Risk Score
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2021 ◽  
Vol 11 ◽  
Author(s):  
Qin Dang ◽  
Zaoqu Liu ◽  
Shengyun Hu ◽  
Zhuang Chen ◽  
Lingfang Meng ◽  
...  

Colorectal cancer (CRC), a seriously threat that endangers public health, has a striking tendency to relapse and metastasize. Redox-related signaling pathways have recently been extensively studied in cancers. However, the study and potential role of redox in CRC remain unelucidated. We developed and validated a risk model for prognosis and recurrence prediction in CRC patients via identifying gene signatures driven by redox-related signaling pathways. The redox-driven prognostic signature (RDPS) was demonstrated to be an independent risk factor for patient survival (including OS and RFS) in four public cohorts and one clinical in-house cohort. Additionally, there was an intimate association between the risk score and tumor immune infiltration, with higher risk score accompanied with less immune cell infiltration. In this study, we used redox-related factors as an entry point, which may provide a broader perspective for prognosis prediction in CRC and have the potential to provide more promising evidence for immunotherapy.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rita Murri ◽  
Jacopo Lenkowicz ◽  
Carlotta Masciocchi ◽  
Chiara Iacomini ◽  
Massimo Fantoni ◽  
...  

AbstractThe COVID-19 pandemic is impressively challenging the healthcare system. Several prognostic models have been validated but few of them are implemented in daily practice. The objective of the study was to validate a machine-learning risk prediction model using easy-to-obtain parameters to help to identify patients with COVID-19 who are at higher risk of death. The training cohort included all patients admitted to Fondazione Policlinico Gemelli with COVID-19 from March 5, 2020, to November 5, 2020. Afterward, the model was tested on all patients admitted to the same hospital with COVID-19 from November 6, 2020, to February 5, 2021. The primary outcome was in-hospital case-fatality risk. The out-of-sample performance of the model was estimated from the training set in terms of Area under the Receiving Operator Curve (AUROC) and classification matrix statistics by averaging the results of fivefold cross validation repeated 3-times and comparing the results with those obtained on the test set. An explanation analysis of the model, based on the SHapley Additive exPlanations (SHAP), is also presented. To assess the subsequent time evolution, the change in paO2/FiO2 (P/F) at 48 h after the baseline measurement was plotted against its baseline value. Among the 921 patients included in the training cohort, 120 died (13%). Variables selected for the model were age, platelet count, SpO2, blood urea nitrogen (BUN), hemoglobin, C-reactive protein, neutrophil count, and sodium. The results of the fivefold cross-validation repeated 3-times gave AUROC of 0.87, and statistics of the classification matrix to the Youden index as follows: sensitivity 0.840, specificity 0.774, negative predictive value 0.971. Then, the model was tested on a new population (n = 1463) in which the case-fatality rate was 22.6%. The test model showed AUROC 0.818, sensitivity 0.813, specificity 0.650, negative predictive value 0.922. Considering the first quartile of the predicted risk score (low-risk score group), the case-fatality rate was 1.6%, 17.8% in the second and third quartile (high-risk score group) and 53.5% in the fourth quartile (very high-risk score group). The three risk score groups showed good discrimination for the P/F value at admission, and a positive correlation was found for the low-risk class to P/F at 48 h after admission (adjusted R-squared = 0.48). We developed a predictive model of death for people with SARS-CoV-2 infection by including only easy-to-obtain variables (abnormal blood count, BUN, C-reactive protein, sodium and lower SpO2). It demonstrated good accuracy and high power of discrimination. The simplicity of the model makes the risk prediction applicable for patients in the Emergency Department, or during hospitalization. Although it is reasonable to assume that the model is also applicable in not-hospitalized persons, only appropriate studies can assess the accuracy of the model also for persons at home.


2021 ◽  
Vol 2021 ◽  
pp. 1-29
Author(s):  
Yanfei Shao ◽  
Hongtao Jia ◽  
Shuchun Li ◽  
Ling Huang ◽  
Batuer Aikemu ◽  
...  

Gastric cancer is a highly malignant tumor with poor survival rate. Ferroptosis, a newly defined regulated cell death, is closely related to several tumors. Introduction of ferroptosis is promising for cancer treatments. However, the predictive role of ferroptosis in GC remains elusive. In this study, we screened the ferroptosis-related genes which were differentially expressed between normal and GC tissues. Then, based on these differentially expressed genes (DEGs), the least absolute shrinkage and selection operator (LASSO) and multivariate Cox regressions were applied to construct the 10-gene prognostic signature (SP1, MYB, ALDH3A2, KEAP1, AIFM2, ITGB4, TGFBR1, MAP1LC3B, NOX4, and ZFP36) in TCGA training dataset. Based on the median risk score, all GC patients in TCGA training dataset and GSE84437 testing dataset were classified into a high- or low-risk group. GC patients in the low-risk group showed significantly higher survival possibilities than those in the high-risk group ( P < 0.001 ). Combined with the clinical characteristics, the risk score was proven as an independent factor for predicting the OS of GC patients. Besides, the GC patients in the high- or low-risk group showed significantly different GO and KEGG functional enrichments, somatic mutation, fractions of immune cells, and immunotherapy response. Then, the expression levels of these genes in signature were further verified in the GC cell lines and our own GC samples (30-paired tumor/normal tissues). Furthermore, the effects of ferroptosis inducer Erastin on these 10 ferroptosis-related genes in GC cell lines were also explored in our study. In conclusion, our study constructed a prognostic signature of 10 ferroptosis-related genes, which could well predict the prognosis and immunotherapy for GC patients.


2021 ◽  
Vol 12 ◽  
Author(s):  
Jiecheng Ye ◽  
Yining Wu ◽  
Heyuan Cai ◽  
Li Sun ◽  
Wanying Deng ◽  
...  

Esophageal squamous cell carcinoma (ESCC) is a common malignant tumor with high mortality and poor prognosis. Ferroptosis is a newly discovered form of cell death induced by iron-catalyzed excessive peroxidation of polyunsaturated fatty acids (PUFAs). However, the prognostic value of ferroptosis-related genes (FRGs) for ESCC remains unclear. Based on the ESCC dataset from the Gene Expression Omnibus (GEO) database, we identified 39 prognostic FRGs through univariate Cox regression analysis. After LASSO regression and multivariate Cox regression analyses, a multigene signature based on 10 prognostic FRGs was constructed and successfully divided ESCC patients into two risk groups. Patients in the low-risk group showed a significantly better prognosis than patients in the high-risk group. In addition, we combined the risk score with clinical predictors to construct a nomogram for ESCC. The predictive ability of the nomogram was further verified by ROC curves and calibration plots in both the training and validation sets. The predictive power of the nomogram was demonstrated to be better than that of either the risk score or clinical variable alone. Furthermore, functional analysis revealed that the 10-FRG signature was mainly associated with ferroptosis, differentiation and immune response. Connectivity map analysis identified potential compounds capable of targeting FRGs in ESCC. Finally, we demonstrated the prognostic value of SRC gene in ESCC using the clinical samples and found that SRC inhibition sensitized ESCC cells to ferroptosis inducers by in vitro experiments. In conclusion, we identified and verified a 10-FRG prognostic signature and a nomogram, which provide individualized prognosis prediction and provide insight into potential therapeutic targets for ESCC.


2021 ◽  
Author(s):  
Atlas Khan ◽  
Michael C. Turchin ◽  
Amit Patki ◽  
Vinodh Srinivasasainagendra ◽  
Ning Shang ◽  
...  

Introduction: Chronic kidney disease (CKD) is a common complex condition associated with significant morbidity and mortality in the US and worldwide. Early detection is critical for effective prevention of kidney disease progression. Polygenic prediction of CKD could enhance screening and prevention of kidney disease progression, but this approach has not been optimized for risk prediction in ancestrally diverse populations. Methods: We developed and validated a genome-wide polygenic score (GPS) for CKD defined by estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2 using common variant association statistics from GWAS for eGFR combined with information on APOL1 risk genotypes. The score was designed to ensure transferability across major continental ancestries, genotyping platforms, imputation panels, and phenotyping strategies, and was tested following ClinGen guidelines. The polygenic component of the score was developed and optimized using 28,047 cases and 251,772 controls (70% of UK Biobank participants of European ancestry), while the weights for APOL1 effects were derived based on UK Biobank participants of African ancestry (967 cases and 6,191 controls). We tested the performance of the score in 15 independent testing cohorts, including 3 cohorts of European ancestry (total 23,364 cases and 117,883 controls), 6 cohorts of African ancestry (4,268 cases and 10,276 controls), 4 cohorts of Asian ancestry (1,030 cases and 9,896 controls), and 2 Hispanic/Latinx cohorts (1,492 cases and 2,984 controls). Results: We demonstrated the risk score transferability with reproducible performance across all independent testing cohorts. In the meta-analyses, disease odds ratios per standard deviation of the score were estimated at 1.49 (95%CI: 1.47-1.50, P<1.0E-300) for European, 1.32 (95%CI: 1.26-1.38, P=1.8E-33) for African, 1.59 (95%CI: 1.52-1.67, P=1.3E-30) for Asian, and 1.42 (95%CI: 1.33-1.51, P=4.1E-14) for Latinx cohorts. The top 2% cutoff of the GPS was associated with nearly 3-fold increased risk of CKD across all major ancestral groups, the degree of risk that is equivalent to a positive family history of kidney disease. In African-ancestry cohorts, APOL1 risk genotype and the polygenic risk components of the GPS had additive effects on the risk of CKD with no significant interactions. We also observed that individuals of African ancestry had a significantly higher polygenic risk score for CKD compared to other populations, even without accounting for APOL1 variants. Conclusions: By combining APOL1 risk genotypes with the available GWAS for renal function, we designed, optimized, and validated a GPS predictive of CKD across four major continental ancestries. With the upper tail of the GPS distribution associated with disease risk equivalent to a positive family history, this score could be used for clinically meaningful risk stratification.


2021 ◽  
Author(s):  
Bertha A Hidalgo ◽  
Bre A Minniefield ◽  
Amit Patki ◽  
Rikki Tanner ◽  
Minoo Bagheri ◽  
...  

There has been great interest in genetic risk prediction using risk scores in recent years, however, the utility of scores developed in European populations and later applied to non-European populations has not been successful. In this study, we used cross-sectional data from the Hypertension Genetic Epidemiology Network (HyperGEN, N=614 African Americans (AA)) and the Genetics of Lipid Lowering Drugs and Diet Network (GOLDN, N=995 European Americans (EA)), to create a methylation risk score (MRS) for metabolic syndrome (MetS), demonstrating the utility of MRS across race groups. To demonstrate this, we first selected cytosine-guanine dinucleotides (CpG) sites measured on Illumina Methyl450 arrays previously reported to be significantly associated with MetS and/or component conditions (CPT1A cg00574958, PHOSPHO1 cg02650017, ABCG1 cg06500161, SREBF1 cg11024682, SOCS3 cg18181703, TXNIP cg19693031). Second, we calculated the parameter estimates for the 6 CpGs in the HyperGEN data and used the beta estimates as weights to construct a MRS in HyperGEN, which was validated in GOLDN. We performed association analyses using a logistic mixed model to test the association between the MRS and MetS adjusting for covariates. Results showed the MRS was significantly associated with MetS in both populations. In summary, a MRS for MetS was a strong predictor for the condition across two ethnic groups suggesting MRS may be useful to examine metabolic disease risk or related complications across ethnic groups.


2021 ◽  
Author(s):  
Miaolong Lu ◽  
Hailun Zhan ◽  
Bolong Liu ◽  
Dongyang Li ◽  
Wenbiao Li ◽  
...  

Abstract Background Bladder cancer (BC) is a commonly occurring malignant tumor of the urinary system, demonstrating high global morbidity and mortality rates. BC currently lacks widely accepted biomarkers and its predictive, preventive, and personalized medicine (PPPM) is still unsatisfactory. N6-methyladenosine (m6A) modification and non-coding RNAs (ncRNAs) have been shown to be effective prognostic and immunotherapeutic responsiveness biomarkers and contribute to PPPM for various tumors. However, their role in BC remains unclear. Methods m6A-related ncRNAs (lncRNAs and miRNAs) were identified through a comprehensive analysis of TCGA, starBase, and m6A2Target databases. Using TCGA dataset (training set), univariate and least absolute shrinkage and selection operator (LASSO) regression analyses were performed to develop an m6A-related ncRNA–based prognostic risk model. Kaplan-Meier analysis of overall survival (OS) and receiver operating characteristic (ROC) curves were used to verify the prognostic evaluation power of the risk model in the GSE154261 dataset (testing set) from Gene Expression Omnibus (GEO). A nomogram containing independent prognostic factors was developed. Differences in BC clinical characteristics, m6A regulators, m6A-related ncRNAs, gene expression patterns, and differentially expressed genes (DEGs)–associated molecular networks between the high- and low-risk groups in TCGA dataset were also analyzed. Additionally, the potential applicability of the risk model in the prediction of immunotherapeutic responsiveness was evaluated based on the “IMvigor210CoreBiologies” data set. Results We identified 183 m6A-related ncRNAs, of which 14 were related to OS. LASSO regression analysis was further used to develop a prognostic risk model that included 10 m6A-related ncRNAs (BAALC-AS1, MIR324, MIR191, MIR25, AC023509.1, AL021707.1, AC026362.1, GATA2-AS1, AC012065.2, and HCP5). The risk model showed an excellent prognostic evaluation performance in both TCGA and GSE154261 datasets, with ROC curve areas under the curve (AUC) of 0.62 and 0.83, respectively. A nomogram containing 3 independent prognostic factors (risk score, age, and clinical stage) was developed and was found to demonstrate high prognostic prediction accuracy (AUC = 0.83). Moreover, the risk model could also predict BC progression. A higher risk score indicated a higher pathological grade and clinical stage. We identified 1058 DEGs between the high- and low-risk groups in TCGA dataset; these DEGs were involved in 3 molecular network systems, i.e., cellular immune response, cell adhesion, and cellular biological metabolism. Furthermore, the expression levels of 8 m6A regulators and 12 m6A-related ncRNAs were significantly different between the two groups. Finally, this risk model could be used to predict immunotherapeutic responses. Conclusion Our study is the first to explore the potential application value of m6A-related ncRNAs in BC. The m6A-related ncRNA–based risk model demonstrated excellent performance in predicting prognosis and immunotherapeutic responsiveness. Based on this model, in addition to identifying high-risk patients early to provide them with focused attention and targeted prevention, we can also select beneficiaries of immunotherapy to deliver personalized medical services. Furthermore, the m6A-related ncRNAs could elucidate the molecular mechanisms of BC and lead to a new direction for the improvement of PPPM for BC.


2021 ◽  
Vol 11 ◽  
Author(s):  
Jianguang Shi ◽  
Zishan Wang ◽  
Jing Guo ◽  
Yingqi Chen ◽  
Changyong Tong ◽  
...  

Epithelial-mesenchymal transition (EMT) process, which is regulated by genes of inducible factors and transcription factor family of signaling pathways, transforms epithelial cells into mesenchymal cells and is involved in tumor invasion and progression and increases tumor tolerance to clinical interventions. This study constructed a multigene marker for lung predicting the prognosis of lung adenocarcinoma (LUAD) patients by bioinformatic analysis based on EMT-related genes. Gene sets associated with EMT were downloaded from the EMT-gene database, and RNA-seq of LUAD and clinical information of patients were downloaded from the TCGA database. Differentially expressed genes were screened by difference analysis. Survival analysis was performed to identify genes associated with LUAD prognosis, and overlapping genes were taken for all the three. Prognosis-related genes were further determined by combining LASSO regression analysis for establishing a prediction signature, and the risk score equation for the prognostic model was established using multifactorial COX regression analysis to construct a survival prognostic model. The model accuracy was evaluated using subject working characteristic curves. According to the median value of risk score, samples were divided into a high-risk group and low-risk group to observe the correlation with the clinicopathological characteristics of patients. Combined with the results of one-way COX regression analysis, HGF, PTX3, and S100P were considered as independent predictors of LUAD prognosis. In lung cancer tissues, HGF and PTX3 expression was downregulated and S100P expression was upregulated. Kaplan-Meier, COX regression analysis showed that HGF, PTX3, and S100P were prognostic independent predictors of LUAD, and high expressions of all the three were all significantly associated with immune cell infiltration. The present study provided potential prognostic predictive biological markers for LUAD patients, and confirmed EMT as a key mechanism in LUAD progression.


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