital roles in preventing HCC progression. Furthermore, tumor environment analysis via ESTIMATION indicated that the low-risk group was associated with high immune and stromal scores. Based on EPIC prediction, CD8+ T and B cell fractions in the TCGA and GSE54236 datasets were significantly higher in the low-risk group than those in the high-risk group. Finally, based on the results of univariate and multivariate analyses three variables were selected for nomogram development. The calibration plots showed good agreement between nomogram prediction and actual observations. Inhibition of autophagy resulted in the overexpression of genes constituting the gene model in HepG2 and Huh7 cells.ConclusionsThe current study determined the role played by autophagy-related genes (ATGs) in the progression of HCC and constructed a novel nomogram that predicts OS in HCC patients, through a combined analysis of TCGA and gene expression omnibus (GEO) databases.

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Ferroptosis regulator genes are a favorable biomarker for hepatocellular carcinoma

10.21203/rs.3.rs-139865/v1 ◽

2021 ◽

Author(s):

Yongfei He ◽

Shuqi Zhao ◽

Zhongliu Wei ◽

Xin Zhou ◽

Tianyi Liang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

High Risk ◽

Cox Regression ◽

Risk Group ◽

Clinical Information ◽

High Risk Group ◽

Low Risk ◽

The Cancer Genome Atlas ◽

Regulator Genes ◽

The Relationship

Abstract BackgroundIn this study, we comprehensively analyzed the relationship between ferroptosis regulator genes (FRGs) and prognosis of hepatocellular carcinoma (HCC), determined the prognostics value of FRGs, established a prediction model, and explored the relationship with immunotherapy for HCC.MethodsThe mRNA transcriptional levels and clinical information of HCC were obtained from The Cancer Genome Atlas (TCGA) database. The 24 FRGs were combined with the differential expression genes (DEGs) of HCC for further analysis. The prognostics values of differential FRGs via the construction of model and validation by the Cox regression analysis.ResultThere were three genes (CARS1, FANCD2, and SLC7A11) were identified as independent risk factors for HCC, and a predictive model was constructed based on CARS1, FANCD2, and SLC7A11. The model showed that the low-risk group HCC patients with a more prolonged overall survival (OS) than the high-risk group (P=0.001). The high-risk group with higher expression of FRGs than the low-risk group. Finally, the relations between FGEs and immune infiltration showed that CARS1, FANCD2, and SLC7A11 had a positive relationship with macrophage infiltration. From these, three genes might be the potential therapeutic targets.ConclusionOur study indicated that CARS1, FANCD2, and SLC7A11 might have potential value for therapeutic strategies as practical and reliable prognostic tools for HCC.

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Identification of an Epithelial-Mesenchymal Transition-Related Long Non-coding RNA Prognostic Signature for Hepatocellular Carcinoma

10.21203/rs.3.rs-642960/v1 ◽

2021 ◽

Author(s):

Shenglan Huang ◽

Dan Li ◽

LingLing Zhuang ◽

Jian Zhang ◽

Jianbing Wu

Keyword(s):

Hepatocellular Carcinoma ◽

High Risk ◽

Cancer Progression ◽

Risk Model ◽

Cox Regression ◽

Epithelial Mesenchymal Transition ◽

Risk Group ◽

High Risk Group ◽

Mesenchymal Transition ◽

Kaplan Meier

Abstract Introduction: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors with poor prognosis. Epithelial–mesenchymal transition (EMT) is crucial for cancer progression and associates with a worse prognosis. Thus, we aimed to construct an EMT-related lncRNAs signature for predicting the prognosis of HCC patients.Methods: We built an EMT-related lncRNA risk signature in the training set by using Cox regression and LASSO regression based on TCGA database. Kaplan-Meier survival analysis was conducted to compare the overall survival (OS) in different risk groups. Cox regression was performed to explore whether the signature could be used as an independent factor. A nomogram was built involving the risk score and clinicopathological features. Furthermore, we explored the biological functions and immune states in two groups.Results: 12 EMT-related lncRNAs were obtained for constructing the prognosis model in HCC. The Kaplan-Meier curve analysis revealed that patients in the high-risk group had worse survival than low-risk group. Time-dependent ROC and Cox regression analyses suggested that the signature could predict HCC survival exactly and independently. The prognostic value of the risk model was confirmed in the validation group. The nomogram was built and could accurately predict survival of HCC patients. GSEA results showed that in high-risk group cancer-related pathways were enriched, and exhibited more cell division activity suggested by Gene Ontology (GO) analysis.Conclusions: We established a novel EMT-related prognostic risk signature including 12 lncRNAs and constructed a nomogram to predict the prognosis in HCC patients, which may improve prognostic predictive accuracy for HCC patients and guide the individualized treatment methods for the patients with HCC.

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