scholarly journals Identification of prognostic hypoxia-related genes signature on the tumor microenvironment in esophageal cancer

2021 ◽  
Vol 18 (6) ◽  
pp. 7743-7758
Author(s):  
Linlin Tan ◽  
◽  
Dingzhuo Cheng ◽  
Jianbo Wen ◽  
Kefeng Huang ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
High Risk ◽  
Immune Cells ◽  
Immune Cell ◽  
Risk Group ◽  
Roc Curves ◽  
Risk Groups ◽  
High Risk Group ◽  
The Cancer Genome Atlas ◽  
Cancer Genome Atlas

<abstract> <sec><title>Background</title><p>Hypoxia is a crucial factor in the development of esophageal cancer. The relationship between hypoxia and immune status in the esophageal cancer microenvironment is becoming increasingly important in clinical practice. This study aims to clarify and investigate the possible connection between immunotherapy and hypoxia in esophageal cancer.</p> </sec> <sec><title>Methods</title><p>The Cancer Genome Atlas databases are used to find two types of esophageal cancer cases. Cox regressions analyses are used to screen genes for hypoxia-related traits. After that, the genetic signature is validated by survival analysis and the construction of ROC curves. GSEA is used to compare differences in enrichment in the two groups and is followed by the CIBERSORT tool to investigate a potentially relevant correlation between immune cells and gene signatures.</p> </sec> <sec><title>Results</title><p>We found that the esophageal adenocarcinoma hypoxia model contains 3 genes (PGK1, PGM1, SLC2A3), and the esophageal squamous cell carcinoma hypoxia model contains 2 genes (EGFR, ATF3). The findings demonstrated that the survival rate of patients in the high-risk group is lower than in the lower-risk group. Furthermore, we find that three kinds of immune cells (memory activated CD4+ T cells, activated mast cells, and M2 macrophages) have a marked infiltration in the tissues of patients in the high-risk group. Moreover, we find that PD-L1 and CD244 are highly expressed in high-risk groups.</p> </sec> <sec><title>Conclusions</title><p>Our data demonstrate that oxygen deprivation is correlated with prognosis and the incidence of immune cell infiltration in patients with both types of esophageal cancer, which provides an immunological perspective for the development of personalized therapy.</p> </sec> </abstract>

scholarly journals Immune-Related Four-lncRNA Signature for Patients with Cervical Cancer

2020 ◽  
Vol 2020 ◽  
pp. 1-15
Author(s):  
Jianfeng Zheng ◽  
Benben Cao ◽  
Xia Zhang ◽  
Zheng Niu ◽  
Jinyi Tong
Keyword(s):  
Cervical Cancer ◽  
High Risk ◽  
Immune Cell ◽  
Risk Group ◽  
Pearson Correlation ◽  
Characteristic Curve ◽  
Risk Groups ◽  
High Risk Group ◽  
Low Risk ◽  
Gynecological Malignancy

Cervical cancer (CC) is a common gynecological malignancy for which prognostic and therapeutic biomarkers are urgently needed. The signature based on immune-related lncRNAs (IRLs) of CC has never been reported. This study is aimed at establishing an IRL signature for patients with CC. A cohort of 326 CC and 21 normal tissue samples with corresponding clinical information was included in this study. Twenty-eight IRLs were collected according to the Pearson correlation analysis between the immune score and lncRNA expression ( p < 0.01 ). Four IRLs (BZRAP1-AS1, EMX2OS, ZNF667-AS1, and CTC-429P9.1) with the most significant prognostic values ( p < 0.05 ) were identified which demonstrated an ability to stratify patients into the low-risk and high-risk groups by developing a risk score model. It was observed that patients in the low-risk group showed longer overall survival (OS) than those in the high-risk group in the training set, valid set, and total set. The area under the curve (AUC) of the receiver operating characteristic curve (ROC curve) for the four-IRL signature in predicting the one-, two-, and three-year survival rates was larger than 0.65. In addition, the low-risk and high-risk groups displayed different immune statuses in GSEA. These IRLs were also significantly correlated with immune cell infiltration. Our results showed that the IRL signature had a prognostic value for CC. Meanwhile, the specific mechanisms of the four IRLs in the development of CC were ascertained preliminarily.

scholarly journals Hypoxia-Related Long Non-Coding RNA Signature Predicts the Prognosis of Breast Cancer

2021 ◽  
Author(s):  
Jinlong Huo ◽  
Shuang Shen ◽  
Chen Chen ◽  
Rui Qu ◽  
Youming Guo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
T Cell ◽  
High Risk ◽  
Risk Group ◽  
Risk Groups ◽  
High Risk Group ◽  
Cytolytic Activity ◽  
Low Risk ◽  
Gene Set Enrichment Analysis ◽  
The Cancer Genome Atlas

Abstract Background: Breast cancer(BC) is the most common tumour in women. Hypoxia stimulates metastasis in cancer and is linked to poor patient prognosis.Methods: We screened prognostic-related lncRNAs(Long Non-Coding RNAs) from the Cancer Genome Atlas (TCGA) data and constructed a prognostic signature based on hypoxia-related lncRNAs in BC.Results: We identified 21 differentially expressed lncRNAs associated with BC prognosis. Kaplan Meier survival analysis indicated a significantly worse prognosis for the high-risk group(P<0.001). Moreover, the ROC-curve (AUC) of the lncRNAs signature was 0.700, a performance superior to other traditional clinicopathological characteristics. Gene set enrichment analysis (GSEA) showed many immune and cancer-related pathways and in the low-risk group patients. Moreover, TCGA revealed that functions including activated protein C (APC)co-inhibition, Cinnamoyl CoA reductase(CCR),check-point pathways, cytolytic activity, human leukocyte antigen (HLA), inflammation-promotion, major histocompatibility complex(MHC) class1, para-inflammation, T cell co-inhibition, T cell co-stimulation, and Type Ⅰ and Ⅱ Interferons (IFN) responses were significantly different in the low-risk and high-risk groups. Immune checkpoint molecules such as ICOS, IDO1, TIGIT, CD200R1, CD28, PDCD1(PD-1), were also expressed differently between the two risk groups. The expression of m6A-related mRNA indicated that YTHDC1, RBM15, METTL3, and FTO were significantly between the high and low-risk groups.Additionally, immunotherapy in patients with BC from the low-risk group yielded a higher frequency of clinical responses to anti-PD-1/PD-L1 therapy or a combination of anti-PD-1/PD-L1and anti-CTLA4 therapies.Except for lapatinib, the results also show that a high-risk score is related to a higher half-maximal inhibitory concentration (IC50) of chemotherapy drugs.Conclusion: A novel hypoxia-related lncRNAs signature may serve as a prognostic model for BC.

scholarly journals Construction and Validation of a Novel Immunosignature for Overall Survival in Uveal Melanoma

2021 ◽  
Vol 9 ◽  
Author(s):  
Chufeng Gu ◽  
Xin Gu ◽  
Yujie Wang ◽  
Zhixian Yao ◽  
Chuandi Zhou
Keyword(s):  
Overall Survival ◽  
High Risk ◽  
Immune Cell ◽  
Risk Group ◽  
Staging System ◽  
Risk Groups ◽  
Tnm Staging ◽  
High Risk Group ◽  
Immune Cell Infiltration ◽  
Tnm Staging System

ObjectivesUveal melanoma (UM) is the most common primary intraocular malignancy in adults, and immune infiltration plays a crucial role in the prognosis of UM. This study aimed to generate an immunological marker-based predictive signature for the overall survival (OS) of UM patients.MethodsSingle-sample gene-set enrichment analysis (ssGSEA) was used to profile immune cell infiltration in 79 patients with UM from The Cancer Genome Atlas (TCGA) database. Univariate and multivariate least absolute shrinkage and selection operator (LASSO) Cox regressions were used to determine the prognostic factors for UM and construct the predictive immunosignature. Receiver operating characteristic (ROC) curves, decision curve analysis (DCA), and calibration curves were performed to evaluate the clinical ability and accuracy of the model. In addition, the predictive accuracy was compared between the immunosignature and the Tumor, Node, Metastasis (TNM) staging system of American Joint Committee on Cancer (AJCC). We further analyzed the differences in clinical characteristics, immune infiltrates, immune checkpoints, and therapy sensitivity between high- and low-risk groups characterized by the prognostic model.ResultsHigher levels of immune cell infiltration in UM were related to a lower survival rate. Matrix metallopeptidase 12 (MMP12), TCDD inducible poly (ADP-ribose) polymerase (TIPARP), and leucine rich repeat neuronal 3 (LRRN3) were identified as prognostic signatures, and an immunological marker-based prognostic signature was constructed with good clinical ability and accuracy. The immunosignature was developed with a concordance index (C-index) of 0.881, which is significantly better than that of the TNM staging system (p &lt; 0.001). We further identified 1,762 genes with upregulated expression and 798 genes with downregulated expression in the high-risk group, and the differences between the high- and low-risk groups were mainly in immune-related processes. In addition, the expression of most of the immune checkpoint-relevant and immune activity-relevant genes was significantly higher in the high-risk group, which was more sensitive to therapy.ConclusionWe developed a novel immunosignature constructed by MMP12, TIPARP, and LRRN3 that could effectively predict the OS of UM.

scholarly journals Prognostic Value of Immune-Related genes in the Tumor Microenvironment of Glioma - Analyzed by Integrated Bioinformatics

2021 ◽  
Author(s):  
Yali Zhong ◽  
Xiaobin Luo ◽  
Fubing Yang ◽  
Xinling Song
Keyword(s):  
T Cells ◽  
High Risk ◽  
Risk Prediction ◽  
Immune Cell ◽  
Risk Group ◽  
Risk Groups ◽  
High Risk Group ◽  
Low Risk ◽  
Lasso Regression ◽  
Immune Related Genes

Abstract Object: Immune related genes play an important role in the process of tumor genesis and development. Therefore, we aim to find the Immune genes which are related to the prognosis of glioma patients, and to explore the infiltration of Immune cells in glioma microenvironment. Methods We downloaded the data of the glioma samples from the CGGA database, and performed batch correction to screen the primary glioma samples for subsequent analysis. Then the ESTIMATE algorithm was used to deal with the Stromal scores and Immune scores of the primary glioma samples, and the difference was analyzed. Then the common Immune related genes (IRGs) were obtained by intersecting with the Immune genes in the ImmPort database. Moreover, we used common IRGs to construct protein-protein interaction (PPI) networks, from which we screened the top 30 genes with high connectivity, and Lasso regression was used to screen the IRGs. Lastly, we obtained the combined genes, which were overlapped both in the top 30 high-connection genes and Lasso regression genes. The final genes were used to construct COX risk prediction models. The accuracy of the model were verified by the TCGA glioma data, and the model genes were analyzed for Immune-related pathways, as well as the Hallmark and KEGG enrichment. Additionally, we used CIBERSOFT algorithm to estimate the Immune cell content of the samples, and analyzed the differences, correlations and survival of the Immune cells in high and low risk groups. Results Firstly, a total of 117 IRGs were obtained from the gene sets, which were overlapped in the data of Stromal score, Immune score and ImmPort database. Secondly, the top 30 genes were selected after the PPI network, and another 26 genes were screened out after the Lasso regression algorithm. And then, six coexist IRGs were obtained from the intersecting sets. Furthermore, the COX risk prediction model was constructed and tested, showing that the overall survival rate of the high-risk group was about 50% of that of the low-risk group. We observed that the high-risk group were enriched in Immune response and Immune process. Most importantly, in KEGG pathways, the high-risk groups were mainly enriched in p53 signaling pathway, JAK-STAT signaling pathway, pathways in cancer and cell cycle. By estimating the Immune cell contents, we also found that the Immune cell Plasma cells, T cells CD8, T cells CD4 naïve, T cells regulatory (Tregs), Macrophages M0 and Neutrophils were higher in high-risk groups, when compared to the low-risk group, with significant difference. Finally, the correlation analysis showed that the degree of Immune infiltration in high-risk groups was related to T cells regulatory (Tregs), Macrophages M0 and Neutrophils. Conclusion A COX risk prediction model of 6 genes was successfully constructed, which was enriched in Immune-related pathways. Meanwhile, survival analysis and TCGA data validation revealed significant differences in the model genes in the overall survival of the glioma patients, and the degree of Immune infiltration in the model was associated with T cells regulatory (Tregs), Macrophages M0 and Neutrophils.

scholarly journals Development and Validation of a Robust Pyroptosis-Related Signature for Predicting Prognosis and Immune Status in Patients with Colon Cancer

2021 ◽  
Vol 2021 ◽  
pp. 1-20
Author(s):  
Zhicheng Zhuang ◽  
Huajun Cai ◽  
Hexin Lin ◽  
Bingjie Guan ◽  
Yong Wu ◽  
...  
Keyword(s):  
High Risk ◽  
Immune Cells ◽  
Risk Group ◽  
Risk Groups ◽  
High Risk Group ◽  
Low Risk ◽  
Immune Checkpoints ◽  
Prognostic Signature ◽  
Tumor Purity ◽  
Kaplan Meier

Background. Pyroptosis has been confirmed as a type of inflammatory programmed cell death in recent years. However, the prognostic role of pyroptosis in colon cancer (CC) remains unclear. Methods. Dataset TCGA-COAD which came from the TCGA portal was taken as the training cohort. GSE17538 from the GEO database was treated as validation cohorts. Differential expression genes (DEGs) between normal and tumor tissues were confirmed. Patients were classified into two subgroups according to the expression characteristics of pyroptosis-related DEGs. The LASSO regression analysis was used to build the best prognostic signature, and its reliability was validated using Kaplan–Meier, ROC, PCA, and t-SNE analyses. And a nomogram based on the multivariate Cox analysis was developed. The enrichment analysis was performed in the GO and KEGG to investigate the potential mechanism. In addition, we explored the difference in the abundance of infiltrating immune cells and immune microenvironment between high- and low-risk groups. And we also predicted the association of common immune checkpoints with risk scores. Finally, we verified the expression of the pyroptosis-related hub gene at the protein level by immunohistochemistry. Results. A total of 23 pyroptosis-related DEGs were identified in the TCGA cohort. Patients were classified into two molecular clusters (MC) based on DEGs. Kaplan–Meier survival analysis indicated that patients with MC1 represented significantly poorer OS than patients with MC2. 13 overall survival- (OS-) related DEGs in MCs were used to construct the prognostic signature. Patients in the high-risk group exhibited poorer OS compared to those in the low-risk group. Combined with the clinical features, the risk score was found to be an independent prognostic factor of CC patients. The above results are verified in the external dataset GSE17538. A nomogram was established and showed excellent performance. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses indicated that the varied prognostic performance between high- and low-risk groups may be related to the immune response mediated by local inflammation. Further analysis showed that the high-risk group has stronger immune cell infiltration and lower tumor purity than the low-risk group. Through the correlation between risk score and immune checkpoint expression, T-cell immunoglobulin and mucin domain-containing protein 3 (TIM-3) was predicted as a potential therapeutic target for the high-risk group. Conclusion. The 13-gene signature was associated with OS, immune cells, tumor purity, and immune checkpoints in CC patients, and it could provide the basis for immunotherapy and predicting prognosis and help clinicians make decisions for individualized treatment.

scholarly journals Comprehensive Analysis of Tumor-Infiltrating Immune Cells and Relevant Therapeutic Strategy in Esophageal Cancer

2020 ◽  
Vol 2020 ◽  
pp. 1-12 ◽  
Author(s):  
Guangrong Lu ◽  
Liping Chen ◽  
Shengjie Wu ◽  
Yuao Feng ◽  
Tiesu Lin
Keyword(s):  
Esophageal Cancer ◽  
Immune Cells ◽  
Immune Cell ◽  
Risk Model ◽  
Risk Group ◽  
Tumor Stage ◽  
Tumor Location ◽  
High Risk Group ◽  
Comprehensive Analysis ◽  
Lasso Regression

A growing body of evidence has indicated that behaviors of cancers are defined by not only intrinsic activities of tumor cells but also tumor-infiltrating immune cells (TIICs) in the tumor microenvironment. However, it still lacks a well-structured and comprehensive analysis of TIICs and its therapeutic value in esophageal cancer (EC). The proportions of 22 TIICs were evaluated between 150 normal tissues and 141 tumor tissues of EC by the CIBERSORT algorithm. Besides, correlation analyses between proportions of TIICs and clinicopathological characters, including age, gender, histologic grade, tumor location, histologic type, LRP1B mutation, TP53 mutation, tumor stage, lymph node stage, and TNM stage, were conducted. We constructed a risk score model to improve prognostic capacity with 5 TIICs by least absolute shrinkage and selection operator (lasso) regression analysis. The risk score=−1.86∗plasma+2.56∗T cell follicular helper−1.37∗monocytes−3.64∗activated dendritic cells−2.24∗resting mast cells (immune cells in the risk model mean the proportions of immune cell infiltration in EC). Patients in the high-risk group had significantly worse overall survival than these in the low-risk group (HR: 2.146, 95% CI: 1.243-3.705, p=0.0061). Finally, we identified Semustine and Sirolimus as two candidate compounds for the treatment of EC based on CMap analysis. In conclusion, the proportions of TIICs may be important to the progression, prognosis, and treatment of EC.

scholarly journals The pattern of alternative splicing in lung adenocarcinoma shows novel events correlated with tumorigenesis and immune microenvironment

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gongjun Wang ◽  
Weiwei Qi ◽  
Liwei Shen ◽  
Shasha Wang ◽  
Ruoxi Xiao ◽  
...  
Keyword(s):  
Alternative Splicing ◽  
Lung Adenocarcinoma ◽  
Immune Cells ◽  
Risk Group ◽  
Progression Free Survival ◽  
High Risk Group ◽  
The Cancer Genome Atlas ◽  
Normal Tissues ◽  
Cancer Genome Atlas ◽  
Score Model

AbstractLung adenocarcinoma (LUAD) is the leading cause of cancer deaths worldwide due to the lack of early diagnostic markers and specific drugs. Previous studies have shown the association of LUAD growth with aberrant alternative splicing (AS). Herein, clinical data of 535 tumor tissues and 59 normal tissues were extracted from The Cancer Genome Atlas (TCGA) database. Each sample was analyzed using the ESTIMATE algorithm; a comparison between higher and lower score groups (stromal or immune) was made to determine the overall- and progression-free survival-related differentially expressed AS (DEAS) events. We then performed unsupervised clustering of these DEASs, followed by determining their relationship with survival rate, immune cells, and the tumor microenvironment (TME). Next, two prognostic signatures were developed using bioinformatics tools to explore the prognosis of cases with LUAD. Five OS- and six PFS-associated DEAS events were implemented to establish a prognostic risk score model. When compared to the high-risk group (HRG), the PFS and OS of the low-risk group (LRG) were found to be considerable. Additionally, a better prognosis was found considerably associated with the ESTIMATE score of the patients as well as immune cells infiltration. Our analysis of AS events in LUAD not only helps to clarify the tumorigenesis mechanism of AS but also provides ideas for revealing potential prognostic biomarkers and therapeutic targets.

scholarly journals Identification of a novel autophagy signature for predicting survival in patients with lung adenocarcinoma

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11074
Author(s):  
Jin Duan ◽  
Youming Lei ◽  
Guoli Lv ◽  
Yinqiang Liu ◽  
Wei Zhao ◽  
...  
Keyword(s):  
Gene Expression ◽  
High Risk ◽  
Immune Cell ◽  
Cox Regression ◽  
Risk Group ◽  
Risk Groups ◽  
High Risk Group ◽  
Low Risk ◽  
Cell Analysis ◽  
Prognostic Signature

Background Lung adenocarcinoma (LUAD) is the most commonhistological lung cancer subtype, with an overall five-year survivalrate of only 17%. In this study, we aimed to identify autophagy-related genes (ARGs) and develop an LUAD prognostic signature. Methods In this study, we obtained ARGs from three databases and downloaded gene expression profiles from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) database. We used TCGA-LUAD (n = 490) for a training and testing dataset, and GSE50081 (n = 127) as the external validation dataset.The least absolute shrinkage and selection operator (LASSO) Cox and multivariate Cox regression models were used to generate an autophagy-related signature. We performed gene set enrichment analysis (GSEA) and immune cell analysis between the high- and low-risk groups. A nomogram was built to guide the individual treatment for LUAD patients. Results We identified a total of 83 differentially expressed ARGs (DEARGs) from the TCGA-LUAD dataset, including 33 upregulated DEARGs and 50 downregulated DEARGs, both with thresholds of adjusted P < 0.05 and |Fold change| > 1.5. Using LASSO and multivariate Cox regression analyses, we identified 10 ARGs that we used to build a prognostic signature with areas under the curve (AUCs) of 0.705, 0.715, and 0.778 at 1, 3, and 5 years, respectively. Using the risk score formula, the LUAD patients were divided into low- or high-risk groups. Our GSEA results suggested that the low-risk group were enriched in metabolism and immune-related pathways, while the high-risk group was involved in tumorigenesis and tumor progression pathways. Immune cell analysis revealed that, when compared to the high-risk group, the low-risk group had a lower cell fraction of M0- and M1- macrophages, and higher CD4 and PD-L1 expression levels. Conclusion Our identified robust signature may provide novel insight into underlying autophagy mechanisms as well as therapeutic strategies for LUAD treatment.

scholarly journals A Prognostic Ferroptosis-Related lncRNAs Signature Associated With Immune Landscape and Radiotherapy Response in Glioma

2021 ◽  
Vol 9 ◽  
Author(s):  
Jianglin Zheng ◽  
Zijie Zhou ◽  
Yue Qiu ◽  
Minjie Wang ◽  
Hao Yu ◽  
...  
Keyword(s):  
High Risk ◽  
Risk Group ◽  
Clinical Information ◽  
Roc Curves ◽  
Risk Groups ◽  
High Risk Group ◽  
Low Risk ◽  
Immune Checkpoints ◽  
Lasso Regression ◽  
Who Grade

Recent studies have demonstrated that long non-coding RNAs (lncRNAs) are implicated in the regulation of tumor cell ferroptosis. However, the prognostic value of ferroptosis-related lncRNAs has never been comprehensively explored in glioma. In this study, the transcriptomic data and clinical information of glioma patients were downloaded from TCGA, CGGA and Rembrandt databases. We identified 24 prognostic ferroptosis-related lncRNAs, 15 of which (SNAI3-AS1, GDNF-AS1, WDFY3-AS2, CPB2-AS1, WAC-AS1, SLC25A21-AS1, ARHGEF26-AS1, LINC00641, LINC00844, MIR155HG, MIR22HG, PVT1, SNHG18, PAXIP1-AS2, and SBF2-AS1) were used to construct a ferroptosis-related lncRNAs signature (FRLS) according to the least absolute shrinkage and selection operator (LASSO) regression. The validity of this FRLS was verified in training (TCGA) and validation (CGGA and Rembrandt) cohorts, respectively. The Kaplan-Meier curves revealed a significant distinction of overall survival (OS) between the high- and low-risk groups. The receiver operating characteristic (ROC) curves exhibited robust prognostic capacity of this FRLS. A nomogram with improved accuracy for predicting OS was established based on independent prognostic factors (FRLS, age, and WHO grade). Besides, patients in the high-risk group had higher immune, stroma, and ESTIMATE scores, lower tumor purity, higher infiltration of immunosuppressive cells, and higher expression of immune checkpoints. Patients in the low-risk group benefited significantly from radiotherapy, while no survival benefit of radiotherapy was observed for those in the high-risk group. In conclusion, we identified the prognostic ferroptosis-related lncRNAs in glioma, and constructed a prognostic signature which was associated with the immune landscape of glioma microenvironment and radiotherapy response.

scholarly journals Comprehensive multi-omics analysis identifies an immune related predicting model in early stage breast cancer

2020 ◽  
Author(s):  
Xuan Li ◽  
Wei Jin
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Immune Cells ◽  
Risk Group ◽  
Early Stage ◽  
Enrichment Analysis ◽  
Risk Groups ◽  
High Risk Group ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Patients

Abstract Background Breast cancer is known the highest incidence cancer in women. Tumor-infiltrating immune cells were reported closely related to cancers’ fate but it’s function still not very clear in breast cancer. The aim of our study is to build a infiltrating immune cells based nomogram model to better predict patients survival and explore its relationship with immune features. Methods We first use CIBERSORT to analyze 22 immune cells’ status in two unrelated breast cancer cohorts (TCGA and METRABRIC). The univariate and multivariate Cox analyses were used to analyze the prognostic ability of immune cells and other clinicopathological factors. Nomogram model were built by using independent prognostic factors. Different immune signatures and gene enrichment analysis were performed in different nomogram risk groups. Results Multivariate cox analysis showed that Macrophages M2 with HR of 1.733 (95% CI: 1.013-2.966) in TCGA cohort and 1.334 (95% CI: 1.125-1.581) in METABRIC cohort is the only independent prognostic factor among the 22 immune cells in early stage breast cancer. Macrophages M2, age, TNM stage and molecular types were used to build the nomogram model. The AUC of the ROC of nomogram reached 0.732 in TCGA cohort and 0.702 in METABRIC cohort. Using the nomogram score can better classified patients to low and high risk group. High risk group showed higher malignant signatures and predicted immunotherapy response rates than low risk group which consistent with the gene entrenchment analysis. Conclusion In this study, we revealed that M2 macrophages could predict the OS of breast cancer patients. Based on M2 and other clinical features we established a nomogram model which were significantly different in immune features that can better assess the OS risk or be a predictor for the immunotherapy response in breast cancer for further research.

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