Abstract

BackgroundLung adenocarcinoma (LUAD) is the most frequent subtype of lung cancer. The prognostic signature could be reliable to stratify LUAD patients according to risk, which helps the management of the systematic treatments. In this study, a systematic and reliable immune signature was performed to estimate the prognostic stratification in LUAD.MethodsThe profiles of immune-related genes for patients with LUAD were used as one TCGA training set: n = 494, other validation set 1: n = 226 and validation set 2: n = 398. Univariate Cox survival analysis was used to identify the candidate immune-related genes from each cohort. Then, the immune signature was developed and validated in the training and validation sets.ResultsIn this study, functional analysis showed that immune-related genes involved in immune regulation and MAPK signaling pathway. A prognostic signature based on 10 immune-related genes was established in the training set and patients were divided into high-risk and low-risk groups. Our 10 immune-related gene signature was significantly related to worse survival, especially during early-stage tumors. Further stratification analyses revealed that this 10 immune-related gene signature was still an effective tool for predicting prognosis in smoking or nonsmoking patients, patients with KRAS mutation or KRAS wild-type, and patients with EGFR mutation or EGFR wild-type. Our signature was negatively correlated with B cell, CD4+ T cell, CD8+ T cell, neutrophil, dendritic cell (DC), and macrophage immune infiltration, and immune checkpoint molecules PD-1 and CTLA-4 (P < 0.05).ConclusionsThese findings suggested that our signature was a promising biomarker for prognosis prediction and can facilitate the management of immunotherapy in LUAD.

Highlights

  • Lung adenocarcinoma (LUAD) is the most frequent subtype of lung cancer

  • gene ontology (GO) analysis showed that the immune-related mechanisms such as immune response-activating/regulating cell surface receptor signaling pathway, T cell activation, T cell receptor signaling pathway, antigen receptor-mediated signaling pathway, antigen processing and presentation, cytokine activity, and major histocompatibility complex (MHC) protein complex etc. were enriched (Fig. 1b)

  • A 10 immune‐related gene signature predicts survival in lung adenocarcinoma (LUAD) The distribution and survival status of patients for the 10 immune-related gene signature were shown in the training and validation sets (Fig. 2a)

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Summary

Introduction

Lung adenocarcinoma (LUAD) is the most frequent subtype of lung cancer. The prognostic signature could be reliable to stratify LUAD patients according to risk, which helps the management of the systematic treatments. A systematic and reliable immune signature was performed to estimate the prognostic stratification in LUAD. Despite recent advances in surgery, chemotherapy, radiotherapy, targeted therapy and immunotherapy, the 5-year survival rate of patients with non-small cell lung cancer (NSCLC) remains poor [2, 3]. NSCLC, accounting for approximately 85% of lung cancer cases, consists of two common histological subtypes: lung adenocarcinoma (LUAD) and squamous cell carcinoma (LUSC) [4]. Epidermal growth factor receptor (EGFR) mutations are more frequent in LUAD than in LUSC [5]. LUAD is the most common subtype of NSCLC [6]

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